Researcher:
Akbay, Aylin Koç

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Doctor

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Aylin Koç

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Akbay

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Akbay, Aylin Koç

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2016 - 20186

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    Quantitative analysis of structural alterations in the choroid of patients with active Behçet uveitis
    (Lippincott Williams and Wilkins (LWW), 2018) Oray, Merih; Herbort, Carl P.; Akman, Mehmet; Tugal-Tutkun, Ilknur; Department of Mathematics; N/A; N/A; N/A; N/A; Mengi, Emre; Önal, Sumru; Uludağ, Günay; Metin, Mustafa Mert; Akbay, Aylin Koç; Faculty Member; Other; Doctor; Undergraduate Student; Doctor; Department of Mathematics; College of Sciences; School of Medicine; N/A; School of Medicine; N/A; N/A; N/A; Koç University Hospital; N/A; Koç University Hospital; 113760; 52359; N/A; N/A; N/A
    Purpose: To quantitatively analyze in vivo morphology of subfoveal choroid during an acute attack of Behcet uveitis. Methods: In this prospective study, 28 patients with Behcet uveitis of <= 4-year duration, and 28 control subjects underwent enhanced depth imaging optical coherence tomography. A novel custom software was used to calculate choroidal stroma-to-choroidal vessel lumen ratio. Subfoveal choroidal thickness was measured at fovea and 750 mu m nasal, temporal, superior, and inferior to fovea. Patients underwent fluorescein angiography and indocyanine green angiography. Receiver operating characteristic curve and area under the curve were computed for central foveal thickness. The eye with a higher Behcet disease ocular attack score 24 was studied. The main outcome measures were choroidal stromato-choroidal vessel lumen ratio and choroidal thickness. Results: The mean total Behcet disease ocular attack score 24, fluorescein angiography, and indocyanine green angiography scores were 7.42 +/- 4.10, 17.42 +/- 6.03, and 0.66 +/- 0.73, respectively. Choroidal stroma-to-choroidal vessel lumen ratio was significantly higher in patients (0.413 +/- 0.056 vs. 0.351 +/- 0.063, P = 0.003). There were no significant differences in subfoveal choroidal thickness between patients and control subjects. Choroidal stroma-tochoroidal vessel lumen ratio correlated with retinal vascular staining and leakage score of fluorescein angiography (r = 0.300, P = 0.036). Central foveal thickness was significantly increased in patients (352.750 +/- 107.134 mu m vs. 263.500 +/- 20.819 p.m, P < 0.001). Central foveal thickness showed significant correlations with logarithm of minimum angle of resolution vision, Behcet disease ocular attack score 24, total fluorescein angiography score, retinal vascular staining and/or leakage and capillary leakage scores of fluorescein angiography, and total indocyanine green angiography score. At 275 mu m cutoff, diagnostic sensitivity and specificity of central foveal thickness for acute Behcet uveitis were 89% and 72%, respectively (area under the curve = 0.902; 95% CI = 0.826-0.978, P < 0.001). Conclusion: There was choroidal stromal expansion which was not associated with thickening of the choroid. Central foveal thickness may be used as a noninvasive measure to assess inflammatory activity in early Behcet uveitis.
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    Interferon alpha for the treatment of cystoid macular edema associated with presumed ocular tuberculosis
    (Mary Ann Liebert, Inc, 2017) Oray, Merih; Tuğal Tutkun, İlknur; N/A; Önal, Sumru; Uludağ, Günay; Akbay, Aylin Koç; Other; Doctor; Doctor; N/A; Koc University Hospital; Koc University Hospital; Koc University Hospital; 52359; N/A; N/A
    Purpose: To report the efficacy and safety of interferon (IFN) alpha-2a in patients with cystoid macular edema (CME) associated with presumed ocular tuberculosis (TB). Methods: We reviewed the clinical records of 5 patients with presumed ocular TB who had been treated with IFN alpha-2a for recurrent CME during or after completion of anti-tubercular therapy. IFN alpha-2a was administered at an initial dose of 3 million IU per day and then tapered after the initial response. Treatment efficacy was assessed by central macular thickness (CMT) measurement using spectral-domain optical coherence tomography and visual acuity. Results: Three patients were men, and 2 were women. Patients were aged between 38 and 66 years. Mean CMT was 483 +/- 178.6 mm at baseline, 302.3 +/- 56 mm at 1 week, 312.3 +/- 49.5 mm at 1 month, and 286.2 +/- 31.9 mm at 3 months. Mean LogMAR visual acuity was 0.6 +/- 0.4 at baseline, 0.4 +/- 0.3 mm at 1 week, 0.3 +/- 0.3 at 1 month, and 0.3 +/- 0.3 at 3 months. The treatment was interrupted for 10 days because of neutropenia after 2 weeks in 1 patient and discontinued in another after 10 days because of intolerance. Total treatment duration was 3-24 months in the remaining 4 patients. Conclusion: The present small case series suggests that IFN alpha-2a may be an effective and safe therapeutic option for CME that is associated with presumed ocular TB.
