TY  - JOUR
T1  - COVID-19 Kapanmasının Yaşa Bağlı Makula Dejenerasyonu Tedavisine Etkileri
TT  - Effects of COVID-19 Lockdown on Age-Related Macular Degeneration Treatment
AU  - Bilici, Serdar
AU  - Şahin-elarslan, Kardelen Ezgi
PY  - 2023
DA  - August
Y2  - 2023
DO  - 10.29058/mjwbs.1294394
JF  - Medical Journal of Western Black Sea
JO  - Med J West Black Sea
PB  - Zonguldak Bulent Ecevit University
WT  - DergiPark
SN  - 2822-4302
SP  - 247
EP  - 251
VL  - 7
IS  - 2
LA  - tr
AB  - Amaç: Yaşa bağlı makula dejenerasyonu (YBMD) olgularında COVID-19 kapanması nedeniyle yaşananintravitreal anti-vasküler büyüme faktörü (VEGF) tedavisindeki gecikmenin anatomik ve fonksiyoneletkilerinin değerlendirilmesi amaçlandı.Gereç ve Yöntemler: COVID-19 nedeniyle anti-VEGF tedavisine ara verilen YBMD olguları çalışmayadahil edildi. Olguların yaş, cinsiyet, tedaviye verilen ara süresi ve tekrar tedavi sonrası enjeksiyonsayısı ile takip süresi kaydedildi. Karantina öncesi son vizitleri (V0), karantina sonrası ilk (V1) ve sonvizitlerindeki (V2) görme keskinlikleri (GK) ve optik koherans tomografi ile santral makula kalınlığı (SMK)değerlendirildi. Olgular tedaviye verilen ara süresine göre 18 hafta ve altı (Grup-1) ile 18 hafta üzeri(Grup-2) olarak alt gruplara ayrıldı.Bulgular: Çalışmaya yaş ortalaması 73,1 olan 53 olgunun 53 gözü dahil edildi. Pandemi sürecindetedaviye verilen ara ortalaması 26,4 ± 10,6 haftaydı. Tekrar tedaviye başlanan olguların ortalama takipsüresi 32,5 (9-52) hafta olup bu süreç içerisinde ortalama 3,84 (1-9) anti-VEGF tedavi uygulanmıştır.Tüm grupta V0, V1 ve V2 vizitlerindeki ortalama GK sırasıyla 0,78, 0,98 ve 0,89 LogMAR, ortalamaSMK değerleri sırasıyla 371,3, 430,8 ve 334,2 mikron bulunmuştur (Sırasıyla p=0,001 ve p=0,010).Grup 1’ de V0, V1 ve V2 vizitlerindeki ortalama GK sırasıyla 0,78, 0,89 ve 0,86 LogMAR; ortalama SMKdeğerleri sırasıyla 374,5, 378,2 ve 308,2 mikron olarak bulunmuştur (Sırasıyla p=0,272 ve p=0,761).Grup 2’de V0, V1 ve V2 vizitlerindeki ortalama GK sırasıyla 0,78, 1,03 ve 0,9 LogMAR; ortalama SMKdeğerleri sırasıyla 369,6, 457,8 ve 347,5 olarak bulunmuştur (Sırasıyla p=0,006 ve p=0,005).Sonuç: YBMD olgularında anti-VEGF tedavisine ara verilmesiyle birlikte anatomik ve fonksiyonel olarakkötüleşme izlenmiştir. Tekrar tedaviye başlanması ile SMK’ da düzelme olmasına rağmen GK kaybıkalıcı olmuştur.
KW  - Anti-vasküler büyüme faktörü
KW  - COVID-19
KW  - optik koherens tomografi
KW  - yaşa bağlı
makula dejenerasyonu
N2  - Aim: Evaluating the anatomical and functional effects of delay in intravitreal anti-vascular growth factor(anti-VEGF) treatment due to the COVID-19 lockdown in age-related macular degeneration (AMD)cases.Material and Methods: AMD cases in which anti-vascular growth factor (VEGF) treatment wasinterrupted due to the COVID-19 lockdown were included in the study. Age, gender, the interval time ofthe treatment delay, the number of injections after retreatment, and the follow-up period were recorded.Visual acuity (VA) and central macular thickness (CMT) of the participants at the last visit before the lockdown (V0), the first (V1), and the last (V2) visit after the lockdown were evaluated. The cases were divided into subgroups based ondelay in treatment: 18 weeks or less (Group-1) and over 18 weeks (Group-2).Results: 53 eyes of 53 patients with an average age of 73.1 were included in the study. The average delay in the treatment during thepandemic period was 26.4 ± 10.6 weeks. The average follow-up period after the initiation of retreatment was 32.5 (9-52) weeks, and anaverage of 3.84 (1-9) anti-VEGF treatments were carried out during this period. The mean VA of V0, V1, and V2 visits of the whole groupwere determined as 0.78, 0.98, and 0.89 LogMAR respectively, and the mean CMT values were found as 371.3, 430.8, and 334.2 micronsrespectively (p=0.001, and p=0.010, respectively). The mean VA of V0, V1, and V2 visits were 0.78, 0.89, and 0.86 LogMAR in Group 1 and,0.78, 1.03, and 0.9 LogMAR in Group 2, respectively (p=0.272, and p=0.006, respectively). The mean CMT values of V0, V1, and V2 visitswere found as 374.5, 378.2, and 308.2 microns in Group 1 and, 369.6, 457.8, and 347.5 in Group 2, respectively (p=0.761, and p= 0.005,respectively).Conclusion: In AMD cases, anatomical and functional deterioration was observed with the discontinuation of anti-VEGF therapy. Althoughthere was an improvement in CMT with re-initiation of treatment, the loss of VA was irreversible.
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UR  - https://doi.org/10.29058/mjwbs.1294394
L1  - https://dergipark.org.tr/en/download/article-file/3130935
ER  -