Consultant Umur Kayabasi, MD Neuroophthalmology

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1 Consultant Umur Kayabasi, MD Neuroophthalmology Total A- B- 464,1 294,22 169,88 A - JOURNAL 28,5 28,5 A 2 / 1. Kayabasi AU, Sergott RC. OCT and FAF in the Early Diagnosis of Alzheimer's Disease. Neurobiology of Aging 2013; 35(4): Abstract: OCT and FAF in the Early Diagnosis of Alzheimer's Disease A. Umur Kayabasi1, Robert C. Sergott2, 1Istanbul University, Istanbul, Turkey; 2Thomas Jefferson University, Department of Neuro-Ophthalmology, Philadelphia, Pensylvania, USA. Objectives. Optical coherence tomography (OCT) macula- retina exam and fundus autoflorescence (FAF) test give us extremely important clues about neurodegenerative diseases. Since the retina and optic nerve share similar tissues with the brain, any defect detected by OCT and FAF may also be related to a disease of the nervous system. It has been proposed that beta-amyloid, which causes Alzheimer s disease (AD) in the brain, may be observed in different tissues of the eye (lens, etina etc.) many years earlier. Methods. We examined 14 patients with a family history of AD and all of whom ( 1 patient with no cognitive defect) had only minor cognitive dysfunction. Results. FAF exam of the retina revealed suspected egions and OCT exam through these retinal lesions revealed plaque deposition in the ganglion layer of the retina. Many plaque deposits colocalized with drusen due to age related macular degeneration. Conclusions. We believe that these deposits an be signs of AD and contain beta-amyloid. They are located in the inner parts of the retina, mostly the ganglion layer and are different from the localization of drusen alone. It is our thought that comprehensive retinal exam should be a part of the neurological exam in AD and similar neurodegenerative diseases. The detection of plaques in the retina may help us with early diagnosis of AD A Kayabasi AU. Different optic neuropathies and novel treatments.journal of Clinical & Experimental Ophthalmology.Open Access; Published September 23, 2013 Abstract: The aim of this workshop is to discuss the diagnosis, treatment and follow- up of different optic neuropathies. Meanwhile, images from the new technology devices like OCT and the conventional machines like Perimetry will be shown. Also, MR images of the orbit and brain and images of optic nerve problems will be the subjects of the main topic. There are ome new developments in the treatment of the optic neuropathies and different ideas about novel treatments will be shared. OPTİC NEUROPATHİES: - Optic neuritis (demyelination of the optic nerve): Acute, painful vision loss. Occurs mainly in women within the age range of Responds well to high dose intravenous steroids. Approximately 1/3 of the cases are seen with disc edema, 2/3 are retrobulber. Retrobulber cases progress to multiple sclerosis (MS) more frequently. The possibility of a woman patient to develop MS after isolated optic neuritis is about 70% in ten years. The progression of optic neuritis to MS an be detected by OCT. - Anterior ischemic optic neuropathy (non-arteritic): Acute, painless visual loss due to a stroke on the optic nerve head. Disc edema is present. Patients usually have hypertension or diabetes. Visual field defect is altitudinal. Cup o disc ratio is small. No definite treatment. Intravitreal injections (triamcinolone and anti- VEGF) may be tried in acute cases. Traumatic optic neuropathy: Occurs after a direct or indirect trauma to the optic nerve. Steroids are not recommended if here is head concussion. Surgery of the optic canal to decompress the nerve may be tried in early stages. There are reports about success with intravenous erythro poietin. - Toxic optic neuropathy: Central, bilateral visual loss. There is a new report about improvement after methanol toxicity with the combination of erythropoietin and steroids. - Radiation optic neuropathy: Bilateral visual loss months or years after radiation therapy of a brain tumor. There are new reports of improvement of vision with intravenous bevacizumab tharapy. - Leber s optic neuropathy: Painless, bilateral visual loss with central scotomas. nherited by the maternal mitochondrial DNA mutations: m.11778, m.14484, m Idebenone treatment in early stage Leber s disease have been shown to be beneficial. - Chronic relapsing inflammatory optic neuropathy: Steroid sensitive optic neuropathy which recurs after steroid withdrawal. Long term steroids or other immunosuppressive agents are used. There are other optic neuropathies with inflammatory, infectious, etc. etiology which can be discusses, too A A- JOURNAL 2 / 1.

