Fatma Sumer

Background/Objectives Wavefront-guided refractive surgery delivers excellent visual outcomes for myopia, but the relative contribution of demographic, refractive, and corneal preoperative variables to safety and efficacy remains incompletely characterized in real-world single-surgeon cohorts. We aimed to identify independent predictors of safety and efficacy after wavefront-guided femtosecond LASIK (i-LASIK) and wavefront-guided PRK (wfPRK) for myopia, using a methodologically robust analytical approach. Methods Single-center, single-surgeon retrospective cohort of consecutive myopic patients operated between January 2020 and July 2024. After exclusion of hyperopia, ectatic disorders, incomplete follow-up, and amblyopia (preoperative best-corrected visual acuity [BCVA] logMAR ≥ 0.3), 329 patients (648 eyes) were analyzed. The primary outcomes were the safety index (postoperative BCVA / preoperative BCVA) and the efficacy index (postoperative uncorrected visual acuity / preoperative BCVA), modelled as continuous variables. To preserve the independence assumption while making full use of bilateral data, all inferential analyses — Spearman correlations, Mann–Whitney U / Kruskal–Wallis H tests, and multivariable linear regression with eight preoperative predictors entered simultaneously — were performed separately for right and left eyes. Standardized regression coefficients (β) and 95% confidence intervals are reported. Results The cohort included 162 male (49.2%) and 167 female (50.8%) patients, mean age 30.0 ± 6.4 years; 411 eyes (63.4%) underwent i-LASIK and 237 (36.6%) wfPRK. Median follow-up was 101 days (range 23 days to 4.2 years). Overall, 99.4% of eyes had a safety index above 0.85 and 98.8% had an efficacy index above 0.80. Across all four multivariable models (safety and efficacy, right and left eyes), preoperative BCVA logMAR was the strongest independent predictor (β = +0.437 to +0.682, all p < 0.001). Preoperative astigmatism was independently associated with reduced left eye safety (β = −0.102, p = 0.028), and high myopia (SEQ ≤ −6.01 D) with reduced right eye safety (β = −0.096, p = 0.040) and efficacy (β = −0.113, p = 0.043). Age, sex, and surgical technique (i-LASIK vs wfPRK) were not independently associated with either index (all p > 0.05). Conclusions In a real-world wavefront-guided refractive surgery cohort, both i-LASIK and wfPRK delivered comparably high safety and efficacy. The strongest determinant of both indices was preoperative BCVA logMAR, while preoperative astigmatism and high myopia showed small but consistent independent contributions. The absence of an independent age, sex, or technique effect supports an indication-based rather than procedure-based decision framework and a more nuanced view of refractive surgery outcome prediction.

To report bilateral sequential phacoemulsification in a patient with high-myopia post-radial keratotomy (RK) corneas and bilateral chorioretinal atrophy, c

