Person: TUĞCU, BETÜL
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Publication Open Access Evaluation of amblyopic eyes with optical coherence tomography angiography and electrophysiological tests(2021-01-01T00:00:00Z) Hamurcu, Mualla; EKİNCİ, CANSU; Koca, Semra; TUĞCU, Betül; EKİNCİ, CANSU; TUĞCU, BETÜLPurpose: To investigate the structural and functional changes of the retina and optic nerve in amblyopia. Methods: Eighteen patients with unilateral anisometropic amblyopia and 27 age-matched healthy controls were involved in this study. All patients underwent optical coherence tomography angiography (OCTA), pattern visual evoked potential (pVEP), and flash electroretinogram (fERG). Results: There was no statistically significant difference in terms of the fovea] avascular zone (FAZ), perifoveal superficial density, whole superficial density, parafoveal deep density, perifoveal deep density among the eyes (P > 0 0.05). Significant differences were found only in superficial capillary plexus (SCP) vessel density in whole (P = 0.029) and parafoveal (P = 0.008) image. In electrophysiological tests, while VEP latencies of the amblyopic eyes increased compared to nonamblyopic eyes and controls (P = 0.027), VEP amplitudes decreased in amblyopic and nonamblyopic eyes compared to controls (P = 0.01), amplitudes of the rod (P = 0.027) and cones (P < 0.001) also decreased in amblyopic eyes compared to nonamblyopic and healthy eyes. When we assessed the correlation between the parameters of OCTA and electrophysiological test, only a significant correlation was found between parafoveal SCP vessel density and VEP amplitudes (r = 0.341). Conclusion: We found a significant decrease only in SCP vessel density of the OCTA parameters in amblyopic eyes compared to healthy eyes. We detected a significant relationship between parafoveal SCP vessel density and VEP parameters, which might be associated with the underlying pathophysiology of the amblyopia.Publication Metadata only Use of Botulinum Toxin A in the Treatment of Intermittent Exotropia: Factors Affecting Treatment Outcome(2022-01-01) Kunduracı M. S.; Kantarcı B.; Araz Erşan H. B.; Tuğcu B.; TUĞCU, BETÜL© 2022 Taylor & Francis.Purpose: To evaluate the efficiency of botulinum toxin A (BTA) injection in the treatment of intermittent exotropia (IXT) and determine factors affecting treatment outcome. Materials and methods: A total of 74 patients diagnosed with any type of IXT were included in the study. BTA injection was administered into both lateral rectus muscles. Gender, refractive error, age, pre- and post-injection measurements of ocular deviation, age at the time of the first BTA injection, number of injections, duration of misalignment, age at the onset of misalignment, presence of amblyopia, presence of anisometropia, preterm birth history, type of delivery, presence of any neurological disorder, follow-up period, postoperative ptosis, and vertical deviation were recorded. The final angle of deviation was used in the statistical analysis. Successful motor alignment was defined as a deviation of ≤10 prism diopters (PD) at distance. The relationship of all factors with treatment success was analyzed using the binary logistic regression analysis. Results: A total of 74 patients, 40 female and 34 male, were included in the study. All the patients were followed up for six to 53 months after the first BTA injection, and the mean follow-up was 16.1 ± 11.1 months. Before the first BTA injection of the patients, the mean amount of deviation was measured as 25.7 ± 14.2 (range, 0–60) PD at near and 37.1 ± 10.9 (range, 16–65) PD at distance. According to the most recent examination of the patients, the mean amount of deviation was 10.6 ± 9.8 (range, 0–45) PD at near and 16.4 ± 10.2 (range, 0–45) PD at distance. There was a statistically significant difference between the first and last examinations of the patients in relation to the amount of deviations measured at both near and distance (p < .001). Successful motor alignment (orthotropia within 10 PD for exodeviation) was achieved in 42 patients (56.7%). Thesuccess of treatment increased with the decreased amount of deviation at distance before the BTA injection. Conclusions: In patients with IXT, BTA injection into the lateral rectus muscles is an effective procedure, which is also less invasive and taking shorter time than surgery, and it can be considered as an alternative treatment option in those with small-medium angle IXT.Publication Open Access Protective effect of pomegranate juice on retinal oxidative stress in streptozotocin-induced diabetic rats.