2 Kayabasi AU, Sergott RC. Immunosuppressive therapy in GCA.Int J Biol Med Res.2013;Vol 4,Issue 4: Review Immunosuppressive therapy in giant cell arteritis Umur A. Kayabasi1, Robert C Sergott2 World Eye Hospital, Istanbul, Turkey Accepted 31 October, 2013 Giant cell arteritis (GCA) is a granulomatous vasculitis of large vessels mostly seen in patients over fifty years of age. Altough GCA causes blindness, stroke and myocardial infarction if left untreated, it has not been clearly shown that life expectancy decreases with it, but for sure the quality of life decreases because of long term use and side effects of drugs, especially steroids. We tried to discuss the treatment of the disease with other drugs, particularly methotrexate to increase the quality of life in patients. Keywords: Methotrexate, Giant cell arteritis, Steroids, mmunosuppression IINTRODUCTION Giant cell arteritis (GCA) is a vasculitis of large vessels generally seen in patients over ifty years of age. The incidence of GCA has been reported as / and the prevalence as 1/133 over age fifty. After seventyeighty years of age, the incidence increases 20-folds and male / female ratio of patients becomes 2-4 / 1 espectively GCA is more common in white population,who lives in high altitudes and frequently seen in patients with Scandinavian descent. (Beyer et al., 2011) Altough GCA causes blindness, stroke and myocardial infarction if left untreated, it has not been clearly shown that life expectancy decreases with it (Bhatia et al., 2005; Bley et al., 2005). There have been major developments in the diagnosis, treatment and life quality of the patients in the recent years. Methotrexate and other mmunosuppressives had been either added to the classical steroid treatment or used alone after a course of steroid reatment (Bhatia et al., 2005). *Corresponding kayabasi@yahoo.com Tel: A Kayabasi UA. Genetics and treatment of LHON. Comprehensive Research Journal of Medicine and Medical Sciences. October (2):18-23 Abstract: Genetics and treatment of Leber' s hereditary optic neuropathy (LHON) Umur Ali Kayabasi World Eye Hospital, stanbul, Turkey. kayabasi@yahoo.com. Article History ABSTRACT Received 09 October, 2013 Received in evised form 17 October, 2013 Accepted 14 November, 2013 Key words: Leber's Hereditary Optic Neuropathy, Mitochondria, Genetics. Article Type: Review The current concepts about Leber's hereditary optic neuropathy (LHON) and mitochondrial onnection are very difficult to understand completely. Even after twenty years of clinical studies, it is still difficult to ompletely explain how LHON mutations cause damage to the optic nerve or why particularly the optic nerve is at risk, and he information about mitochondria, the mitochondrial genome, the metabolism of the optic nerve and the phenotypic variability of LHON are still being discussed. We cannot fully explain the incomplete penetrance or the male predominance of LHON, the typical onset in young adults or the bilaterality of visual loss. Evidence points to abnormalities of the mitochondria as the direct or indirect cause of LHON. Primary LHON mutations definitely are not present in every family with the LHON phenotype and multigenerational maternal inheritance. They may be present in only a minority of patients with LHON phenotype without a clear family history. Therefore, the mitochondria-lhon connection needs to be examined more closely and understood better. This is a review that will attempt to provide an update on different aspects of LHON and current novel reatment options BluePen Ltd. All rights reserved INTRODUCTION German ophthalmologist, Theodore Leber ), described Leber' s hereditary optic neuropathy (LHON) for the first time (Puomila et al., 2007). LHON is one of he most common inherited optic neuropathies, with an approximate disease prevalence of 1 in 30,000 (Man et al., 2003). LHON is mostly detected between 15 and 35 years of age, but the range of onset can vary between childhood and over 60 years (Nikoskelanien et al., 1996; Howell, 1997). The age of onset is slightly higher in females (19-55 years, average being 31.3 years) than males (15-53 years, average being 24.3) (Leber, 1871; Howell, 1997). LHON affects mostly males, 80% of patients being male (Spruijt et al., 2007). There may be differences in male to female ratio between mutations: 3:1 for m.3460g>a, 6:1 for m.11778g>a and 8:1 for m.14484t>c. The cause of this predominance is still undetermined. Almost one n three cases have no definite family history (Man et al., 2003). Patients present with painless visual loss and both eyes become affected either simultaneously (25% of patients) or sequentially ( A A- JOURNAL Curr Opin Ophthalmol Nov;23(6): doi: /ICU.0b013e328358c7a6 Journal 3 / 1. Abstract: Curr Opin Ophthalmol Nov;23(6): doi: /ICU.0b013e328358c7a6. Different ophthalmologic manifestations of sarcoidosis. Umur KA, Tayfun B, Oguzhan O. information Abstract PURPOSE OF REVIEW: Sarcoidosis an manifest with different ocular findings. Three different cases have been presented, each of which showed different ocular problems. The literature has also been reviewed as to find out other eye signs and treatment strategies of the disease. The diagnosis may be difficult and the treatment may include combination of different immunosuppressors. RECENT FINDINGS: Recent findings include a genetic basis, and certain human leukocyte antigens may affect the course of the disease. Sarcoidosis can influence the eye and the optic nerves in the beginning, and biopsy of the involved tissue may be necessary

