Browsing by Author "Altinisik M."
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Item Miliary microemboli of the retinal arterioles and choriocapillaris after subcutaneous injection of triamcinolone acetonide(Iranian Society of Ophthalmology, 2019) Kayikcioglu O.R.; Altinisik M.; Inan S.; Kurt E.Purpose: To report a case of triamcinolone crystals associated miliary microemboli of the retinal arterioles and choriocapillaris. Methods: A 30-year-old woman with alopecia areata on her left auriculotemporal scalp, scheduled for 10 mg/ml triamcinolone acetonide steroid injections (maximum volume of 3 ml per session) for 1 month intervals, presented with a sudden decrease in vision in her left eye after 1 ml injection in a dermatology clinic. Results: On ocular examination her best corrected visual acuity (BCVA) was hand movement in the left eye. Retinal examination showed multiple white-yellow steroid emboli in the superior and inferior temporal branch retinal arterioles which involves macula. Also there were diffuse yellow infiltrates in the choroid consistent with choroidal microemboli. Fluorescein angiography and optical coherence tomography images were suggestive for the retinal and choroidal ischemia. Conclusion: Subcutaneous triamcinolon injection may cause embolic occlusion of retinal and choroidal capillaries. © 2018 Iranian Society of OphthalmologyItem Evaluation of xenon, light-emitting diode (LED) and halogen light toxicity on cultured retinal pigment epithelial cells(Taylor and Francis Ltd, 2019) Sezer T.; Altinisik M.; Guler E.M.; Kocyigit A.; Ozdemir H.; Koytak A.Objective: To compare the possible toxic effects of three light sources used in vitreoretinal endoillumination systems; halogen, xenon, and light-emitting diode (LED) on retinal pigment epithelium (RPE) cell cultures, after two different exposure times. Material and methods: ARPE-19 human RPE cell cultures were exposed to halogen, xenon, and LED light sources at a distance of 1.5 cm for 30 and 60 min with equal lumen output levels. Cells in the control group were not exposed. RPE cell cultures were compared in terms of cell viability, DNA damage, apoptosis rate, and IL-1ß, IL-6, and TNF- α levels. Results: The halogen light group showed significantly more DNA damage, higher TNF-α, IL-1β, and IL-6 levels, and lower viable cell count at 30 min compared to the control group. The rates of early and late apoptosis were also significantly higher at 60 min. There were no statistically significant differences in any of the parameters between the xenon and LED light sources and the control group at 30 or 60 min. Conclusion: New generation lights, xenon, and LED, seem to be safe in terms of RPE cells. Halogen light may cause toxic effects on RPE cells when used for a long time with maximal power output. © 2018, © 2018 Informa UK Limited, trading as Taylor & Francis Group.Item Comparison of postoperative anterior segment changes associated with pars plana vitrectomy with and without vitreous base shaving(International Journal of Ophthalmology (c/o Editorial Office), 2020) Toklu E.; Altinisik M.; Elbay A.; Koytak A.AIM: To compare changes in anterior segment topography and axial length (AL) evaluated with Pentacam and IOL Master after pars plana vitrectomy (PPV) performed with and without vitreous base shaving. METHODS: This prospective study included patients who underwent PPV or phacoemulsification+PPV (Phaco+PPV) for various indications. Patients who underwent total posterior hyaloid detachment and excessive vitreous base shaving with scleral indentation were referred to as complete PPV (c-PPV). The patients whom posterior hyaloid was separated as far as the posterior arcades and vitreous base shaving with scleral depression was not performed were classified as the partial PPV (p-PPV) group. All patients underwent detailed ophthalmologic examinations preoperatively and 1wk, 1, and 3mo postoperatively. Changes in the anterior chamber depth (ACD), anterior chamber volume (ACV), iridocorneal angle (ICA), central corneal thickness (CCT), and keratometric measurements (K1 and K2) were evaluated with Pentacam HR. Changes in the AL measurements were analyzed with IOL Master. RESULTS: A significant increase in ACD was observed in c-PPV cases (P=0.02), but this increase was not significant in the p-PPV group (P=0.053). In contrast, ICA increased significantly in the c-PPV group (P=0.02) but decreased in the p-PPV group (P=0.09). BCVA was significantly improved in the c-PPV group from week 1 (P<0.001) while the increase in the p-PPV group reached significance at 3mo (P=0.035). CCT increased in the first week and later returned to baseline in both groups. No significant differences in the other parameters were observed between the groups, and there were no significant changes in intraocular pressure, ACV, AL, K1 or K2 values (P>0.05 for all). CONCLUSION: Incomplete posterior hyaloid excision and not removing the vitreous base in PPV surgeries may create a more stable anterior chamber, thus preventing the downward movement of the lens-iris diaphragm, and may cause ciliary body retraction, thereby reducing ICA. Awareness of these effects can provide some amount of guidance to physicians in selecting the appropriate PPV procedure and preempting surgical complications. © 2020 International Journal of Ophthalmology (c/o Editorial Office). All rights reserved.Item A multimodal ophthalmic analysis in patients with systemic sclerosis using ocular response analyzer, corneal topography and specular microscopy(Springer, 2020) Mayali H.; Altinisik M.; Sencan S.; Pirildar T.; Kurt E.Purpose: To conduct a multimodal ophthalmic evaluation of systemic sclerosis (SSc) in patients using ocular response analyzer (ORA), Pentacam, and specular microscopy (SM). Methods: Thirty-one SSc patients and a group of age- and sex-matched controls were enrolled in this cross-sectional study. Corneal hysteresis (CH), corneal resistance factor (CRF), corneal-compensated intraocular pressure (IOPcc), and Goldmann-correlated IOP (IOPg) were measured with ORA. Anterior chamber depth (ACD), central corneal thickness (CCT), and corneal volume (CV) measurements were obtained using Pentacam. Corneal endothelial cell density (ECD) and CCT were evaluated by SM. Results: SSc patients had significantly lower CH, ACD, and ECD values compared to the control group (p = 0.018; < 0.001; < 0.001, respectively). There was no significant difference regarding CRF, IOP, CV, or CCT measurements acquired by Pentacam and SM. Regarding CCT, SM and Pentacam showed relatively better agreement in SSc patients. Conclusions: Multimodal imaging can provide more comprehensive and useful information regarding the ocular involvement of systemic diseases. The multimodal evaluation in our study demonstrated that the pathologic effects of SSc may manifest as reductions in ACD, corneal elasticity, and ECD before there are any detectable changes in corneal thickness or IOP. © 2019, Springer Nature B.V.Item Quantitative Analysis of the Activity in Choroidal Neovascularizations after a Single Anti-VEGF Injection: OCT Versus OCT Angiography(Taylor and Francis Ltd., 2021) Altinisik M.; Kurt E.; Kayikcioglu O.; Yildirim A.Purpose: To analyze early quantitative changes in the choroidal neovascularization (CNV) area observed with optical coherence tomography angiography (OCTA) after single anti-vascular endothelial growth factor (anti-VEGF) injection. Materials and Methods: Treatment-naive patients with CNV secondary to neovascular age-related macular degeneration were analyzed immediately before and ~4 weeks after anti-VEGF injection. The primary endpoints of the study included changes in CNV total and vascular area. Secondary endpoints were best-corrected visual acuity (BCVA), central macular thickness (cMT), central total macular thickness (cTMT), and subfoveal choroidal thickness (SFCT). Results: A total of 27 patients (69.19 ± 5.91 years, 21 men/6 women, 14 type 1 NV, 11 type 2 NV, and 2 type 3 NV) were included in the study. There was a significant increase in BCVA and decreases in cMT, cTMT, and SFCT after treatment (p<0.05 for all). CNV total and vascular area changed by −11.55 ± 44.26% (95% confidence interval [CI]: −29.06 and 5.95; p=0.269) and −21.06 ± 41.2% (95% CI: −36.45/−5.67; p=0.786), respectively. The cases with decreased cTMT were accompanied by a decrease in CNV area only in 37% of the cases. No significant correlation was detected between cTMT and CNV total and vascular area percentage changes (r = −0.06, p=0.74; r = 0.02, p=0.9, respectively). Conclusions: Changes in CNV total and vascular area seem to have limited sensitivity as