(2017-11-18) Tugcu, BETÜL; NACAROGLU, SA; GEDIKBASI, A; UHRI, M; ACAR, N; ÖZDEMIR, HÜSEYİN; TUĞCU, BETÜL; ÖZDEMİR, MEHMET HAKANAim: To investigate the effect of pomegranate juice (PJ) intake on overall oxidation status in retinas of diabetic rats. Methods: Twenty-seven rats were divided into four groups as control (CO), diabetic (DM), control treated with PJ (CO-PJ), and diabetic treated with PJ (DM-PJ).The retina tissues were used to determine 8-hydroxy-2'-deoxyguanosine (8OHdG), malondialdehyde (MDA), reduced glutathione (GSH) levels, and the enzyme activities of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px). Results: The levels of 8OHdG and MDA were significantly increased in the retina of DM group compared to CO group (P=0.001, P<0.001 respectively). Both 8OHdG and MDA levels were decreased in PJ-DM group compared to DM group (P=0.004, P<0.001 respectively). The activities of antioxidant enzymes GSH, SOD, and GDH-Px were significantly decreased in the retina of DM group compared to CO group (P≤0.01). GSH and GSH-Px activities were higher in PJ-DM group compared with DM group (P=0.010, P=0.042, respectively) but SOD activity was not statistically different (P=0.938). Conclusion: PJ intake is found to be effective in decreasing oxidative end products, and in increasing the activities of antioxidant enzymes in diabetic retinas of rats, which suggests it may be effective against oxidative stress in diabetic retinas.Publication Open Access Imaging Methods in the Diagnosis of Optic Disc Drusen.(2016-10-01) Tuğcu, BETÜL; Özdemir, HÜSEYİN; TUĞCU, BETÜL; ÖZDEMİR, MEHMET HAKANOptic disc drusen (ODD) are benign congenital anomalies of the optic nerve characterized by calcified hyaline bodies. While superficial drusen can be diagnosed easily during fundus examination, detecting buried drusen requires the use of additional imaging methods such as B-scan ultrasonography (USG), fundus fluorescein angiography (FFA), computed tomography (CT) and fundus autofluorescence (FAF). ODD can be detected by USG with the presentation of highly reflective round structures. ODD appear as hyperautofluorescent areas on FAF and bright spots on CT scans. FFA can be helpful in differentiating ODD from true optic disc edema. Optic disc edema shows early hyperfluorescence due to diffuse leakage whereas ODD presents as well-defined hyperfluorescence in the late phase. In recent years, it has been reported that optical coherence tomography (OCT) examination has allowed more detailed evaluation of ODD and yielded useful findings for the differentiation of optic disc edema from ODD. In this review, the role of OCT in the diagnosis of ODD is discussed.Publication Open Access Adie-Holmes syndrome associated with COVID-19 infection: A case report(2021-03-01T00:00:00Z) Tutar, Nurhan Kaya; Kale, Nilufer; TUĞCU, Betül; TUĞCU, BETÜLWith increasing experience, it has been suggested that the SARS-CoV-2 virus has a neurotropic effect. Here, we present a case of a tonic pupil who developed after COVID-19 infection. A 36-year-old woman presented with progressive photophobia and blurred vision. On neurological examination, loss of deep tendon reflexes accompanying a tonic pupil was detected and brain MR imaging was normal. With this case, we aimed to describe a rare pattern of neurological involvement caused by the possible SARS-CoV-2 virus.Publication Open Access Angioid streaks in a case of Camurati-Engelmann disease.(2017-07-01) ÖZDEMIR, HÜSEYİN; Tugcu, BETÜL; SEZER, TAHA; ELBAY, AHMET; TUĞCU, BETÜL; SEZER, TAHA; ELBAY, AHMET; ÖZDEMİR, MEHMET HAKANPublication Metadata only Botulinum toxin A for the treatment of strabismus in children with neurological impairment Toxına botulínica tipo A para o tratamento de estrabısmo em crianças neurologicamente comprometidas(2023-01-01) TUĞCU B.; Araz-Ersan B.; Özkan S. B.; TUĞCU, BETÜLPurposes: To assess the efficacy of botulinum toxin A injection in the treatment of strabismus in patients with neurological impairment and evaluate the factors associated with treatment success. Methods: The study included 50 patients with strabismus and neurological impairment. In all children, botulinum toxin injection was performed into the appropriate extraocular muscle. The relationship between demographic features, clinical characteristics, and treatment success were analyzed. Results: In the study group, 34 patients had esotropia, and 16 patients had exotropia. As neurological problems, 36 patients had cerebral palsy, and 14 had hydrocephalus. The average follow-up period was 15.3 ± 7.3 months. The mean number of injections was 1.4 ± 0.6. The mean angle of deviation was 42.5 ± 13.2 PD before the treatment, which decreased to 12.8 ± 11.9 PD after the treatment. Successful motor alignment (orthotropia within 10 PD) was achieved in 60% of the patients. Binary logistic regression analysis revealed that esotropic misalignment and shorter duration of strabismus was significantly associated with treatment success in the study group. Patients with esotropia and lower angles of misalignment were more likely to be treated with a single injection. Conclusion: The use of botulinum toxin A for the treatment of strabismus in children with neurological impairment is a good alternative to conventional surgical therapy with a lower risk of over-correction. The treatment outcome is better in esodeviations and shorter duration of strabismus, implying an advantage of early treatment.