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Öğe An important contributing factor in dry eye disease: somatization(Springer, 2024) Yavrum, Fuat; Ezerbolat Ozates, Melike; Ozates, SerdarPurposeSomatization is an important mental process that may causes medically unexplained and treatment-resistant somatic symptoms. The aim of the study is assess the presence of somatization in patients with dry eye disease (DED).MethodsEighty-eight patients with no objective DED finding and ongoing DED treatment were included in this prospective and observational study. Patients with subjective symptoms formed the symptom group and patients without subjective symptoms formed the control group. All patients were scored with the Turkish version of the Ocular Surface Disease Index (OSDI), Hamilton Depression Rating Scale (HAM-D), Hamilton Anxiety Rating Scale (HAM-A), Symptom Checklist-90-R (SCL-90R) somatization subscale, Toronto Alexithymia Scale (TAS), Pain Catastrophizing Scale (PCS), and Symptom Interpretation Questionnaire (SIQ).ResultsMean OSDI score was significantly higher in the symptom group than in the control group. The mean HAM-D and HAM-A outcomes did not differ between the groups. The mean SCL-90R somatization subscale, TAS, and PCS scores were significantly higher in the symptom group than in the control group. In the SIQ, somatic attributional style score was significantly higher in the symptom group than in the control group. The SCL-90R somatization subscale, PCS, and somatic attributional style scores had positive and mild-moderate correlation with OSDI scores in the symptom group. The TAS score had positive and moderate correlation with OSDI scores in all sample analyses.ConclusionSomatization should be considered in patients with DED with chronic ocular surface symptoms. Presence of subjective symptoms resistant to treatment may be an indicator of somatization.Öğe Aripiprazole-Related Acute Myopia A Case Report(Lippincott Williams & Wilkins, 2025) Sinanoglu, Gokce Kavak; Yavrum, Fuat[Abstract Not Available]Öğe Choroidal thickness and choroidal vascular index in childhood malnutrition(Elsevier Science Inc, 2025) Sukun, Elmas Yuksel; Yavrum, Fuat; Yavrum, BegumObjectives: Malnutrition is a global health issue affecting growth and systemic health in children, yet its impact on the choroid-a vascular layer essential for retinal nourishment-remains underexplored. This study evaluates the choroidal vascular index (CVI) and choroidal thickness in malnourished children compared to healthy controls using optical coherence tomography (OCT). It also examines the relationship between these parameters and nutritional markers, including serum ferritin, vitamin B12, vitamin D, and hemoglobin levels. Methods: This cross-sectional study involved 52 malnourished and 40 healthy children aged 6-16 years. Malnutrition severity was categorized as mild, moderate, or severe based on WHO BMI criteria. Choroidal parameters were measured using spectral-domain optical coherence tomography (SD-OCT). Statistical analysis compared CVI and thickness between groups and assessed correlations with malnutrition severity and nutritional markers. Results: CVI was significantly lower in malnourished children compared to controls (P < 0.05), while choroidal thickness showed no significant difference (P > 0.05). CVI negatively correlated with malnutrition severity (r = -0.45, P < 0.01). Ferritin and vitamin D levels were positively associated with CVI (P < 0.001), whereas vitamin B12 showed no significant relationship. Lower hemoglobin levels were linked to vascular compromise. Conclusions: Malnutrition adversely affects CVI, even in early stages, suggesting it as a marker of choroidal vascular compromise. Micronutrients, particularly ferritin and vitamin D, appear protective. Monitoring choroidal parameters and addressing nutritional deficiencies may help prevent ocular complications in malnourished children. (c) 2025 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.