a biomarker in terms of activation, as wide variability was observed in CNV area after anti-VEGF injection. © 2021 Taylor & Francis.Item Relation between nocturnal decline in blood pressure and choroidal thickness: a comparative analysis in dipper vs. non-dipper hypertensive patients(Lippincott Williams and Wilkins, 2021) Tas S.; Altinisik M.; Tas Ü.Purpose To compare choroidal thickness (ChT) and echocardiographical changes in patients with dipper and non-dipper systemic arterial hypertension (HT). Methods Patients with HT were evaluated in two groups according to the 24-hour ambulatory BP monitoring. Compared to day-time values, those whose night-time SBP decreased ≥10% were defined as dippers, and those whose SBP decreased <10% were defined as non-dippers. Transthoracic echocardiography was conducted in all patients. ChT and central macular thickness were measured with spectral-domain optical coherence tomography. ChT was obtained at the subfoveal, 1500 µm nasal and temporal to the fovea. Results Thirty non-dipper (18 females and 12 males) and 23 dipper (16 females and seven males) hypertensive patients were recruited. Sex distribution and the mean age were similar between the groups (P = 0.472; P = 0.12). Disease duration was longer in the non-dipper group (8 ± 3.39 vs. 4.96 ± 1.19 years, P = 0.001). The non-dipper group had lower ChT in subfoveal and temporal locations (P = 0.02 and 0.03, respectively) and higher left atrial volume index (LAVI) and pulmonary valve maximum flow (PV-max; P < 0.001). The night-time SBP was negatively correlated with ChT (P = 0.048) and positive correlated with LAVI and PV-max (P < 0.05). However those correlations were not significant when were controlled by the possible confounding factors as disease duration, age and gender. Conclusion Non-dipper HT patients may have thinner choroid than dippers due to longer duration of HT and higher ambulatory BP levels. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.Item Multimodal ocular evaluation in hemodialysis patients(Springer Science and Business Media B.V., 2021) Mayali H.; Altinisik M.; Sarigul C.; Toraman A.; Turkoglu M.S.; Kurt E.Purpose: To evaluate choroidal thickness, intraocular pressure (IOP), axial length, central corneal thickness (CCT), lens thickness, anterior chamber depth, and ocular pulse amplitude (OPA) in hemodialysis patients. Materials and methods: The patients with end-stage renal disease and undergoing hemodialysis were included in the study. Immediately before and 1 hour after hemodialysis, all patients underwent measurement of choroidal thickness with spectral domain optical coherence tomography (SD-OC, Cirrus HD-OCT; Carl Zeiss Meditec Inc., Dublin, CA), IOP and OPA with Pascal dynamic contour tonometry (Ziemer Ophthalmic Systems AG, Port, Switzerland), and anterior chamber depth, lens thickness, and axial length with optical biometry (LenStar LS900; Haag-Streit AG, Koeniz, Switzerland). Data from the patients’ right eyes were included in the statistical analysis. Results: The patient group included 8 (36.4%) males and 14 (63.6%) females with a mean age of 56, 14 ± 9, 96 (40–70) years. The mean subfoveal choroidal thickness before and after hemodialysis was 255.21 ± 6.15 (245–263) µm and 234.95 ± 7.89 (220–247) µm, respectively (p < 0.001). Mean choroidal thickness at 1500 µm and 3000 µm nasal and temporal of the fovea also decreased significantly after hemodialysis (p < 0.001). Mean OPA values before and after hemodialysis were 2.14 ± 1.07 (0.6–4) mmHg and 1.6 ± 0.86 (0.5–3.2) mmHg, respectively (p < 0.001). There was a statistically significant correlation between OPA and choroidal thickness measurements (p < 0.001, R = 0.923). IOP increased from 15.11 ± 2.58 (11–20) to 15.99 ± 2.21 (13–20) mmHg, but the change did not reach statistical significance (p = 0.05). There was no statistically significant change in mean axial length, anterior chamber depth, lens thickness, or CCT after hemodialysis (p > 0.05 for all). Conclusion: Although choroidal thickness and OPA may be decreased immediately after hemodialysis, there may be no significant changes in IOP or avascular ocular structures such as the lens and cornea. © 2021, The Author(s), under exclusive licence to Springer Nature B.V.Item Comparison of central corneal thickness measurements by contact and