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    Electroretinographic improvement after rituximab therapy in a patient with autoimmune retinopathy
    (Elsevier, 2016) Arf, Serra; Sayman Muslubaş, Işıl; N/A; N/A; N/A; N/A; N/A; Uludağ, Günay; Önal, Sumru; Selçukbiricik, Fatih; Akbay, Aylin Koç; Mandel, Nil Molinas; Doctor; Other; Faculty Member; Doctor; Faculty Member; N/A; School of Medicine; School of Medicine; N/A; School of Medicine; Koc University Hospital; N/A; N/A; Koc University Hospital; N/A; N/A; 52359; 202015; N/A; 194197
    Purpose: To describe the effect of rituximab on full-field electroretinography (ERG) in a patient with nonparaneoplastic autoimmune retinopathy (npAIR). Observations: A 58-year-old male patient with visual complaints, positive anti-retinal antibodies and negative work-up for cancer was diagnosed with npAIR. Visual acuity and ancillary tests were normal except abnormal ERG in both eyes. The patient was given one course of rituximab 375 mg/m2/week for 4 weeks and cyclophosphamide 1 gr/m2/month for 6 months. A second course of rituximab was necessary as autoantibody titers showed no change and as new antibodies were noted after treatment with rituximab and cyclophosphamide. Electroretinography was repeated after the first course of rituximab, after cyclophosphamide, and the second course of rituximab therapy. Conclusions and Importance: Rituximab therapy led to marked improvement in full-field ERG readings and regression of symptoms was reported by the patient after rituximab infusions. The effect of rituximab in npAIR was objectively demonstrated with ERG.
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    Screening for depression and anxiety in patients with active uveitis
    (Taylor and Francis Inc, 2018) Oray, Merih; Akman, Mehmet; Tugal-Tutkun, Ilknur; N/A; Önal, Sumru; Yasa, Çağla; Uludağ, Günay; Akbay, Aylin Koç; Other; N/A; Doctor; Doctor; N/A; Koc University Hospital; Koc University Hospital; Koc University Hospital; Koc University Hospital; 52359; N/A; N/A; N/A
    Purpose: To screen for psychological disorders in patients with active uveitis. Methods: Patients were screened for depression (BDI-II), state anxiety (STAI-I), VR-QOL (NEI-VFQ-25), and HR-QOL (SF-36). Association of depression and anxiety with sociodemographic and clinical parameters and with VR-QOL and HR-QOL were analyzed. Multivariate linear regression models were constructed for NEI-VFQ-25 and SF-36 subscales. Results: of 99 patients, 37.3% screened positive for depression and 52.5% for anxiety. Depressed patients had lower visual acuity in the better seeing eye (p = 0.013) and more frequently panuveitis (p = 0.018). Anxious patients were younger (p = 0.009), had earlier onset of uveitis (p = 0.015), and had more frequently panuveitis (p = 0.016). Bivariate comparisons showed significant associations between psychological disorders and VR-QOL and HR-QOL. Significant bivariate associations were mostly lost in multivariate analyses for anxiety, but were preserved for depression. Conclusions: A positive screening test for depression and anxiety is common in patients with uveitis. Low vision and panuveitis are associated with depression. Depression is associated with impairment of VR-QOL and HR-QOL.
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    PublicationOpen Access
    Quantitative analysis of structural alterations in the choroid of patients with active Behçet uveitis
    (Lippincott Williams and Wilkins (LWW), 2018) Oray, Merih; Herbort, Carl P.; Akman, Mehmet; Tuğal Tutkun, İlknur; Department of Mathematics; Önal, Sumru; Uludağ, Günay; Mengi, Emre; Metin, Mustafa Mert; Akbay, Aylin Koç; Other; Faculty Member; Department of Mathematics; School of Medicine; College of Sciences; Koç University Hospital; 52359; 175586; 113760; N/A; N/A
    Purpose: To quantitatively analyze in vivo morphology of subfoveal choroid during an acute attack of Behçet uveitis. Methods: In this prospective study, 28 patients with Behçet uveitis of <= 4-year duration, and 28 control subjects underwent enhanced depth imaging optical coherence tomography. A novel custom software was used to calculate choroidal stroma-to-choroidal vessel lumen ratio. Subfoveal choroidal thickness was measured at fovea and 750 mu m nasal, temporal, superior, and inferior to fovea. Patients underwent fluorescein angiography and indocyanine green angiography. Receiver operating characteristic curve and area under the curve were computed for central foveal thickness. The eye with a higher Behçet disease ocular attack score 24 was studied. The main outcome measures were choroidal stromato-choroidal vessel lumen ratio and choroidal thickness. Results: The mean total