Öğe Does corneal epithelial thickness show the severity of psoriasis? SD-OCT study(2023) Güneş, İrfan Botan; Aksoy, Berna; Öztürk, Hakan; Yavrum, Fuat; Özen, BedizBackground: Previous studies have generally focused on dry eye test abnormalities and ocular involvements such as uveitis, and blepharitis in psoriasis. Psoriasis area severity ındex (PASI), which is used to assess psoriasis severity, is a time-consuming and complex tool. Objective: To evaluate the relationship between disease severity and central corneal epithelial thickness (CCET) in psoriasis. Methods: 175 eyes of 175 psoriasis patients and 57 eyes of 57 healthy individuals as a control group was included in this study. Psoriasis patients were divided into three subgroups according to PASI score as < 10 mild, 10---20 moderate and > 20 severe. CCET was measured by spectral domain-optical coherence tomography (SD-OCT), and mean values were recorded. Mean CCET values were compared between the psoriasis groups and the control group. Additionally, the relationship between PASI score and CCET was examined. Results: The mean CCET value was 58.06 ± 3.1m in the mild group, 60.10 ± 5.0m in the moderate group, 65.75 ± 6.3m in the severe group and 56.16 ± 3.1m in the control group. It was determined that the mean CCET value was significantly higher in all psoriasis groups compared to the control group (p < 0.001). The mean CCET value was significantly higher in the moderate psoriasis group than in the mild psoriasis group (p = 0.018), and in the severe psoriasis group compared to the moderate psoriasis group (p < 0.001). There was a strong positive correlation between PASI score and CCET (p < 0.001, r = 0.519). Study limitations: Cross-sectional design and a relatively small number of participants. Conclusions: There is a strong positive correlation between psoriasis severity and CCET. Contactless measurement of CCET by SD-OCT can be an indicator of psoriasis severity. © 2023 Sociedade Brasileira de Dermatologia. Published by Elsevier Espana, ˜ S.L.U. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).Öğe Evaluation of meibomian glands in childhood malnutrition(Nature Portfolio, 2025) Yavrum, Fuat; Yavrum, Begum; Yuksel-Sukuen, Elmas; Sahinoglu-Keskek, NedimeChildhood malnutrition is a condition that affects a large population and can have significant implications for eye health. Our study aims to assess the impact of childhood malnutrition to the ocular surface by evaluating meibomian gland morphology and function. This study included 92 patients aged 6-18 years, with 52 diagnosed with malnutrition and 40 serving as healthy controls. Patients' nutritional status was determined based on body mass index (BMI) according to WHO criteria. Meibomian gland morphology and function were assessed using non-invasive imaging techniques and clinical evaluations along with the bloodwork results, including serum ferritin, hemoglobin, serum 25-hydroxyvitamin D, and vitamin B12 levels. Children with malnutrition exhibited significantly lower mean BMI, hemoglobin, serum 25-hydroxyvitamin D, serum ferritin levels and significantly worse meibomian gland loss (MGL) compared to healthy controls (p < 0.001 for all). However, differences in mean non-invasive tear break-up time (NI-BUT) and vitamin B12 levels were not statistically significant. Subgroup analysis based on malnutrition severity revealed no significant differences in MGL or NI-BUT levels. Negative correlations were observed between BMI and MGL, as well as between MGL and serum ferritin and 25-hydroxyvitamin D levels (p < 0.001 for all). This study provides novel insights into the ocular consequences of malnutrition in children, highlighting significant alterations in meibomian gland morphology and function associated with nutritional deficiencies. These findings may inform targeted interventions to reduce ocular morbidity and improve the overall health outcomes of malnourished children.Öğe How does high-refractive error affect quantitative pupillometry values?