BibTex RIS Kaynak Göster

The evaluation of efficacy of subtenon triamcinolone injection combined with focal laser photocoagulation in diabetic macular edema

Yıl 2012, Cilt: 39 Sayı: 2, 184 - 188, 01.06.2012
https://doi.org/10.5798/diclemedj.0921.2012.02.0124

Öz

Objectives: The aim of this study was to investigate efficacy and safety of subtenon triamcinolone (ST) in combination with focal laser photocoagulation in diabetic macular edema (DME). Materials and methods: Medical records of patients with DME, treated with 40 mg subtenon injection of triamcinolone acetonid prior to focal laser photocoagulation were retrospectively analyzed. Seventeen eyes of 17 patients with DME were enrolled in the study. All patients underwent a comprehensive ophthalmological examination before the treatment. Efficacy of the treatment after ST injection was evaluated by visual acuity and flourescein angiography (FA). Follow-up visits were performed at 1st, 3rd, 6th and 12th months. Repeated measures ANOVA was used for statistical analysis. Results: The mean age was 61.5 ± 8.7 years and the mean visual acuity in the study eyes was 0.22 ± 0.13 before the treatment, 0.39 ± 0.15 at 1st month, 0.36 ± 0.18 at 3rd month, 0.33 ± 0.15 at 6th month and 0.34 ± 0.16 at 12th month. The differences in the visual acuity before the treatment and follow-up visits were significant (p ˂0.05). Visual acuity was increased in 13 (%76,4) patients, decreased in 1 (%5,8) and unchanged in 3 (%17,6). Conclusion: Injection of 40 mg of triamsinolon via subtenon route combined with focal laser photocoagulation is a safe and beneficial treatment in cases of DME

Kaynakça

  • Yılmaz A, Akan Z, Yılmaz H. Prevalence of diabetes mellitus and affecting factors of diabetes mellitus in adult age group in Van province. J Clin Exp Invest 2011;2 (4); 392-9.
  • Klein R, Klein B, Moss S, et al. The Wisconsin Epidemio- logic Study of Diabetic Retinopathy, IV: diabetic macular edema. Ophthalmology 1984;91(12):1464-74.
  • Early Treatment Diabetic Retinopathy Study research group. Photocoagulation for diabetic macular edema. Early Treat- ment Diabetic Retinopathy Study Report Number 1. Arch Ophthalmol 1985;103(12):1796-806.
  • Jonas JB, Kreissig I, Söfker A, et al. Intravitreal injection of triamcinolone for diffuse diabetic macular edema. Arch Ophthalmol 2003;121(1):57-61.
  • Massin P, Audren F, Haouchine B, et al. Intravitreal triam- cinolone acetonide for diabetic diffuse macular edema: pre- liminary results of a prospective controlled trial. Ophthal- mology 2004;111(2):218-24.
  • Wada M, Ogata N, Minamino K, Koriyama M, et al. Trans- Tenon’s retrobulbar injection of triamcinolone acetonide for diffuse diabetic macular edema. Jpn J Ophthalmol 2005;49(6):509-15.
  • Diabetic Retinopathy Clinical Research Network. Random- ized trial of peribulbar triamcinolone acetonide with and without focal photocoagulation for mild diabetic macular edema: A Pilot Study. Ophthalmology 2007;114(6):1190-6.
  • Shima C, Ogata N, Minamino K, et al. Posterior sub-Tenon injection of triamcinolone acetonide as pretreatment for fo- cal laser photocoagulation in diabetic macular edema pa- tients. Jpn J Ophthalmol 2008;52(4):265-8.
  • Dafflon ML, Tran VT, Guex-Closier Y, et al. Posterior sub- Tenon’s steroid injections for the treatment of posterior ocular inflammation: indications, efficacy and side effects. Graefes Arch Clin Exp Ophthalmol 1999;237(4):289-95.
  • Jennings T, Rusin MM, Tessler HH, et al. Posterior sub- Tenon injection of corticosteroids in uveitis patients with cystoid macular edema. Jpn J Ophthalmol 1988;32(4):385- 91.
  • Amsterdam A, Tajima K, Sasson R. Cell-specific regula- tion of apoptosis by glucocorticoids: implication to their anti-inflammatory action. Biochem Pharmacol 2002;64(5- 6):843-50.
  • Shimura M, Nakazawa T, Yasuda K, et al. Pre-treatment of posterior subtenon injection of triamcinolone aceton- ide has beneficial effects for grid pattern photocoagulation against diffuse diabetic macular edema. Br J Ophthalmol 2007;91(4):449-54.
  • Tunc M, Onder HI, Kaya M. Posterior sub-Tenon’s capsule triamcinolone injection combined with focal laser photo- coagulation for diabetic macular edema. Ophthalmology 2005;112(6):1086-91.
  • Ozdek S, Bahceci UA, Gurelik G, et al. Posterior subtenon and intravitreal triamcinolone acetonide for diabetic macu- lar edema. J Diabetes Complications 2006;20(4):246-51.
  • Cardillo JA, Melo LA, Costa RA, et al. Comparison of in- travitreal versus posterior sub-tenon’s capsule injection of triamcinolone acetonide for diffuse diabetic macular ede- ma. Ophthalmology 2005;112(9):1557-63.
  • Toda J, Fukushima H, Kato S. Injection of triamcinolone acetonide into the posterior sub-tenon capsule for treatment of diabetic macular edema. Retina 2007;27(6):764-9
  • Beer PM, Bakri AJ, Singh RJ, et al. Intraocular concen- tration and pharmacokinetics of triamcinolone aceton- ide after a single intravitreal injection. Ophthalmology 2003;110(4):681-6.
  • Inoue M, Takeda K, Morita K, et al. Vitreous concentrations of triamcinolone acetonide in human eyes after intravitreal or subtenon injection. Am J Ophthalmol 2004;138(6):1046- 8.
  • Herschler J. Intractable intraocular hypertension induced by repository triamcinolone acetonide. Am J Ophthalmol 1972; 74(3):501-4.
  • Yalcinbayir O, Gelisken O, Kaderli B, Avci R. Intravitreal versus sub-tenon posterior triamcinolone injection in bi- lateral diffuse diabetic macular edema. Ophthalmologica 2011;225(4):222-7.
  • Ozkiriş A, Erkiliç K. Complications of intravitreal in- jection of triamcinolone acetonide. Can J Ophthalmol 2005;40(1):63-8.
  • Unoki N, Nishijima K, Kita M, Suzuma K, et al. Ran- domised controlled trial of posterior sub-Tenon triamcino- lone as adjunct to panretinal photocoagulation for treatment of diabetic retinopathy. J Ophthalmol 2009;93(6):765-70.