Behçet disease ocular attack score 24, fluorescein angiography, and indocyanine green angiography scores were 7.42 +/- 4.10, 17.42 +/- 6.03, and 0.66 +/- 0.73, respectively. Choroidal stroma-to-choroidal vessel lumen ratio was significantly higher in patients (0.413 +/- 0.056 vs. 0.351 +/- 0.063, P = 0.003). There were no significant differences in subfoveal choroidal thickness between patients and control subjects. Choroidal stroma-tochoroidal vessel lumen ratio correlated with retinal vascular staining and leakage score of fluorescein angiography (r = 0.300, P = 0.036). Central foveal thickness was significantly increased in patients (352.750 +/- 107.134 mu m vs. 263.500 +/- 20.819 p.m, P < 0.001). Central foveal thickness showed significant correlations with logarithm of minimum angle of resolution vision, Behçet disease ocular attack score 24, total fluorescein angiography score, retinal vascular staining and/or leakage and capillary leakage scores of fluorescein angiography, and total indocyanine green angiography score. At 275 mu m cutoff, diagnostic sensitivity and specificity of central foveal thickness for acute Behçet uveitis were 89% and 72%, respectively (area under the curve = 0.902; 95% CI = 0.826-0.978, P < 0.001). Conclusion: There was choroidal stromal expansion which was not associated with thickening of the choroid. Central foveal thickness may be used as a noninvasive measure to assess inflammatory activity in early Behçet uveitis.
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    PublicationOpen Access
    Diverse clinical signs of ocular involvement in cat scratch disease
    (Türk Oftalmoloji Derneği, 2017) Oray, Merih; Tutkun, İlknur Tuğal; Önal, Sumru; Akbay, Aylin Koç; Other; School of Medicine; Koç University Hospital; 52359; N/A
    Objectives: To describe ocular manifestations, diagnosis, and treatment of cat scratch disease. Materials and Methods: Clinical records of patients with ocular cat scratch disease were reviewed. Results: Thirteen eyes of 10 patients (7 female, 3 male) with a mean age of 26.9 +/- 18.5 years were included. Nine patients had a history of cat contact and had systemic symptoms associated with cat scratch disease 2-90 days prior to the ocular symptoms. Ocular signs were: neuroretinitis in 4 eyes (associated with serous retinal detachment in the inferior quadrant in 1 eye), optic neuropathy in 2 eyes (1 papillitis and optic disc infiltration, 1 optic neuritis), retinal infiltrates in 6 eyes, retinochoroiditis in 1 eye, branch retinal arteriolar occlusion in 3 eyes, and endophthalmitis in 1 eye. Visual acuities at presentation were 1.0 in 7 eyes, 0.3 in 1 eye, = 0.1 in 4 eyes, and light perception in 1 eye. Bartonella henselae immunoglobulin (Ig) M and/or IgG were positive in all patients. Systemic antibiotic therapy was administered in all patients. Systemic corticosteroid treatment (15-40 mg/day) was added to the therapy in 4 patients, following 5 days of intravenous pulse methylprednisolone in 2 patients. Treatment was ongoing for 1 patient and the mean treatment duration of the other 9 patients was 47 +/- 14.5 days. Visual acuities at final visit were 1.0 in 9 eyes, 0.8 in 1 eye, 0.4 in 1 eye, and no light perception in 1 eye. Conclusion: Cat scratch disease may present with different ocular signs and should be considered in the differential diagnosis in patients with such presentations. / Amaç: Kedi tırmığı hastalığı oküler tutulumu olan hastaların klinik bulguları, tanı ve tedavi yaklaşımlarının değerlendirilmesidir. Gereç ve Yöntem: Kedi tırmığı hastalığına bağlı oküler tutulumu olan olguların klinik kayıtları incelendi. Bulgular: Çalışmaya yaş ortalaması 26,9±18,5 yıl olan 10 hastanın (7 kadın, 3 erkek) 13 gözü dahil edildi. Dokuz hastada kedi teması hikayesi olup hastaların göz şikayetleri başlamadan 2-90 gün önce kedi tırmığı hastalığı ile ilişkili sistemik semptomları vardı. Klinik bulgular, 4 gözde nöroretinit (1 gözde alt periferde seröz retina dekolmanı eşlik etmekte), 2 gözde optik nöropati (1 papillit ve optic disk infiltrasyonu, 1 optik nörit), 6 gözde retinal infiltratlar, 1 gözde retinokoroidit ve 3 gözde retinal arter dal tıkanıklığı, 1 gözde endoftalmi şeklindeydi. Başvuru anında görme keskinliği 7 gözde 1,0, 1 gözde 0,3, 4 gözde ≤0,1 ve 1 gözde ışık hissi düzeyindeydi. Tüm hastalarda Bartonella henselae immünoglobülin (Ig) M ve/veya IgG pozitif idi. Tüm hastalara antibiyotik tedavisi uygulandı. İki hastaya 5 gün pulse metilprednizolon intravenöz tedaviyi takiben ve 4 hastaya 15-40 mg/gün dozunda oral kortikosteroid tedavisi de eklendi. Bir hastanın tedavisi devam etmekte ve kalan 9 hastanın ortalama toplam tedavi süresi 47±14,5 gündü. Son vizitte görme keskinliği 9 gözde 1,0, 1 gözde 0,8, 1 gözde 0,4 ve 1 gözde ışık negatifti.Sonuç: Kedi tırmığı hastalığı farklı oküler tutulum bulguları ile karşımıza çıkabilen ve bu tablolarda ayırıcı tanıda akılda bulundurulması gereken bir hastalıktır.