Murat Atabey Ozer

Objective: The earthquakes that struck Kahramanmaraş on February 6, 2023, caused severe destruction and significantly impacted public health priorities in southeastern Türkiye. This study aimed to evaluate changes in public interest in ophthalmological topics before and after the disaster using Google Trends data. Methods: Thirty ophthalmological terms potentially influenced by disaster-related factors (e.g., stress, poor hygiene, sunlight exposure) were initially identified through literature review and expert consensus. Due to insufficient search volume, ten terms were excluded. Weekly relative search volume (RSV) values for 20 ophthalmological topics were retrieved using Google Trends for the three most devastated provinces (Hatay, Kahramanmaraş, and Adıyaman) from February 6, 2022, to February 3, 2024. The Wilcoxon signed-rank test (SPSS v22.0) was used to compare the time before and after the earthquake. Terms showing significant changes in at least two provinces were further analyzed across all 11 affected provinces. The threshold for statistical significance was established at p < 0.05. Results: Public search interest in “glasses” significantly decreased in Hatay (−15.2%, p<0.01), Kahramanmaraş (−16.91%, p<0.01), and Adıyaman (−19.49%, p<0.01). In Hatay (−92.11%, p<0.01) and Kahramanmaraş (−88.8%, p0.05), however, there was a noticeable but not statistically significant drop. A decline was also observed in searches for cataract, strabismus, and several other conditions; however, increases were noted in searches for conjunctivitis, eye strain, and glaucoma, but these changes were not statistically significant. Conclusion: Following this large-scale natural disaster, public interest in most non-urgent ophthalmic conditions decreased, suggesting a shift away from routine eye care needs. Google Trends may serve as a valuable tool for identifying community health priorities after catastrophic events, enabling a more efficient allocation of healthcare resources and targeted interventions.

Diabetic retinopathy (DR) occurs due to high blood glucose damage to the retina and leads to blindness if left untreated. KATP and related genes (KCNJ11 and ABCC8) play an important role in insulin secretion by glucose-stimulated pancreatic beta cells and the regulation of insulin secretion. KCNJ11 E23K (rs5219), ABCC8-3 C/T (rs1799854), Thr759Thr (rs1801261) and Arg1273Arg (rs1799859) are among the possible related single nucleotide polymorphisms (SNPs). The aim of this study is to find out how DR and these SNPs are associated with one another in the Turkish population. This study included 176 patients with type 2 diabetes mellitus without retinopathy (T2DM-rp), 177 DR patients, and 204 controls. Genomic DNA was extracted from whole blood, and genotypes were determined by the PCR-RFLP method. In the present study, a significant difference was not found between all the groups in terms of Arg1273Arg polymorphism located in the ABCC8 gene. The T allele and the TT genotype in the -3 C/T polymorphism in this gene may have a protective effect in the development of DR (p = 0.036 for the TT genotype; p = 0.034 for T allele) and PDR (p = 0.042 and 0.025 for the TT genotype). The AA genotype showed a significant increase in the DR group compared to T2DM-rp in the KCNJ11 E23K polymorphism (p = 0.046). Consequently, the T allele and TT genotype in the -3 C/T polymorphism of the ABCC8 gene may have a protective marker on the development of DR and PDR, while the AA genotype in the E23K polymorphism of the KCNJ11 gene may be effective in the development of DR in the Turkish population.

Objective Type 2 diabetes mellitus (T2DM) and diabetic retinopathy (DR) development is affected by genetic factors. Matrix metalloproteinases (MMPs) are involved in many cellular processes, such as remodeling of extracellular matrix proteins and angiogenesis. In this study, we investigated the relationship between MMP9 −1562 C/T (rs3918242) polymorphism and the development of T2DM and DR in Turkish population. Material and Method A total of 510 participants, involving 168 T2DM cases with DR, 168 T2DM cases without DR, and 174 controls, were included in the study. The polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method was carried out to identify genotypes. Results The CT, CT+TT genotypes and the T allele of the MMP9 −1562 C/T polymorphism were associated with increased risk of DR (p=0.001). On the other hand, no relationship was found between the development of T2DM and this polymorphism. In addition, CT (p=0.010) and CT+TT (p=0.015) genotype frequencies were found to be higher in proliferative diabetic retinopathy (PDR) cases compared to nonproliferative diabetic retinopathy (NPDR) cases, but after regression analysis, only insulin use (p=0.003) was found to be associated with the development of PDR. Conclusion Our data show that the MMP9 −1562 C/T polymorphism is associated with the development of DR in Turkish T2DM patients, but no significant relationship was found between this polymorphism and the severity of DR and the development of T2DM.