non-contact pachymetry devices(Jaypee Brothers Medical Publishers (P) Ltd, 2021) Mayali H.; Altinisik M.; Diri I.; Ilker S.; Kurt E.; Kayikcioglu O.Aim and objective: To compare central corneal thickness (CCT) measurements obtained by handheld contact ultrasound pachymetry (HCUP) and non-contact pachymetry devices. Materials and methods: Ninety eyes of 90 patients (52 male and 38 female) were included in the study. Measurements from two non-contact devices, —specular microscopy (SM, Konan Medical, CA, USA) and Oculus Pentacam (Oculus Inc., Germany)—were compared against HCUP (Pachmate 2, DGH Technology, Inc, PA, USA). Ultrasound measurements were obtained 3 times by the same user and averaged. The differences were calculated by one-way ANOVA. Agreement between measurements were assessed by Bland–Altman plots and intraclass correlation coefficient tests. Coefficient of repeatability (%, CR) was defined as 1.96*standard deviations of the differences between pairs of measurements divided by the average of the means. Results: The mean age was 34.31 ± 14.39 (14–74) years, and the mean intraocular pressure was 16.48 ± 2.63 mm Hg (12–21). Mean CCT measured by HCUP, SM, and Pentacam was 557.76 ± 36.76 μm, 550.29 ± 43.74 μm, and 541.41 ± 35.7 μm, respectively (p < 0.05). In the Bland–Altman plot, 95% limit of agreements were 19.5 and 14.18 μm among HCUP measurements, 34.55 μm between HCUP and Pentacam, 41.49 μm between SM and Pentacam, and 46.98 μm between HCUP and SM. CR values (%) were 3.49, 2.54, 6.28, 7.68, and 8.47, respectively. Conclusion: There were significant differences between the mean CCT values of the measurement devices. Clinical significance: Contact and non-contact devices may not interchangeable in the clinical assessment of CCT. © Jaypee Brothers Medical Publishers. 2021 Open Access.Item Evaluation of retinochoroidal tissues in third trimester pregnants: An optical coherence tomography angiography study(SAGE Publications Ltd, 2022) Yildirim A.; Kurt E.; Altinisik M.; Uyar Y.Introduction: The structural and vascular changes in the retina and choroid in women in the third trimester of pregnancy were analyzed using optical coherence tomography angiography (OCTA). Methods: Forty women in the third trimester of uncomplicated pregnancy and 40 age-matched healthy women were included. Vascular density (VD) in the superficial and deep capillary plexuses (SCP/DCP), foveal density (FD), and foveal avascular zone (FAZ) area and perimetry measured with OCTA, as well as OCT measurements of central macular thickness (CMT) and choroidal thickness (CT) were compared between the groups. Correlations between structural OCT parameters and vascular OCTA metrics were analyzed. Results: The mean gestational age was 34 (28–41) weeks. Mean age was comparable in the groups (p = 0.732). The pregnant women had significantly higher parafoveal DCP-VD (p = 0.015), FAZ area (p = 0.044), and FD (p = 0.002). Mean subfoveal CT was 21 µm higher in pregnant women but was not significant (p = 0.472). There was no difference in CMT (p = 0.448). FAZ metrics were positively correlated with CT in pregnants and with CMT in the control group (p < 0.05). Parafoveal VD was negatively correlated with CT in the control group (p < 0.05). After adjusting for CT and CMT, the significant difference in VD and FD persisted (p < 0.05), while the difference in FAZ area lost significance (p > 0.05). Conclusions: Considering the effects of the probable covariant factors CMT and CT, systemic changes in pregnant women in their third trimester may cause an increase in VD in the macula and parafoveal DCP. © The Author(s) 2020.Item A comparative study of type 1 neovascularization: Neovascular age-related macular degeneration versus pachychoroid neovasculopathy(SAGE Publications Ltd, 2022) Altinisik M.; Kurt E.; Sonmezer P.; Kayikcioglu O.; Ilker S.S.Purpose: This study aimed to compare type 1 choroidal neovascularization (CNV) characteristics in eyes with pachychoroid neovasculopathy (PNV) and neovascular age-related macular degeneration (nAMD) using optical coherence tomography angiography (OCTA). Methods: Treatment naive 23 eyes of 23 patients with PNV and 24 eyes of 24 patients with nAMD were evaluated. The height of pigment epithelial detachment (PED) and the central macular thickness were determined. OCTA