Evaluation of Optical Coherence Tomography Biomarkers During the COVID-19 Pandemic in Patients with Diabetic Retinopathy for whom Anti-Vascular Endothelial Growth Factor Cannot Be Applied

Year 2023, Volume: 16 Issue: 3, 207 - 213, 30.12.2023

Mehmet Canleblebici Hakan Yıldırım Mehmet Balbaba Mustafa Bülbül Ülkü Çeliker

https://doi.org/10.52976/vansaglik.1223055

Abstract

Objective: Aim of this study is evaluation of the predictive effect of biomarkers evaluated by optical coherence tomography(OCT) on vision for at least 6 months in patients who received anti-VEGF therapy for diabetic retinopathy(DR) and who could not receive treatment due to the COVID-19 pandemic.
Material and methods: Age, number of previous injections, pre-injection and last visit best corrected visual acuity(BCVA), HbA1C values, OCT, CMT and OCT biomarkers were evaluated at least 6 months post-injection of patients who received minimum 3 doses of Anti-VEGF due to DR in our clinic between the 7th month of 2019 and the 1st month of 2020. The chi-square test, the paired t test, the regression analysis were used for statistical analysis.
Results: A total of 61 patients, 82 eyes were included in the study, 33 patients(53.2%) were women. Mean age was 64.2(±7.2) years, and BCVA was 0.23±0.19 and 0.25±0.23 at pre-injection and final follow-up, respectively. Initial CMT was 418.6±143.2, and at the last control it was 496.6±134.7 micrometers. The effect of OCT biomarkers on final vision was evaluated; the absence of DRIL, intact EZ-ELM and HRNS below 20 and CMT less than 350 µm after the last injection were found to be statistically significant(p<0.05).
Conclusion: In this process, patients with DR could not receive treatment even though they had an anti-VEGF indication; patients with deterioration in retinal layers, high CMT had worse vision levels. We think that the treatment-free follow-up period of patients who do not have these findings can be extended.

Keywords

Diabetic Retinopathy, COVID 19, Anti VEGF Treatment, Optical Coherens Tomography

Project Number

Yoktur

Anti-Vasküler Endotelyal Büyüme Faktörü Uygulanamayan Diyabetik Retinopatili Hastalarda Optik Koherens Tomografi Biyobelirteçlerinin COVID-19 Pandemi Sürecinde Değerlendirilmesi

Abstract

Amaç: Diyabetik retinopati (DR) için yükleme ve idame tedavisi alan ve COVİD-19 pandemisi nedeniyle Anti-VEGF uygulanması gerektiği halde tedavisini alamayan hastalar üzerinden optik koherens tomografinin (OKT) ile değerlendirilen biyobelirteçlerinin en az 6 aylık sürede görme üzerine prediktör etkisinin değerlendirilmesi amaçlanmıştır.
Gereç ve yöntemler: Kliniğimizde DR nedeniyle 2019’nin 7.ayı ve 2020’in 1.ayı arası en az 3 doz Anti-VEGF yapılan ancak pandemi nedeniyle sonraki aylarda tekrar tedavi edilemeyen hastaların yaşı, önceki enjeksiyon sayıları, enjeksiyon öncesi, en az 6 ay sonrası en iyi düzeletilmiş görme keskinlikleri (EİDGK), HbA1C değerleri, OKT ile SMK ve OKT biyomarkerları değerlendirildi.
Bulgular: Çalışmaya toplam 61 hastanın, 82 göz dahil edildi, 33 hasta (%53,2) kadındı. Ortalama yaş 64,2 (±7,2), enjeksiyon öncesi ve son kontrolde EİDGK sırasıyla 0,23±0,19 ve 0,25±0,23 idi. İlk SMK 418,6±,143,2, son kontrolde 496,6±134,7 mikrometreydi. SMK’nın 350 µm’den düşük olan hastalarda istatistiksel olarak daha iyi görsel sonuçlar bulundu (p<0,05). OKT biyobelirteçlerinin son görme üzerine etkisi regresyon analizi ile değerlendirildiğinde ise DRIL olmaması, EZ-ELM’nin intakt ve HRNS’nın 20 altında olması istatiksel olarak anlamlı bulundu (p<0,05).
Sonuç: DR’li hastalarda Anti-VEGF endikasyonu olduğu halde tedavi alamadıkları bu süreçte; retina tabakalarında bozulma, yüksek SMK bulunan hastaların görme seviyeleri daha kötü seviyede seyretmiştir. Bu bulguları olmayan hastaların tedavisiz takip süresinin uzatılabileceğini düşünmekteyiz.

Keywords

Diyabetik retinopati, COVİD 19, Anti VEGF tedavisi, Optik koherens tomografi, Diabetic Retinopathy, COVID 19, Anti VEGF Treatment, Optical Coherens Tomography

Supporting Institution

Yoktur

Project Number

Yoktur

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