3 or the diagnosis. Laboratory investigation may be unyielding. Once the diagnosis is made, steroids are generally started. Other than the classical corticosteroid treatment, other immunosuppressive agents show promise in the atypical cases. SUMMARY: Our cases show different manifestations of the disease like bilateral optic neuropathy, Horner's syndrome, pars planitis, and anterior and posterior uveitis. Patients recovered with steroid treatment, but especially in young patients other agents like methotrexate were needed because of the sideeffects of steroids. PMID: [PubMed - indexed for MEDLINE] B - BOOK / E-BOOK P: A Original Topic:The importance of OCT ve FAF in neurological diseases. Published by DunyaGoz- and Medical Tribune. B- B / E- B A Original Topic: Optic Neuropathies. Published by Dunya Goz Hosptal B- B./ E- B A Original Topic: MS and optic neuritis. Published by Dunya Goz: Eye Diseases: Neuro-ophthalmology chapter. B- B. / E-B A Translation. Topic: Non-organic diseases. Walsh and Hoyt Translation. B- B. / E-B. C EDUCATION AND DIPLOMAS P: A C- Education Wills Eye Observership. Dept. of N-O A C- DIPLOMA NO Clinical Fellowship Dept. of N-O. N-O Certificate. Assistant Professor- Neuroophthalmology Uskudar University, 2015 Michigan State University 1995

4 D2 SCIENTIFIC ACTİVİTİES. D2 3,6 0,72 A 2,88 B Non-organic visual loss. -Oral Presentation Dunyagoz N-O ,5 0,3 A 1,2 B Moderator Dunyagoz N-O. / 0. Diplopia. 11,4 2,28 A 9,12 B Topic: FAF and OCT in Alzheimer s. Summary: 17,1 3,42 A Topic: OCT in AD. 13,68 B - Oral Presentation. 1.retina days December / 1. -Oral Presentation International OCT en face, Rome- December / 1. Summary: E- AWARDS. E A 16 B E- AWARDS Red Crescent Award International Red Crescent NO Congress. Summary: ame: Umur A. Kayabasi ate of Birth: November 29, 1963 ationality: Turkish. Work: Uskudar University Brain Mapping Society D- NO Visual Therapy Center hone: mail kayabasi at yahoo.com Web :wwwumurkayabasi.com.tr CERTIFICATES: N-O Certificate.

5 ECFMG Certificate. ATTENDUM: Vigabatrin toxicity in children. Oral presentation at TOD meeting, Antalya November 6, mportance of retina examination in AD. Oral presentation at Turkish Neurology Society Meeting, Antalya. November 26, Retina examination with OCT in AD. Oral presentation. 2nd International OCT Symposium, Rome December 13, RESEARCH PROJECTS: - Interocular asymmetry in PD. OCTrnfl and OCTmacula comparisons between eyes in PD patients. ( German study demonstrated interocular asymmetry at Euretina, London. But, there are contradictory findings in literature ) - Retinal Examination in Alzheimer s and Parkinson s. OCT and FAF exams. for the early diagnosis of AD and PD. - Retinal Stem Cell therapy in Retinitis Pigmentosa. Proposal submitted to RP Fighting Blindness. - Intravitreal Drug Therapy in R Proposal submitted as a sponsored research project.

Non-arteritic anterior ischemic optic neuropathy (NAION) with segmental optic disc edema. Jonathan A. Micieli, MD Valérie Biousse, MD

Non-arteritic anterior ischemic optic neuropathy (NAION) with segmental optic disc edema Jonathan A. Micieli, MD Valérie Biousse, MD A 75 year old white woman lost vision in the inferior part of her visual