sensitivity, CNV area, morphological patterns, and retinal superficial capillary plexus vessel density (SCP-VD) values were compared. The frequency of quiescent CNV, subretinal hyperreflective exudation (SHE), subretinal/intraretinal fluid, serous PED, double-layer sign (DLS), and pachyvessels were noted. Results: CNV was detected on OCTA in 83.3% of nAMD eyes and 91.3% of PNV eyes (p = 0.66). Indistinct pattern was more common (74% vs 50%) and the CNV area (mm2) was smaller in PNV (0.77 ± 0.54 vs 1.57 ± 1.43) but did not reach significant levels (p = 0.27 and 0.33 respectively). SCP-VD was similar between the groups (p = 0.38). Statistically significant differences were found between groups in age and subfoveal choroidal thickness (p < 0.05). DLS and pachyvessels were found to be more frequently in PNV (p < 0.05). However, both groups had similar rates of quiescent CNV, SHE, subretinal/intraretinal fluid, and serous PED (p > 0.05). Conclusion: Morphological features, area, and activation findings of type 1 CNV may play a limited role in differentiating nAMD and PNV cases. © The Author(s) 2021.Item Quantitative analysis of early retinal vascular changes in type 2 diabetic patients without clinical retinopathy by optical coherence tomography angiography(Springer Science and Business Media B.V., 2022) Altinisik M.; Kahraman N.S.; Kurt E.; Mayali H.; Kayikcioglu O.Purpose: To investigate the quantitative differences in optical coherence tomography angiography (OCTA) data between type 2 diabetes patients without clinically detectable diabetic retinopathy (DR) and healthy subjects. Methods: Thirty-nine patients with type 2 diabetes without DR and 41 age- and sex-matched healthy controls were recruited. The vessel density and foveal avascular zone (FAZ) area in the superficial capillary plexus and deep capillary plexus were measured using Nidek RS-3000 Advance® and compared between patient cohorts. Foveal vessel density (%) and FAZ (%) were also calculated. Results: A significant decrease in vessel density has been observed in the deep capillary plexus of the patients compared to healthy individuals (5.58 ± 0.98 mm2 versus 6.15 ± 0.89 mm2, p < 0.001). However, there were no significant differences in other parameters between cohorts (p > 0.05 in all parameters). Despite the decrease of deep capillary plexus density in the macular region, there was no significant change observed in foveal vessel density (p:0.44). It has also been observed that the duration of diabetes mellitus correlates with vessel density decrease in deep capillary plexus (R:–0.52; p < 0.001). In both groups, all parameters in deep capillary plexus were significantly higher than superficial capillary plexus (p < 0.001 for all parameters). Conclusions: OCTA can identify quantitative changes in DCP before the manifestation of clinically apparent retinopathy. DCP-VD reduction may be an earlier finding than FAZ enlargement. Despite the reduction of VD, FVD could be preserved for a certain period of time in DM patients. © 2022, The Author(s), under exclusive licence to Springer Nature B.V.Item Histopathological Results of Conjunctival Masses with Suspected Malignancy Based on Slit-lamp Biomicroscopy(College of Physicians and Surgeons Pakistan, 2023) Erdogan M.; Mayali H.; Malgaz S.; Altinisik M.; Ilker S.S.Objective: To evaluate the histopathological results of conjunctival masses suspected to be malignant based on biomicroscopic examination. Study Design: Observational study. Place and Duration of the Study: Department of Ophthalmology, Celal Bayar University, Hafsa Sultan Hospital, Manisa, Turkiye, from November 2013 to February 2021. Methodology: Patients who underwent excision for the diagnosis and treatment of conjunctival surface masses with clinical suspicion of malignancy were evaluated retrospectively. The masses were categorised as benign, premalignant, and malignant lesions according to the histopathological results. The distribution of conjunctival masses was analysed according to patients’ gender and age groups. Results: The study included 98 conjunctival masses in 98 patients (57.1% men, mean age 48.6±21.85 years). On pathological examination, 63 of the masses were found to be benign (64.3%), 22 were premalignant (22.4%), and 13 were malignant (13.3%). The most common benign lesion was nevus (n=21, 