Purpose: Although ocular involvement in Familial Mediterranean Fever (FMF) has been described, the corneal endothelium has not been systematically evaluated in these patients. This study aimed to compare corneal endothelial and anterior segment parameters between FMF patients in clinical remission and healthy controls, and to explore whether these parameters differ according to MEFV M694V genotype. Methods: In this prospective, observational case–control study, 90 genetically confirmed FMF patients in clinical remission and 60 age- and sex-matched healthy controls were evaluated. Only the right eye of each participant was analyzed. Corneal endothelial parameters were assessed by non-contact specular microscopy, and corneal structural parameters by Scheimpflug-based tomography. Measured parameters included endothelial cell density (ECD), central corneal thickness (CCT), coefficient of variation of cell area (CV), and percentage of hexagonal cells (HEX). MEFV mutation analysis was performed by Sanger sequencing. Results: Compared with controls, FMF patients showed a lower ECD (median 2154.5 vs. 2348 cells/mm ² , p < 0.001; approximately 8.2% lower), a higher CCT (556.5 vs. 543 μm, p < 0.001), a higher CV (42 vs. 39.5, p = 0.003), and a lower HEX (44.5% vs. 48%, p < 0.001). Intraocular pressure was modestly higher (18 vs. 15 mmHg, p < 0.001) and the iridocorneal angle was narrower (42° vs. 47°, p < 0.001) in the FMF group, with both groups remaining within normal physiological ranges. Within the FMF group, patients homozygous for M694V ( n = 14) showed a higher mean CCT (540.93 ± 39.14 vs. 510.93 ± 36.21 μm, p = 0.020) and a lower median ECD (2071 vs. 2218.5 cells/mm ² , p = 0.006) than heterozygotes ( n = 29). In an exploratory multivariable logistic regression within this subgroup, CCT and ECD were jointly associated with M694V homozygous versus heterozygous status (correct classification 69.8%). Conclusion: FMF patients in clinical remission show measurable differences in corneal endothelial parameters compared with healthy controls, and these differences appear more pronounced in M694V homozygous patients. Because the study is cross-sectional, it is not possible to conclude that these parameters reflect ongoing disease activity; prospective, longitudinal studies are needed to determine whether corneal endothelial assessment has a role in the ophthalmologic follow-up of patients with FMF.

Adenoviral keratoconjunctivitis (AKC) is a common ocular infection that causes acute inflammation of the ocular surface. However, the long-term effects of

Age-related macular degeneration (AMD) represents one of the most common causes of permanent vision impairment in individuals over 50 years of age. This st

Amaç: Bu çalışmada, oküler yüzey lezyonlarına ait cerrahi olarak çıkarılmış histopatolojik örneklerin epidemiyolojik özelliklerinin değerlendirilmesi ve klinik ön tanı ile histopatolojik tanılar arasındaki uyum oranının belirlenmesi amaçlanmıştır. Aynı zamanda histopatolojik incelemenin tanısal süreçlerdeki rolü ve hasta yönetimine katkısı ortaya konulmaya çalışılmıştır. Gereç ve Yöntemler: Bu retrospektif kesitsel araştırma, 2011 ile 2022 yılları arasında Recep Tayyip Erdoğan Üniversitesi Tıp Fakültesi Göz Hastalıkları ile Tıbbi Patoloji Anabilim Dalları’nın iş birliğiyle yürütülmüştür. Oküler patoloji nedeniyle cerrahi eksizyon yapılan ve histopatolojik değerlendirme için gönderilen toplam 1116 örnek incelenmiştir. Hastaların yaş, cinsiyet gibi demografik bilgileri, klinik ön tanıları ve histopatolojik tanıları retrospektif olarak analiz edilmiştir. Klinik tanılar ile histopatolojik bulgular karşılaştırılarak tanısal doğruluk ve uyum değerlendirilmiştir. Bulgular: Olguların yaş ortalaması 53,1 olup (yaş aralığı 4–95), %60,4’ü kadın hastalardan oluşmaktaydı. Klinik ön tanı ile histopatolojik tanı arasında %75,1 oranında uyum saptanmıştır. Malignite tanılarındaki doğruluk oranı oldukça yüksektir (%98,9). En sık rastlanan lezyon ksantelazma olup (%12,8), sebase karsinom, sebase hiperplazi ve steatositoma en nadir görülen lezyonlar olarak her biri %0,09 oranında tespit edilmiştir. Genel malignite oranı %4,7’dir. Sonuç: Histopatolojik inceleme, yalnızca kesin tanıya ulaşmak için değil; aynı zamanda etkili tedavi planlaması, klinik yönetimin yönlendirilmesi ve hasta prognozunun iyileştirilmesi açısından da vazgeçilmez bir unsurdur. Bu nedenle, klinik gözlemlerle birlikte patolojik doğrulama yapılması, oküler yüzey lezyonlarında güvenilir hasta yönetimi için kritik öneme sahiptir.

