Retinal ven oklüzyonunda intravitreal deksametazon implant uygulaması sonrası tekrarlayan makula ödemi tedavisinde intravitreal deksametazon implant ve ranibizumabın kısa dönem sonuçlarının kıyaslanması
Küçük Resim Yok
Tarih
2018
Yazarlar
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Yayıncı
Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
Amaç: Santral retinal ven tıkanıklığı (SRVT) ve retinal ven dal tıkanıklığı (RVDT) ile ilişkili makuler ödem nedeniyle öncelikle intravitreal dekzame- tazon implant (IVDI) tedavisi alan ve nüks maküler ödem gelişen hastalarda intravitreal ranibizumab (IVR) ve IVDI uygulamasının kısa dönem oküler etkilerinin karşılaştırılması. Gereç ve Yöntemler: Retrospektif olarak yaptığımız çalışmamızda çalışma kriterlerine uyan 52 hastanın verileri değerlendirildi. Otuz dört hastada RVDT, 18 hastada SRVT bulunmaktaydı. Tüm hastaların ilk muayenede fundus fl oresein anjiografi (FFA) ve optik koherens tomografi (OKT) görün- tülemesi mevcuttu. Tüm hastalara RVDT ve SRVT ile ilişkili makuler ödem nedeniyle ilk olarak IVDI enjeksiyonu yapılmıştı. Retinal ven tıkanıklığı meydana gelmesi ile ilk muayene ve tedavi arasındaki ortalama süre 2 aydı. IVDI tedavisi sonrası maküler ödem nüksü nedeniyle IVR enjeksiyonu yapılan 25 hasta Grup 1 olarak değerlendirildi. Maküler ödem nüksü nedeniyle 2 kez ardışık IVDI tedavisi uygulanılan 27 hasta ise Grup 2 olarak değerlendirildi. Tüm hastaların en az 12 aylık takipleri mevcuttu. İki grubun ilk IVDI enjeksiyonu öncesi, ilk enjeksiyonlar sonrası 1. ay ve ikinci en- jeksiyonlar sonrası 1. ay oküler bulguları karşılaştırıldı. Bulgular: İki grup arasında ilk enjeksiyon öncesi ve 1 ay sonrası düzeltilmiş en iyi görme keskinliği, göz içi basıncı (GİB), merkezi kornea kalınlığı (MKK), merkezi 1 mm ve 3 mm’ deki retinal hacimleri, subfoveal, temporal ve nazal koroid kalınlıkları ile global retina sinir lifi tabakası (RSLT) kalın- lığı arasında istatsistiksel olarak anlamlı fark yoktu (p değer aralığı 0,05-0,88). İkinci enjeksiyon sonrası birinci ay GİB değerleri Grup 1’in 16.62±3.94 mmHg, Grup 2’ nin ise 20.03±5.40 mmHg idi ve aralarındaki fark istatistiksel olarak anlamlıydı (p=0,02). Grup 1’in ikinci enjeksiyon sonrası temporal koroidal kalınlığı (237,72±75,42 μm) Grup 2’ den (282,40±65,43 μm) anlamlı düzeyde inceydi (p=0,03). İki grubun ikinci enjeksiyon sonrası diğer parametreleri arasında istatistiksel olarak anlamlı farklılık saptamadık. Sonuç: RVT ile ilişkili makuler ödem nedeniyle iki kez IVDI enjeksiyonu yapılan hastaların GİB değerleri IVDI sonrası IVR enjeksiyonu yapılan hastalardan daha yüksekti. Ancak görme keskinliğinde ve retina kalınlığındaki düzelme IVDI grubunda daha belirgindi.