(2025) Kocabas, Dilara Ozkoyuncu; Yavrum, FuatPURPOSE: To evaluate the static and dynamic pupil responses in differentiating eyes with high-refractive errors from emmetropic controls. METHODS: The study was conducted using data obtained from 36 participants with high myopia, 26 participants with high hyperopia, and 38 age-gender-matched controls. The cycloplegic spherical equivalent refraction (SER), axial length (AL), and pupil responses were examined. In static pupillometry, pupil diameters were recorded at scotopic, mesopic, and photopic light intensities. The mean pupil dilation speed was calculated according to changes in pupil size over time, as dynamic pupillometry. RESULTS: The mean scotopic and mesopic pupil diameters were smaller in high hyperopic eyes compared with high myopic and control eyes (P < 0.05). The photopic pupil diameter in the high hyperopic group was significantly lower than in the high myopic group (P = 0.003). There was no statistical difference between the high myopia and control groups regarding static pupillometry (P > 0.05). No significant difference was noted between the refractive groups regarding the speed of pupil dilation (P = 0.241). While SER and AL were correlated with scotopic and mesopic pupil diameters (P < 0.05), no correlation was observed with photopic pupil diameter or the speed of pupil dilation (P > 0.05). CONCLUSIONS: The difference in static pupil responses was prominent in high hyperopic eyes compared to high myopic and emmetropic eyes. Unlike static pupil responses, the speed of pupil dilation was not affected by high-refractive errors. © © 2025 Indian Journal of Ophthalmology.Öğe Impact of malnutrition on pupillary responses in pediatric population(Sage Publications Ltd, 2026) Kocabas, Dilara Ozkoyuncu; Yavrum, Fuat; Sukun, Elmas Yuksel; Yavrum, BegumPurpose : To investigate the effect of nutritional status on pupillary responses in children aged 5 to 18 years. Methods : This cross-sectional study comprised 92 eyes of malnourished children and 80 eyes of age- and gender-matched healthy children based on BMI Z-score. Serum ferritin, hemoglobin, serum 25-hydroxyvitamin D, and vitamin B12 levels were recorded. Pupillary responses were taken using Sirius topography (CSO, Italy) with the automated pupillometry function. Static pupillometry consisted of pupil diameters at scotopic, mesopic, and photopic luminances. In dynamic pupillometry, the mean pupil dilation speed at the 10th second was calculated by dividing the distance by time in each 0.2 s period. Results : No significant difference was observed between the groups regarding age, gender, visual acuity, and spherical equivalent (p > 0.05). Mean hemoglobin, serum ferritin, serum 25-hydroxyvitamin D, and vitamin B12 levels were lower in malnourished children than healthy children (p < 0.001). The malnutrition group had lower mean pupil diameters under all luminance and higher speed of pupil dilation compared to the control group (p < 0.05). While malnutrition subgroups were similar in terms of pupil diameters under all luminance (p > 0.05), the speed of pupil dilation was significantly different between the groups (p = 0.024). BMI z-score was positively correlated with mesopic and photopic pupil diameter but also negatively correlated with the speed of pupil dilation (p < 0.05). Conclusion : Malnourished children have smaller pupil diameters and higher speed of pupil dilation than healthy controls, indicating an autonomic impairment.Öğe Is ChatGPT a Useful Tool for Ophthalmology Practice?(2024) Yavrum, Fuat; Kocabaş, Dilara ÖzkoyuncuAim: This study aimed to assess ChatGPT-3.5's performance in ophthalmology, comparing its responses to clinical case-based and multiple-choice (MCQ) questions. Methods: ChatGPT-3.5, an AI model developed by OpenAI, was employed. It responded to 98 case-based questions from \"Ophthalmology Review: A Case-Study Approach\" and 643 MCQs from \"Review Questions in Ophthalmology\" book. ChatGPT's answers were compared to the books, and statistical analysis was conducted. Results: ChatGPT achieved an overall accuracy of 56.1% in case-based questions. Accuracy varied across categories, with the highest in the retina section (69.5%) and the lowest in the trauma section (38.2%). In MCQ, ChatGPT's accuracy was 53.5%, with the weakest in the optics section (32.6%) and the highest in pathology and uveitis (66.7% and 63.0%, respectively). ChatGPT performed better in case-based questions in the retina and pediatric ophthalmology sections than MCQ. Conclusion: ChatGPT-3.5 exhibits potential as a tool in ophthalmology, particularly in retina and pediatric ophthalmology. Further research is needed to evaluate ChatGPT's clarity and acceptability for open-ended questions.