Diabetik maküler ödemde subtenon triamsinolon ile kombine fokal lazer fotokoagülasyonun etkinliğinin değerlendirilmesi

Yıl 2012, Cilt: 39 Sayı: 2, 184 - 188, 01.06.2012
https://doi.org/10.5798/diclemedj.0921.2012.02.0124

Öz

Amaç: Bu çalışmanın amacı subtenon triamsinolon (ST) enjeksiyonu ile fokal lazer fotokoagülasyon kombinasyonunun diyabetik maküler ödem (DMÖ)\'de etkinlik ve güvenilirliğinin araştırılmasıdır. Gereç ve yöntem: Diyabetik maküler ödem olan ve fokal lazer fotokoagülasyon ile birlikte 40 mg ST enjeksiyonu yapılan hastaların dosyaları retrospektif olarak değerlendirildi. On yedi hastanın 17 gözü çalışma kapsamına alındı. Tüm hastalara tedavi öncesi tam bir oftalmolojik muayene yapıldı. Tedavi sonrası 1. hafta, 1. ay ve daha sonra 3 aylık dönemlerde kontrole çağrıldı. Tedavinin etkinliği ST enjeksiyonundan sonraki 1. ay ve ardından 3 aylık dönemlerde görme keskinliği ve flöresein anjiyografi (FA) ile değerlendirildi. İstatistik analizde tekrarlı ölçümlerde ANOVA testi kullanıldı. Bulgular: Hastaların yaş ortalaması 61,5±8,7 yıl idi. Görme keskinliği enjeksiyon öncesi 0.22±0.13 iken 1. ayda 0.39±0.15, 3. ayda 0.36±0.18, 6. ayda 0.33±0.15 ve 12. ayda 0.34±0.16 oldu. Tüm takip muayenelerindeki ortalama görme keskinlikleri enjeksiyon öncesi ile karşılaştırıldığında aradaki fark anlamlı idi (p ˂0.05). Son muayenede görme keskinliği 13 (%76,4) hastada arttı, 3\'ünde (%17,6) aynı kaldı ve 1\'inde (%5,8) azaldı. Sonuç: Diyabetik maküler ödemi olan hastaların tedavisinde subtenon 40 mg triamsinolon enjeksiyonu ile fokal lazer fotokoagülasyon kombinasyonunun güvenli ve yararlı olduğu düşünüldü.