Objective: To compare the short-term ocular effects of intravitreal ranibizumab (IVR) and intravitreal dexamethasone implant (IVDI) in the treatment of recurrent macular edema related with central (CRVO) and branch retinal vein occlussion (BRVO) previously treated with IVDI. Materials and Methods: The data of 52 patients that met the study criteria were investigated in our retrospective study. Thirty-four patients had BRVO and 18 patients had CRVO. All patients had fundus fl uorescein angiography (FFA) and optical coherence tomography (OCT) at fi rst examination. All patients had IVDI injection fi rst because of the macular edema related with BRVO and CRVO. The mean time period between retinal vein occlussion occurrence and initial examination and treatment was 2 months. Patients were seperated into two groups. Twenty-fi ve patients who had intravitreal ranibizumab injection after fi rst IVDI treatment due to the recurrence of macular edema were defi ned as Group 1. Twenty-seven patients who had 2 consecutive IVDI treatments due to the recurrence of macular edema defi ned as Group 2. All patients had a minimum follow-up of 12 months. Ocular fi ndings of the groups were compared before the fi rst IVDI injection, 1 month after the fi rst injections and 1 month after the second injections. Results: There were no statically signifi cant differance in best corrected visual acuity, intraocular pressure (IOP), central cornea thickness (CCT), retinal volume in central 1 mm and 3 mm, subfoveal, temporal and nasal choroid thickness and global retina nerve fi ber layer (RNFL) thickness before and 1 month after fi rst injection between two groups (range of p value 0.05-0.88). IOP was 16.62±3.9 mmHg in group 1 and and 20.03±5.4 mmHg in Group 2. The fi rst month IOP of Group 1 and Group 2 were 16.62±3.94 and 20.03±5.40 mmHg, respectively after second injection and the difference was statistically signifi cant (p=0.02). Temporal choroidal thickness of Group 1 after second injection (237.72±75.4 μm) was signifi cantly thinner than the Group 2 (282.40±6.4 μm) (p=0.03). We did not noticed statically signifi cant difference in other parameters between the two groups after second injection. Conclusions: IOP was higher in patients who undergone IVDI treatment twice due to the macular edema related with RVO than the patients who had ranibizumab injection after IVDI treatment.However, there was signifi cant improvement in visual acuity and retinal thickness in IVDI group.
Objective: To compare the short-term ocular effects of intravitreal ranibizumab (IVR) and intravitreal dexamethasone implant (IVDI) in the treatment of recurrent macular edema related with central (CRVO) and branch retinal vein occlussion (BRVO) previously treated with IVDI. Materials and Methods: The data of 52 patients that met the study criteria were investigated in our retrospective study. Thirty-four patients had BRVO and 18 patients had CRVO. All patients had fundus fl uorescein angiography (FFA) and optical coherence tomography (OCT) at fi rst examination. All patients had IVDI injection fi rst because of the macular edema related with BRVO and CRVO. The mean time period between retinal vein occlussion occurrence and initial examination and treatment was 2 months. Patients were seperated into two groups. Twenty-fi ve patients who had intravitreal ranibizumab injection after fi rst IVDI treatment due to the recurrence of macular edema were defi ned as Group 1. Twenty-seven patients who had 2 consecutive IVDI treatments due to the recurrence of macular edema defi ned as Group 2. All patients had a minimum follow-up of 12 months. Ocular fi ndings of the groups were compared before the fi rst IVDI injection, 1 month after the fi rst injections and 1 month after the second injections. Results: There were no statically signifi cant differance in best corrected visual acuity, intraocular pressure (IOP), central cornea thickness (CCT), retinal volume in central 1 mm and 3 mm, subfoveal, temporal and nasal choroid thickness and global retina nerve fi ber layer (RNFL) thickness before and 1 month after fi rst injection between two groups (range of p value 0.05-0.88). IOP was 16.62±3.9 mmHg in group 1 and and 20.03±5.4 mmHg in Group 2. The fi rst month IOP of Group 1 and Group 2 were 16.62±3.94 and 20.03±5.40 mmHg, respectively after second injection and the difference was statistically signifi cant (p=0.02). Temporal choroidal thickness of Group 1 after second injection (237.72±75.4 μm) was signifi cantly thinner than the Group 2 (282.40±6.4 μm) (p=0.03). We did not noticed statically signifi cant difference in other parameters between the two groups after second injection. Conclusions: IOP was higher in patients who undergone IVDI treatment twice due to the macular edema related with RVO than the patients who had ranibizumab injection after IVDI treatment.However, there was signifi cant improvement in visual acuity and retinal thickness in IVDI group.
Açıklama
Anahtar Kelimeler
Dexametazon İntravitreal İmplant, Göz İçi Basıncı, Koroid Kalınlığı, Ranibizumab, Retina Kalınlığı, Choroidal Thickness, Dexamethasone Intravitreal Implant, Intraocular Pressure, Ranibizumab, Retina Thickness
Kaynak
Retina-Vitreus
WoS Q Değeri
Scopus Q Değeri
Cilt
27
Sayı
1