Aim: Diabetes mellitus (DM) is an important health problem with an increasing incidence worldwide and causes many complications. Diabetic retinopathy (DR) is one of the most serious complications of DM. Polymorphisms of the AKR1B1 gene, which encodes an aldose reductase enzyme, have been associated with development of DM and DR in some studies. The current study aims to investigate the relationship of AKR1B1 rs759853 polymorphism with type 2 DM (T2DM), DR and DR severity in the Turkish population. Materials and Methods: A total of 437 individuals, including 141 T2DM patients without DR, 125 T2DM patients with DR, and 171 healthy controls, were included in the study. Genotyping was performed using PCR-RFLP method.Results: An association between T allele / TT genotype and increased risk of proliferative diabetic retinopathy (PDR) was detected. In the logistic regression analysis in which other risk factors were included, rs759853 polymorphism and diabetes duration were found to be associated with the PDR development. There was no significant relationship between the AKR1B1 rs759853 variation and the development of T2DM and DR. Conclusion: Obtained data showed that AKR1B1 rs759853 polymorphism is not associated with the development of T2DM and DR in the Turkish patients, but TT genotype and diabetes duration are independent risk factors for the development of PDR.

OBJECTIVE: Long-term ocular effects of tumor necrosis factor-alpha inhibitors remain to be elucidated. This study aimed to examine the long-term effects of adalimumab use on neural tissue of the anterior visual pathways using optical coherence tomography in patients with ankylosing spondylitis.METHODS: This was a single-center, open-label, cross-sectional study conducted at the Giresun University Faculty of Medicine, Physical Medicine and Rehabilitation Department, between November 2019 and August 2020. This study included 26 ankylosing spondylitis patients receiving adalimumab for at least 1 year and 21 healthy controls. All subjects underwent a full ophthalmological examination and optical coherence tomography examination with the following measurements: peripapillary retinal nerve fiber layer thickness, peripapillary retinal thickness, peripapillary choroidal thickness, ganglion cell complex thickness, and the optic head properties.RESULTS: Peripapillary retinal nerve fiber layer thickness and retinal thickness measurements were lower in the adalimumab group. In addition, ganglion cell complex thickness was significantly lower and the cup-to-disc ratio was significantly higher in the adalimumab group (p0.05).CONCLUSION: Although tumor necrosis factor-alpha inhibitors have some favorable effects on the ocular involvement of patients with ankylosing spondylitis, they may also have paradoxical detrimental effects as evidenced by structural changes observed by optical coherence tomography. Future studies with better design, probably including a large number of patients with a range of rheumatological diseases and tumor necrosis factor-alpha inhibitors, are warranted.

Purpose To evaluate the effects of Duloxetine on anterior segment parameters and intraocular pressure (IOP) in open angle eyes. Methods 38 eyes of 38 patients with fibromyalgia who had open or wide open angles according to the Shaffer classification. Anterior segment optic coherence tomography was performed before and after (month 3) Duloxetine treatment. IOP, central corneal thickness (CCT), corneal endothelial cell density (CECD) and anterior chamber depth (ACD) were also recorded and evaluated. Results No statistically significant difference was determined in IOP, CCT and CECD (p > 0.05). However, a statistically significant decrease was determined in both the temporal and nasal anterior chamber angle, angle opening distance, nasal trabecular-iris space area and ACD values between the baseline and month 3 (p < 0.001). Discussion We think that the short term use of Duloxetine does not lead to clinically significant changes despite their statistically significant effects on the anterior chamber parameters.

Purpose: To evaluate the effects of Duloxetine on anterior segment parameters and intraocular pressure(IOP) in open angle eyes.Methods: 38 eyes of 38 patients with fibromyalgia who had open or wide open angles according to the Shaffer classification. Anterior segment optic coherence tomography was performed before and after (month 3) Duloxetine treatment. IOP, central corneal thickness(CCT), corneal endothelial cell density(CECD) and anterior chamber depth(ACD) were also recorded and evaluated. Results: No statistically significant difference was determined in IOP, CCT and CECD(p > 0.05). However, a statistically significant increase was determined in both the temporal and nasal anterior chamber angle, angle opening distance, nasal trabecular-iris space area and ACD values between the baseline and month 3 (p < 0.001). Conclusion: We think that the short term use of Duloxetine does not lead to clinically significant changes despite their statistically significant effects on the anterior chamber parameters.