21.4%). All detected premalignant lesions were conjunctival intraepithelial neoplasms (CIN), detected in 22 patients (22.4%). Of these, 13 patients (13.3%) had carcinoma in situ (CIN III). Thirteen (13.3%) of the masses were malignant, the most common being squamous cell carcinoma (n=10, 10.2%). The frequency of premalignant and malignant lesions increased with age (p<0.001). There was no statistical relationship between malignancy and gender (p=0.619). Conclusion: Most conjunctival masses in this series were benign, with nevi being the most common. The most common premalignant and malignant lesions were intraepithelial neoplasia and squamous cell carcinoma, respectively. Malignant conjunctival lesions were more common in older patients. © 2023 College of Physicians and Surgeons Pakistan. All rights reserved.Item Evaluation of Cerebral Vasomotor Reactivity by Transcranial Doppler Ultrasound in Patients with Diabetic Retinopathy(Taylor and Francis Ltd., 2023) Yaman Kula A.; Deniz Ç.; Özdemir Gültekin T.; Altinisik M.; Asil T.The aim of this study was to assess the correlation between cerebral vasomotor reactivity (CVR) and the grade of diabetic retinopathy. A total of 43 diabetic patients with matched severity of diabetic retinopathy between their right and left eyes were included in this study. Diabetic retinopathy was graded in three groups. Right and left middle cerebral artery CVR was assessed by the breath-holding index (BHI) using transcranial Doppler ultrasound (TCD). The mean age of the patients was 56.51 ± 9.34 years with a mean duration of having diabetes mellitus of 14.49 ± 8.06 years. Diabetic retinopathy was graded as mild, moderately severe, and severe in 27.9%, 34.9%, and 37.2% of the patients, respectively. The grade of diabetic retinopathy was associated with the HbA1c level (p <.049), microalbuminuria (p <.024), and BHI (p =.001). In patients with severe diabetic retinopathy, the right-sided BHI was significantly lower as compared to those with mild or moderately severe retinopathy (p =.001 and p =.008, respectively). The left-sided BHI value in patients with severe diabetic retinopathy was significantly lower as compared to those with mild or moderately severe retinopathy (p =.001 and p =.012, respectively). In subjects with moderately severe diabetic retinopathy, both-sided BHI was significantly reduced compared to those with mild retinopathy (p =.001). Our results indicate that the grade of diabetic retinopathy was associated with impaired CVR. © 2023 Taylor & Francis Group, LLC.Item Analysis of the Natural Course of Quiescent Macular Neovascularization with Optical Coherence Tomography Angiography(SAGE Publications Ltd, 2024) Delibay Akgun Y.; Kurt E.; Altinisik M.Purpose: This study investigates the natural progression of quiescent macular neovascularization (qMNV) using optical coherence tomography angiography (OCTA). Methods: The study monitored 30 eyes of 28 qMNV patients over a period of at least six months. Best-corrected visual acuity (BCVA), optical coherence tomography (OCT), and OCTA were used to perform qualitative and quantitative analyses, noting any cases of activation during follow-up. Results: Among the 30 eyes (14 female, mean age 69.70 ± 7.63 years), 21 had age-related macular degeneration (AMD) and 9 had pachychoroid neovasculopathy (PNV). The mean follow-up duration was 18.9 months. There were no significant changes in qualitative morphological features, BCVA, or choroidal thickness (p > 0.05). However, there was a statistically significant increase in the areas of MNV and flow (p = 0.043 and p = 0.018, respectively). BCVA and MNV area showed no significant correlation (p = 0.103). Four cases (13.33%) showed activation after an average follow-up period of 27.75 months (6 to 48). Additionally, extrafoveal location was identified as a significant risk factor for exudation (p = 0.033). Conclusion: OCTA is a valuable tool for monitoring qMNV and identifying potential predictors of disease activation. The qMNV area may increase over time, even in the absence of activation. Extrafoveal location appears to be a potential risk factor for qMNV activation. © The Author(s) 2024.Item Changes in optical coherence tomography angiography measures throughout the day: Diurnal variation or test-retest variability?