Yaşa Bağlı Makula Dejenerasyonunda Fotodinamik Tedavi ile Kombine İntravitreal Bevacizumabın Değerlendirilmesi

Abstract

Amaç: Yaşa bağlı makula dejenerasyonu (AMD) olan hastalarda fotodinamik tedavi (PDT) ve PDT ile kombine intravitreal bevacizumab enjeksiyonu (PDT+IVB) tedavi sonuçlarının karşılaştırılması amaçlandı. Gereç ve Yöntemler: Neovasküler YBMD’li 55 hastanın 63 gözü dahil edildi. Grup 1 35 hastanın 40 gözü, Grup 2, 20 hastanın 23 gözü içermekteydi. Görme keskinliği (VA), göz içi basıncı ölçümü ve göz dibi muayenesi yapıldı. Patern Elektroretinografi P50 genliği ve ödem haritası değerleri (EMV) Heidelberg Retina Tomografi (HRTII) ile ölçüldü. Bulgular: Grup 1’de (PDT) 14 (%35) gözde VA arttı, 17 (%42.5)’sinde değişmedi, 9 (%22.5)’unda azaldı. PERG P50 amplitüdleri tedavi öncesi değerlerle karşılaştırıldı ve 1., 3. ve 6. aylarda sırasıyla %10.6, %11.98 ve %8.46 artmış ve HRTII EMV %5.86, %4.88 ve %11.22 bulundu. Grup 2’de (PDT+IVB) 9 (%39.13)’unda VA düzeldi, 8 (%34.78)’inde değişmedi, 6 (%34.78)’sında azaldı. PERG P50 amplitüdleri 1., 3. ve 6. aylarda sırasıyla %10.15, %5.8 ve %0.1, HR-TII EMV %13.07, %12.17 ve %14.87 azaldı. Sonuç: Verteporfin ve PDT, neovasküler AMD’ye bağlı subfoveal koroidal neovasküler membranlarda VA’yı koruyan etkili ve güvenli yöntemlerdir.

Keywords

• Yaşa bağlı makula dejenerasyonu
• fotodinamik tedavi
• vasküler endotelyal büyüme faktörü
• erken tanı
• intravitreal enjeksiyon
• bevacizumab

Evaluation of Photodynamic Therapy-Combined Intravitreal Bevacizumab in Age Related Macular Degeneration

Abstract

Aim: It was aimed to compare treatment results of photodynamic therapy (PDT) and PDT-combined intravitreal bevacizumab injection (PDT+IVB) in patients with age-related macular degeneration (AMD). Materials and Methods: 63 eyes of 55 patients with neovascular AMD were included. Group 1 consisted of 40 eyes of 35, Group 2 consisted of 23 eyes of 20 patients. Visual acuity (VA), intraocular pressure measurement and fundus examination were performed. Pattern Electroretinography P50 amplitude and edema map values (EMV) were measured with Heidelberg Retina Tomograph (HRTII). Results: VA increased in 14 (35%), remained unchanged in 17 (42.5%), and decreased in 9 (22.5%) eyes in Group 1 (PDT). The PERG P50 amplitudes were compared with values of pre-treatment, and found to increased at 10.6%, 11.98%, and 8.46% and HRTII EMV were 5.86%, 4.88%, and 11.22% at 1st, 3rd, and 6th months, respectively. In Group 2 (PDT+IVB), VA improved in 9 (39.13%), remained unchanged in 8 (34.78%), and decreased in 6 (34.78%) eyes. PERG P50 amplitudes were reduced to 10.15%, 5.8%, and 0.1% and HRTII EMV were reduced to 13.07%, 12.17%, and 14.87% at 1st, 3rd, and 6th months, respectively. Conclusion: Verteporfin and PDT are effective and safe methods that preserve VA in subfoveal choroidal neovascular membranes due to neovascular AMD.

Keywords

• Age-related macular degeneration
• photodynamic therapy
• vascular endothelial growth factor
• early diagnosis
• intravitreal injection
• bevacizumab

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