To prospectively examine the effects of selective laser trabeculoplasty (SLT) on the anterior chamber angle (ACA) and its related parameters using anterior segment-optic coherence tomography (AS-OCT). Fifty eyes of 50 patients with primary open angle glaucoma (POAG) and ocular hypertension were included in the study. AS-OCT was performed before SLT application, immediately after and at 1 day and 1 month. Intraocular pressure (IOP), central corneal thickness (CCT) and anterior chamber depth (ACD) were also recorded and evaluated. No statistically significant difference was determined in ACA and other AS-OCT parameters (AOD, angle opening distance at 500 and 750 mm; TISA, trabecular-iris space area at 500 and 750 mm) before and 1 day after SLT application (p > 0.05). However, a statistically significant increase was determined in both the temporal and nasal ACA, AOD and TISA values between the baseline and day 30 (p < 0.001). No statistically significant change was observed in the CCT or ACD values (p > 0.05). SLT resulted in an increase in ACA, AOD and TISA when evaluated using AS-OCT. We think that this study provides a different perspective concerning the effects of SLT in the angle region and the involved mechanism.

Summary: One of the most important causes of visual loss (blindness) is glaucoma, which occurs due to the degeneration of the ganglion cells in retina. It has been shown that hydrogen sulphide (H₂S) acts an antioxidant, neuroprotective and neuromodulator and provides protection against oxidative stress and apoptosis. This study aims to examine through which apoptotic pathway H₂S acts in experimental glaucoma model. Twenty‐two male wistar albino rats were used in this study. Group 1 (n = 6, control group): Intravitreal saline was given in the third week without inducing ocular hypertension (OHT) with laser photocoagulation. Group 2 (n = 8): After the induction of OHT with laser photocoagulation, intravitreal saline was given in the third week. Group 3 (n = 8): After the induction of OHT with laser photocoagulation, intravitreal H₂S’s donor sodium hydrosulphide (NaSH) 100 nmol/L was given in the third week. At the end of the 6th week, the eyes of the rats were sacrified under anaesthesia and extracted and then routine tissue follow‐up was undertaken. Besides haematoxylin & eosin (H&E) staining, Bax, Bcl‐2, p53 and caspase‐3 activation were examined immunohistochemically in the retina and the cornea. This showed that ocular hypertension caused apoptosis through the intrinsic pathway, due to Bax and caspase‐3 activation, in both retina and cornea, and that this led to DNA damage due to p53 activation. Also, we found that H₂S exposure in glaucoma distinctly suppressed Bax, caspase‐3 and p53 activations in retina but that it has a limited effect on the cornea. According to these results, glaucoma caused apoptosis in the retina through intrinsic pathway, and the damage to the retina could be compensated partially by H₂S but would have limited on the cornea.

Objective: To determine possible associations between long-term HCQ use and corneal changes in patients who used HCQ for at least three years. Materials and methods: The study included 62 healthy controls and 62 consecutive patients who used HCQ for the treatment of rheumatologic disease and were referred to the ophthalmology department between August 2018 and November 2018 for HCQ retinal toxicity screening. Central corneal thickness (CCT), corneal endothelial cell density (ECD), the coefficient of variation (CV) of cell size, and the percentage of hexagonal cells (HEX) were measured to evaluate changes in the cornea. Results: The mean age of the patient group and control group was 50.10 ± 10.91 years and 50.53 ± 10.67 years, respectively. The mean ECD was 2742 ± 347 cells/mm2 in the patient group, and 2875 ± 188 cells/mm2 in the control group. There was a significant difference between groups (p = 0.01). The mean CCT was 567.05 ± 32.35 µm in the patient group, and 540.15 ± 38.50 µm in the control group. Central corneal thickness was significantly higher in the patient group compared with control group (p < 0.001). There was no significant difference between groups in terms of mean CV and HEX values (p > 0.05). Conclusion: Patients using long-term HCQ demonstrated lower ECD and higher CCT than the control group. However, the CV of cell sizes and the HEX% values were not significantly different from the controls.