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Öğe Evaluation of cycloplegic and noncycloplegic performance of spot vision screener in detection of amblyopia risk factors using 2021 AAPOS guidelines(Elsevier, 2024) Bulut, Erkan; Dayi, Ozlem; Celik, Yusuf; Bulut, Hatice; Basar, EmelPurpose: This research evaluates the effectiveness of the Spot Vision Screener (SVS) before and after cycloplegia to detect amblyogenic refractive errors in children. Methods: Children ages 3 to 10 years old were screened by the SVS before and after cycloplegia. Sensitivity, specificity, positive and negative predictive value, paired t -test, Bland -Altman plot and receiver operating characteristic area under the curve were evaluated by comparing the results of the SVS (v3.0.05) measurements with the results of the cycloplegic Topcon autorefractometer according to the 2021 guidelines of the American Association for Pediatric Ophthalmology and Strabismus. Results: Both eyes of 211 patients aged 3 to 10 years old were included. Regarding the amblyopia risk factors, the noncycloplegic SVS had 65.7 % sensitivity, 94.9 % specificity, 81.2 % positive predictive value and 89.3 % negative predictive value. The SVS's sensitivity increased from 65.7 % to 81.9 % with cycloplegia compared to noncycloplegic SVS results. The sensitivity detection of hyperopia was improved from 4.2 % to 100 % after cycloplegia. Areas under the receiver operator characteristic curve for noncycloplegic SVS and cycloplegic SVS were 0.506 (95 % CI, 0.395 to 0.646, p = 0737) and 0.905 (95 % CI, 0.915 to 0.971, p < 0.001) for hyperopia, respectively. Using the +1.64 D revised cutoff criteria for hyperopia increased sensitivity from 4.2 % to 78 %. Conclusion: Noncycloplegic SVS measurements showed relatively high specificity in detecting amblyopia risk factors. The fact that noncycloplegic measurements have a very low sensitivity for hyperopia is an important weakness of the SVS, especially because hyperopia is the most frequently encountered refractive error in very young children. It should be noted that amblyogenic hyperopia may be overlooked by an SVS without cycloplegia.Öğe Impact of obesity on peripapillary choroidal thickness, macular choroidal thickness, and lamina cribrosa morphology(Elsevier, 2023) Koprubasi, Sumeyra; Bulut, ErkanBackground: Obesity is known to be a significant risk factor for many ocular diseases. In order to understand the mechanism of obesity-related ocular diseases, we examined the lamina cribrosa morphology, peripapillary choroidal thickness (PPCT), and macular choroidal thickness (MCT) in obese women using optical coherence tomography (OCT).Methods: This comparative cross-sectional study included the right eyes of 72 obese women and 63 healthy women classified based on body mass index (BMI). Each participant underwent a thorough ophthalmological examination and enhanced depth (EDI) OCT imaging, including measurements of PPCT from a total of 12 re-gions, MCT from a total of 7 regions, Bruch's membrane opening (BMO), lamina cribrosa thickness (LCT), lamina cribrosa depth (LCD), intraocular pressure (IOP), and central corneal thickness (CCT). Results: The mean age and BMI of the obese group were 32.36 +/- 7.38 years and 35.11 +/- 4.39 kg/m2, while those of the control group were 31.64 +/- 7.78 years and 20.88 +/- 1.72 kg/m2 (p = 0.658, and p<0.001, respectively). PPCT N1000, PPCT N1500, PPCT S1500, and PPCT T1500 were statistically significantly thinner in the obese group than the control group (p values were 0.039, 0.012, 0.027, and 0.036, respectively). IOP and CCT were significantly higher in the obese group than the control group (p = 0.016, and p = 0.019, respectively). There was no statistically significant difference between the two groups in terms of MCT, BMO, LCT, and LCD.Conclusion: We discovered thinning in the PPCT, which indicates microvascular abnormalities in the optic disc head. Microvascular alteration in the peripapillary region may be a potential initial event in the pathogenesis of several obesity-related ocular diseases, especially glaucoma.Öğe New Age Borders Obtained from Spot Photoscreener by Using Multivariate Cluster Analysis(Pera Yayıncılık Hizmetleri, 2022) Bulut, Erkan; Çelik, Yusuf; Dayi, Özlem; Bulut, HaticeObjective: The aim of this study is to analyze all the variables obtained from photoscreener using hierarchical cluster analysis to create more homogeneous age groups for more reliable and consistent measurement by photoscreener. Methods: The variables obtained from photoscreener examination of consecutive children who attended the ophthalmology department were evaluated. Medical records of the children were evaluated to ontain data including refractive parameters, deviation angle, pupil diameter variables and the calculated spherical equivalent, the cylindrical power vector J0, J45 values. These variables were analyzed by the multivariate cluster analysis. Results: Based on a dendrogram, 4 main clusters of similar quality variables were created. The calculated spherical equivalent decreased gradually from cluster I to IV, from 0.745 D to –0.235 D. The average pupil size in the Ist cluster was 5.06 mm, while in the IVth cluster, it was 6.38 mm. The proposed new age borders are distinct and statistically significant (P <.001). The ultimate proposed new age borders were found as 1-20, 21-64, 65-101, and 102-120 months, respectively. Conclusions: We proposed new age borders for the evaluation of refraction and pupil size of children which create new groups with a statistically different and homogeneous distribution. The proposed new age borders in this research would provide more reliable and consistent measurement results for clinical diagnosis.