Öğe Meibomian gland changes and influencing factors following cataract surgery(Springer, 2025) Yavrum, Fuat; Alcikaya, Berra; Acar, Aysegul; Sahinoglu-Keskek, NedimePurpose Meibomian gland dysfunction (MGD) is a leading cause of evaporative dry eye disease (DED), and its exacerbation after cataract surgery has been reported. This study aims to evaluate meibomian gland (MG) morphological and functional changes following cataract surgery and identify influencing factors. Methods This prospective, observational study included 132 patients who underwent phacoemulsification with intraocular lens implantation. Meibomian gland loss (MGL) and non-invasive tear break-up time (NI-BUT) were assessed preoperatively at postoperative week one, and at month one using a corneal topography device via infrared meibography (Sirius, CSO, Italy). Correlations between MGL, NI-BUT, cataract grade, and surgery duration were analyzed. Results Postoperatively, MGL increased at week one (32.0% +/- 15.1) and month one (30.9% +/- 14.5) compared to preoperative values (15.1% +/- 7.0). NI-BUT decreased at both time points (week one: 6.8 s +/- 4.3; month one: 6.7 s +/- 4.6; preoperative: 9.4 s +/- 4.5). A significant correlation was found between increased MGL and longer surgery duration (p < 0.001). ROC analysis identified a surgical duration threshold of 11.5 min, beyond which MGL changes were more pronounced. Conclusions Cataract surgery induces significant MG changes, with increased MGL and reduced NI-BUT postoperatively. Longer surgical duration is a key risk factor for MG deterioration. These findings highlight the importance of ocular surface management in cataract surgery to improve postoperative outcomes.Öğe Optical quality of the cornea one year after Cretan protocol plus in eyes with keratoconus(Taylor & Francis Ltd, 2025) Kocabas, Dilara Ozkoyuncu; Yavrum, Fuat; Ozulken, KemalClinical relevance Cretan protocol plus is a novel technique that combines corneal cross-linking with refractive procedures in patients with keratoconus. Visual improvement is not only limited to visual acuity, the optical quality may also be enhanced by the Cretan protocol. Background To evaluate the higher-order aberrations (HOAs) and optical quality of the cornea 1 year after the Cretan protocol plus in keratoconus patients. Methods The uncorrected (UDVA) and corrected (CDVA) distance visual acuity, manifest refraction spherical equivalent (MRSE), and topographical analysis of the cornea were assessed. The corneal optical quality parameters, including total HOA (Z(3-8)), vertical coma (Z(3)(-1)), horizontal coma (Z(3)(1)), vertical trefoil (Z(3)(-3)), oblique trefoil (Z(3)(3)), and spherical aberration (Z(4)(0)), modulation transfer function (MTF) and Strehl ratio of point spread function (PSF) over the 4 mm diameter pupil were recorded via Sirius dual-scanning corneal tomography. All data were analysed preoperatively, 1 month, 6 months, and 1 year postoperatively. Results Twenty eyes of 16 keratoconus patients with 1 year of follow-up were included. After the Cretan protocol plus, the mean UDVA, CDVA, MRSE, corneal astigmatism, simulated keratometry-1, simulated keratometry-2, and maximum keratometry (Kmax) improved significantly throughout the follow-up visits (p < 0.001). Total HOA, vertical coma, and spherical aberration were significantly reduced at 1 year compared with the preoperative values (p < 0.05). Vertical coma was decreased from preoperative to all postoperative time points (p = 0.009). Regarding optical quality, MTF 5 and MTF 10 at both the vertical and horizontal meridians were significantly increased 1 year after the Cretan protocol plus compared to preoperatively (p < 0.05). Significant improvements in the PSF occurred at all postoperative time points (p < 0.001). Conclusions The Cretan protocol plus is more efficient in improving optical quality while reducing corneal aberrations in keratoconus patients. Vertical coma and PSF could be objective indicators of optical performance after this procedure.