(Lippincott Williams and Wilkins, 2024) Tekin Altinbay B.; Kurt E.; Altinisik M.Purpose:To evaluate the repeatability and diurnal variation of the retinal vessel density and foveal avascular zone parameters using optical coherence tomography angiography.Methods:Forty-one healthy individuals were measured twice in the morning and once in the evening. Foveal avascular zone area, perimetry, foveal density; superficial and deep capillary plexus (superficial capillary plexus, deep capillary plexus) vessel density, and central macular thickness were evaluated with the intraclass correlation coefficient, coefficient of repeatability, and Bland-Altman plots.Results:Repeatability was evaluated with two consecutive scans taken in the morning. The coefficient of repeatabilities (%) was 5.4; 4.3, and 8.8 for the foveal avascular zone area, perimetry, and foveal density, respectively, with excellent intraclass correlation coefficients. Intraclass correlation coefficient was poor for parafovea (0.33), whereas excellent for fovea (0.97) in superficial capillary plexus-vessel density. Coefficient of repeatability for fovea and parafovea was 19.19% and 10.43%, respectively. Intraclass correlation coefficient values were poor (0.3-0.4) with 10% to 16% measurement differences in deep capillary plexus-vessel density parameters. Coefficient of repeatabilities for central macular thickness was between 1% and 2% with excellent intraclass correlation coefficient. The analysis on diurnal variation yielded comparable results.Conclusion:Except for the parafoveal vessel density, optical coherence tomography angiography is a highly reproducible device for measuring foveal avascular zone and vessel density using 6 × 6 scans with undilated pupils. However, variation in optical coherence tomography angiography parameters observed throughout the day could be attributed to test-retest variation rather than diurnal rhythm. © 2024 Lippincott Williams and Wilkins. All rights reserved.Item Acute Posterior Multifocal Placoid Pigment Epitheliopathy: A Rare Presentation of Anklylosing Spondylitis or a Paradoxical Reaction to Secukinumab?(Taylor and Francis Ltd., 2024) Altinisik M.; Delibay Y.; Erdogan M.Purpose: To describe an atypical presentation of acute posterior multifocal placoid pigment epitheliopathy (APMPPE) in a patient with ankylosing spondylitis (AS) receiving secukinumab. Methods: Retrospective chart review. Results: A 48-year-old female patient with AS receiving secukinumab complained of impaired vision in her left eye. Left eye examination revealed multiple yellow-white lesions at the posterior pole and central subfoveal fluid.The lesions regressed without scarring. The case was diagnosed with clinically APMPPE. Conclusion: In AS patients, posterior uveitis can manifest as APMPPE. It should be recorded as an entity to be considered in the differential diagnosis. © 2023 Taylor & Francis Group, LLC.Item Aspergillus Endogenous Endophthalmitis as a Clue to Identifying a Delayed Lumbosacral Osteomyelitis(Taylor and Francis Ltd., 2025) Altinisik M.; Delibay Akgun Y.; Erdogan M.; Mutawakkil A.F.; Gazi H.Purpose: To present a case of aspergillus-induced endogenous endophthalmitis evolving into delayed lumbosacral osteomyelitis, initially misdiagnosed as ankylosing spondylitis (AS) in an immunocompetent patient. Method: Case Report. Results: A 38-year-old woman, initially treated for pneumonia, experienced sudden loss of vision in her left eye, prompting a thorough examination that revealed a distinct chorioretinal infiltrate. Microbiological analysis of the patient’s vitreous samples detected Aspergillus fumigatus, leading to the diagnosis of endogenous endophthalmitis. Treatment involved vitrectomy, intravitreal injections, and intravenous amphotericin B. Two months later, she was referred for lower back pain, misdiagnosed as AS. Lumbosacral biopsy confirmed Aspergillus involvement once more, necessitating antifungal therapy. Conclusion: This case highlights the atypical progression of Aspergillus-induced endogenous endophthalmitis to delayed lumbosacral osteomyelitis in an immunocompetent individual. It highlights the crucial role of a meticulous medical history examination and interdisciplinary collaboration in diagnosing and managing diseases, especially in cases with atypical presentations. © 2024 Taylor & Francis Group, LLC.