Öğe Obez ve Sağlıklı Çocuklarda Koroid Kalınlığının Klinik İlişkisi: Makine Öğrenimi Çalışması(Erkan Mor, 2023) Bulut, Erkan; Köprübaşı, Sümeyra; Dayi, Özlem; Bulut, HaticeAmaç: “Random forest” (RF), “support vector machine” (SVM) ve “multilayer perceptrons” (MLP) algoritmalarının performansını karşılaştırarak maküler koroid kalınlığı (MKT) ve peripapiller koroid kalınlığının (PPKT) obez ve sağlıklı çocukların sınıflandırılması üzerindeki etkisini analiz etmek. Gereç ve Yöntem: Bu prospektif karşılaştırmalı çalışmada yaşları 6-15 arasında olan 59 obez çocuk ve 35 sağlıklı çocuk optik koherens tomografi kullanılarak incelendi. MKT ve PPKT, fovea ve optik diskten 500 µm, 1.000 µm ve 1.500 µm mesafelerde ölçüldü. Çıkarılan tüm özelliklerin en belirgin olanlarını belirlemek için üç farklı özellik seçim algoritması kullanıldı. Çıkarılan özelliklerin sınıflandırma etkinliği, RF, SVM ve MLP algoritmaları kullanılarak analiz edildi ve bunların obezleri sağlıklı çocuklardan ayırt etmedeki etkinlikleri gösterildi. Ölçümlerin kesinliği ve güvenilirliği kappa analizi kullanılarak değerlendirildi. Bulgular: Korelasyon özellik seçimi algoritması, farklı özellik seçim yöntemleri arasında en başarılı sınıflandırma sonuçlarını üretmiştir. Obez ve sağlıklı grupları birbirinden ayırmada en belirgin özellikler PPKT temporal 500 µm, PPKT temporal 1.500 µm, PPKT nazal 1.500 µm, PPKT inferior 1.500 µm ve subfoveal MKT idi. RF, SVM ve MLP algoritmaları için sınıflandırma oranları sırasıyla %98,6, %96,8 ve %89 idi. Sonuç: Obezite, özellikle subfoveal bölgede ve optik disk başından 1.500 µm uzaklıktaki dış yarım dairede olmak üzere çocukların koroidal kalınlıkları üzerinde etkilidir. Hem RF hem de SVM algoritmaları, obez ve sağlıklı çocukları sınıflandırmada etkili ve doğru yöntemlerdir.Öğe Ocular Biometry Characteristics and its Relationship with Age, Gender, Spherical Equivalent in Turkish Children(WOLTERS KLUWER MEDKNOW PUBLICATIONS, WOLTERS KLUWER INDIA PVT LTD, A-202, 2ND FLR, QUBE, C T S NO 1498A-2 VILLAGE MAROL, ANDHERI EAST, MUMBAI, Maharashtra 400059, INDIA, 2022) Dayi, Özlem; Bulut, Erkan; Karadağ, Mevlüde; Bulut, HaticeBackground: Studying ocular biometric parameters in different populations and determining the relationship with personal characteristics can provide valuable information about ocular growth and help provide a better understanding of refractive errors. Aims: To describe distributions of ocular biometry and to evaluate its associations with age, gender, spheric equivalent in Turkish children. Patients and Methods: In this prospective study 344 children aged 3-14 years were evaluated. Parameters studied included axial length (AL), anterior chamber depth (ACD), and mean corneal radius (CR) measured with optical biometry. Cycloplegic refraction values were obtained using autorefractometer. The change of biometric parameters according to age and gender were evaluated. The relationship between ocular biometry parameters with refraction and age was analyzed by linear regression. Results: Mean spherical equivalent (SE), AL, ACD and AL/CR observed to be lowest in the preschooler group (P < 0.001). SE reduced with age, and a weak correlation observed between SE and age (r = ?0.333). AL and ACD had moderate and weak positive correlations with age respectively (r = 0.511; r = 0.304). There were negative correlations between SE with AL, ACD and AL/CR (r = -0.826; r = -0.540; r = -0.886). The strongest correlation with SE among these parameters was identified for AL/CR. AL and ACD were higher in boys, while the CR was lower in girls (p < 0.001). Conclusion: While AL in children in late schooler group is higher than European countries, it shows similar characteristics in early schooler group. In addition AL is lower in all age groups than Asian population sexcept preschooler group. With age AL increases, SE decreases and AL plays a key role in refractive development.Öğe Publication trends in the feld of the cornea in the last 4 decades: a bibliometric study(SPRINGER, VAN GODEWIJCKSTRAAT 30, 3311 GZ DORDRECHT, NETHERLANDS, 2023) Zırtıloğlu, Sibel; Bulut, ErkanPurpose The objective of this bibliometric study was to identify the top 100 most-cited articles on the cornea published in the English language between 1980 and 2021 using multidimensional citation analysis. Methods The data were obtained from the Thomson Reuters Web of Science Core Collection and the PubMed databases. The top 100 articles in terms of citation number were identifed and analyzed. Results A total of 40,792 articles related to the cornea were retrieved. The 100 most-cited articles were published between 1995 and 2000. The average time since publication was 19.64±5.75 years. The mean impact factor of the journals was 10.27±17.14 and the Q category of most journals was Q1. Ophthalmology was the journal with the most published articles (n=10), which represented level 3 evidence. The three most common topics among the top 100 articles were treatment modality, histopathology, and diagnostic imaging. The most frequently mentioned treatments were related to limbal stem cell failure, crosslinking, and lamellar keratoplasty. We observed a negative correlation between the average number of citations per year and the time passed since publication (r=?0.629; p=0.001). Conclusion Our analysis of the top 100 mostcited articles on the cornea revealed scientifc contributions, vital current data related to clinical implementations, and valuable insights into the current developments in ophthalmology. To our knowledge, this is the frst study to evaluate the most infuential papers on the cornea, and our fndings highlight the research quality and latest discoveries and trends in the management cornea diseases.