Öğe Sosyodemografik koşulların genç erişkinlerdeki gözlük tedavisine uyum üzerine etkilerinin incelenmesi(2023) Yavrum, Fuat; İlhan, ÇağrıAim: To investigate the effects of several sociodemographic conditions on adherence to spectacles treatment in adolescents. Material and Methods: 10-19-year-old otherwise healthy adolescents who had been prescribed spectacles at least one year ago were included in this study. To quantitatively evaluate adherence to spectacles treatment, patients were asked to mark along a visual analog scale and the result was noted as an adherence score (AS). Sociodemographic conditions that have potential to affect adherence to spectacles treatment were questioned. Results: This study includes 107 patients and the mean age of patients was 14.83 ± 2.75 years (10-19). The mean AS was 8.59 ± 2.21 (3-10) for mothers with a higher educational degree, and 6.85 ± 3.14 (0-10) for mothers with a lower educational degree (p =0.018). Similarly, the mean AS was 8.45 ± 2.40 (3-10) for fathers with a higher educational degree and 6.94 ± 3.08 (0-10) for fathers with a lower educational degree (p =0.033). According to logistic regression analysis, a higher educational degree in fathers was associated with 8 and more AS (odds ratio: 4.17, 95% confidence interval 1.14-15.25, and p =0.031). There was no significant difference in AS according to conditions regarding whether or not to use spectacles in a family and social environment (p >0.05, for all). Conclusion: It was concluded that higher parental educational level is associated with higher adherence to spectacles treatment in adolescents.Öğe Uzaktan Eğitim Sürecinin 6-13 Yaş Arası Çocuklarda Miyopi Progresyonuna Etkisi: Olgu Kontrol Çalışması(2023) Güneş, İrfan Botan; Yavrum, FuatAmaç: Koronavirüs hastalığı-2019 [coronavirus disease-2019 (COVID-19)] pandemisi döneminde, uzaktan eğitim sürecinin çocuk- larda miyopi progresyonuna etkisini araştırmaktır. Gereç ve Yöntem- ler: Mart 2020-Eylül 2021 tarihleri aras ında, klini ğimizde miyopi nedeni ile takip edilmiş 6-13 yaş arasındaki 144 hastanın 144 gözü pan- demi grubu olarak, Mart 2018-Eylül 2019 tarihleri aras ında yüz yüze eğitim görmüş ve miyopi nedeni ile takip edilmiş aynı yaş grubundaki 134 hastanın 134 gözü kontrol grubu olarak çalışmaya dâhil edildi. Her iki gruptaki hastaların 1 ve 2. muayenelerindeki siklopleji sonrası oto- refraktometri ölçümleri kaydedildi ve sferik e şdeğer değerleri hesap- landı. Kat ılımcıların aç ık alanda ve ekran kar şısında geçirdikleri ortalama süre sorguland ı ve kaydedildi. Ortalama sferik e şdeğer de- ğerlerindeki değişim gruplar arasında ve grupların kendi içerisinde kar- şılaştırıldı. Bulgular: Birinci ölçümde pandemi grubunda ortalama sferik eşdeğer -0,59±1,9 dioptri (D), 2. ölçümde -1,15±2,1 D olarak he- saplandı (p<0,001). Kontrol grubunda 1. ölçümde ortalama sferik e ş- değer -0,61±2,0 D, 2. ölçümde -0,97±2,2 D olarak saptandı (p=0,002). Bir ve 2. ölçüm arasındaki ortalama sferik eşdeğer farkı pandemi gru- bunda -0,56±0,8 D iken, kontrol grubunda -0,36±0,9 D olarak saptandı. Pandemi grubunun ortalama sferik eşdeğerindeki değişim kontrol gru- buna göre anlamlı düzeyde yüksek saptandı (p<0,001). Açık alanda ge- çirilen süre açısından 2 grup arasında anlamlı farklılık olmadığı görüldü (p=0,102). Ekran kar şısında geçirilen süre pandemi grubunda günlük ortalama 5,86±1,8 saat, kontrol grubunda 1,24±0,8 saat olarak saptandı (p<0,001). Sonuç: Çalışmamızda, COVID-19 pandemisi döneminde uygulanan uzaktan eğitim sürecinin çocuklarda miyopi progresyonunu artırdığını saptadık. Gelecekte benzer durumlar yaşanır ise toplum göz sağlığı açısından bu durumun dikkate al ınması gerektiğini düşünüyo- ruz.