Objective: We aimed to determine the incidence and screening outcomes of retinopathy of prematurity (ROP) in preterm infants managed at a tertiary neonatal intensive care unit (NICU) and to identify associated risk factors. Material and Methods: Medical records of 454 premature infants who underwent ROP screening between April 2016 and August 2021 were retrospectively analyzed. Infants with birth weight (BW) ≤ 1500 g or ≤32 weeks of gestational age and those with BW > 1500 g or GA > 32 weeks who had an unstable clinical course were included. All of them were born in the same center. Demographic characteristics, potential risk factors for ROP, ocular examination findings, and treatment requirement were recorded. Results: During the five-year study period, ROP was observed in 75 (16.6%) of a total of 454 premature infants with a mean gestational age (GA) of 30.19 ± 2.49 weeks and a mean BW of 2025.15 ± 614.46 g in the NICU. Of these patients, 67 (14.8%) had stage I disease and 8 (1.8%) had stage II disease. Advanced-stage ROP was not detected in any of the cases. The median GA of patients diagnosed with ROP was 29 weeks (22–35) and the median BW was 2100 g (500–3750), which were significantly lower than those without ROP (p < 0.001). When multivariate logistic regression analysis was evaluated with the Wald method, the accuracy rate of the model examining the combined effect of GA, intraventricular hemorrhage (IVH), respiratory distress syndrome (RDS), patent ductus arteriosus (PDA), necrotizing enterocolitis (NEC), and surfactant treatment was 85.9%. In this model, gestational age (OR: 0.712, p < 0.001), IVH (OR: 2.915, p = 0.010), RDS (OR: 2.129, p = 0.004), NEC (OR: 3.679, p < 0.001), PDA (OR: 2.434, p = 0.021), and surfactant treatment (OR: 2.271, p = 0.002) were found to be independent risk factors for ROP development. Conclusions: Small GA and low BW are the main risk factors for the development of ROP. The incidence of ROP was found to be lower than similar studies conducted in our country. While severe ROP cases have been reported in more mature infants in Turkey, our study found no treatment-requiring ROP cases, likely reflecting the higher mean GA and BW characteristics of our cohort.

Background/Objectives: Although methylphenidate is a first-line pharmacological agent in the treatment of Attention-Deficit/Hyperactivity Disorder (ADHD), its long-term effects on ocular tissues, particularly the corneal endothelium, remain poorly understood. Given the cornea’s metabolic sensitivity, subclinical changes may occur even in the absence of overt ophthalmologic symptoms. This study aims to evaluate the impact of six-month methylphenidate treatment on corneal endothelial morphology and intraocular pressure (IOP) in pediatric patients with ADHD. Methods: This prospective observational study included 100 treatment-naive children with ADHD and 100 age- and sex-matched healthy controls. All participants underwent comprehensive ophthalmologic assessment at baseline. In the ADHD group, follow-up evaluations were performed after six months of methylphenidate therapy. Endothelial cell density (ECD), average cell area (AVE), standard deviation (SD), coefficient of variation (CV), hexagonality index (6A), central corneal thickness (CCT), and IOP were measured using specular microscopy and corneal topography. ADHD symptom severity was evaluated using the Turgay DSM-IV-Based Rating Scale. Results: Significant reductions in ECD and increases in CCT, CV, AVE, and SD were observed following treatment (p < 0.001). IOP also showed a statistically significant increase while remaining within normal physiological limits. Weak but significant correlations were found between inattention scores and ECD (r = 0.222), and between inattention and corneal volume (r = −0.248). Conclusions: Chronic methylphenidate use may be associated with measurable changes in corneal endothelial microstructure and IOP in children with ADHD. These findings highlight the need for routine ophthalmologic monitoring during stimulant therapy and underscore the importance of further large-scale, long-term studies exploring the neuro-ophthalmologic implications of pediatric psychopharmacological treatment.