Kaynakça

  • Yılmaz A, Akan Z, Yılmaz H. Prevalence of diabetes mellitus and affecting factors of diabetes mellitus in adult age group in Van province. J Clin Exp Invest 2011;2 (4); 392-9.
  • Klein R, Klein B, Moss S, et al. The Wisconsin Epidemio- logic Study of Diabetic Retinopathy, IV: diabetic macular edema. Ophthalmology 1984;91(12):1464-74.
  • Early Treatment Diabetic Retinopathy Study research group. Photocoagulation for diabetic macular edema. Early Treat- ment Diabetic Retinopathy Study Report Number 1. Arch Ophthalmol 1985;103(12):1796-806.
  • Jonas JB, Kreissig I, Söfker A, et al. Intravitreal injection of triamcinolone for diffuse diabetic macular edema. Arch Ophthalmol 2003;121(1):57-61.
  • Massin P, Audren F, Haouchine B, et al. Intravitreal triam- cinolone acetonide for diabetic diffuse macular edema: pre- liminary results of a prospective controlled trial. Ophthal- mology 2004;111(2):218-24.
  • Wada M, Ogata N, Minamino K, Koriyama M, et al. Trans- Tenon’s retrobulbar injection of triamcinolone acetonide for diffuse diabetic macular edema. Jpn J Ophthalmol 2005;49(6):509-15.
  • Diabetic Retinopathy Clinical Research Network. Random- ized trial of peribulbar triamcinolone acetonide with and without focal photocoagulation for mild diabetic macular edema: A Pilot Study. Ophthalmology 2007;114(6):1190-6.
  • Shima C, Ogata N, Minamino K, et al. Posterior sub-Tenon injection of triamcinolone acetonide as pretreatment for fo- cal laser photocoagulation in diabetic macular edema pa- tients. Jpn J Ophthalmol 2008;52(4):265-8.
  • Dafflon ML, Tran VT, Guex-Closier Y, et al. Posterior sub- Tenon’s steroid injections for the treatment of posterior ocular inflammation: indications, efficacy and side effects. Graefes Arch Clin Exp Ophthalmol 1999;237(4):289-95.
  • Jennings T, Rusin MM, Tessler HH, et al. Posterior sub- Tenon injection of corticosteroids in uveitis patients with cystoid macular edema. Jpn J Ophthalmol 1988;32(4):385- 91.
  • Amsterdam A, Tajima K, Sasson R. Cell-specific regula- tion of apoptosis by glucocorticoids: implication to their anti-inflammatory action. Biochem Pharmacol 2002;64(5- 6):843-50.
  • Shimura M, Nakazawa T, Yasuda K, et al. Pre-treatment of posterior subtenon injection of triamcinolone aceton- ide has beneficial effects for grid pattern photocoagulation against diffuse diabetic macular edema. Br J Ophthalmol 2007;91(4):449-54.
  • Tunc M, Onder HI, Kaya M. Posterior sub-Tenon’s capsule triamcinolone injection combined with focal laser photo- coagulation for diabetic macular edema. Ophthalmology 2005;112(6):1086-91.
  • Ozdek S, Bahceci UA, Gurelik G, et al. Posterior subtenon and intravitreal triamcinolone acetonide for diabetic macu- lar edema. J Diabetes Complications 2006;20(4):246-51.
  • Cardillo JA, Melo LA, Costa RA, et al. Comparison of in- travitreal versus posterior sub-tenon’s capsule injection of triamcinolone acetonide for diffuse diabetic macular ede- ma. Ophthalmology 2005;112(9):1557-63.
  • Toda J, Fukushima H, Kato S. Injection of triamcinolone acetonide into the posterior sub-tenon capsule for treatment of diabetic macular edema. Retina 2007;27(6):764-9
  • Beer PM, Bakri AJ, Singh RJ, et al. Intraocular concen- tration and pharmacokinetics of triamcinolone aceton- ide after a single intravitreal injection. Ophthalmology 2003;110(4):681-6.
  • Inoue M, Takeda K, Morita K, et al. Vitreous concentrations of triamcinolone acetonide in human eyes after intravitreal or subtenon injection. Am J Ophthalmol 2004;138(6):1046- 8.
  • Herschler J. Intractable intraocular hypertension induced by repository triamcinolone acetonide. Am J Ophthalmol 1972; 74(3):501-4.
  • Yalcinbayir O, Gelisken O, Kaderli B, Avci R. Intravitreal versus sub-tenon posterior triamcinolone injection in bi- lateral diffuse diabetic macular edema. Ophthalmologica 2011;225(4):222-7.
  • Ozkiriş A, Erkiliç K. Complications of intravitreal in- jection of triamcinolone acetonide. Can J Ophthalmol 2005;40(1):63-8.
  • Unoki N, Nishijima K, Kita M, Suzuma K, et al. Ran- domised controlled trial of posterior sub-Tenon triamcino- lone as adjunct to panretinal photocoagulation for treatment of diabetic retinopathy. J Ophthalmol 2009;93(6):765-70.
Toplam 22 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Araştırma Yazıları
Yazarlar

Özgür İlhan Bu kişi benim

Mesut Coşkun Bu kişi benim

Nilüfer İlhan Bu kişi benim

Emre Ayıntap Bu kişi benim

Uğurcan Keskin Bu kişi benim

Esra Tuzcu Bu kişi benim

Hüseyin Öksüz Bu kişi benim

Yayımlanma Tarihi 1 Haziran 2012
Gönderilme Tarihi 2 Mart 2015
Yayımlandığı Sayı Yıl 2012 Cilt: 39 Sayı: 2

Kaynak Göster

APA İlhan, Ö., Coşkun, M., İlhan, N., Ayıntap, E., vd. (2012). Diabetik maküler ödemde subtenon triamsinolon ile kombine fokal lazer fotokoagülasyonun etkinliğinin değerlendirilmesi. Dicle Tıp Dergisi, 39(2), 184-188. https://doi.org/10.5798/diclemedj.0921.2012.02.0124
AMA İlhan Ö, Coşkun M, İlhan N, Ayıntap E, Keskin U, Tuzcu E, Öksüz H. Diabetik maküler ödemde subtenon triamsinolon ile kombine fokal lazer fotokoagülasyonun etkinliğinin değerlendirilmesi. diclemedj. Haziran 2012;39(2):184-188. doi:10.5798/diclemedj.0921.2012.02.0124
Chicago İlhan, Özgür, Mesut Coşkun, Nilüfer İlhan, Emre Ayıntap, Uğurcan Keskin, Esra Tuzcu, ve Hüseyin Öksüz. “Diabetik maküler ödemde Subtenon Triamsinolon Ile Kombine Fokal Lazer fotokoagülasyonun etkinliğinin değerlendirilmesi”. Dicle Tıp Dergisi 39, sy. 2 (Haziran 2012): 184-88. https://doi.org/10.5798/diclemedj.0921.2012.02.0124.
EndNote İlhan Ö, Coşkun M, İlhan N, Ayıntap E, Keskin U, Tuzcu E, Öksüz H (01 Haziran 2012) Diabetik maküler ödemde subtenon triamsinolon ile kombine fokal lazer fotokoagülasyonun etkinliğinin değerlendirilmesi. Dicle Tıp Dergisi 39 2 184–188.
IEEE Ö. İlhan, “Diabetik maküler ödemde subtenon triamsinolon ile kombine fokal lazer fotokoagülasyonun etkinliğinin değerlendirilmesi”, diclemedj, c. 39, sy. 2, ss. 184–188, 2012, doi: 10.5798/diclemedj.0921.2012.02.0124.
ISNAD İlhan, Özgür vd. “Diabetik maküler ödemde Subtenon Triamsinolon Ile Kombine Fokal Lazer fotokoagülasyonun etkinliğinin değerlendirilmesi”. Dicle Tıp Dergisi 39/2 (Haziran 2012), 184-188. https://doi.org/10.5798/diclemedj.0921.2012.02.0124.
JAMA İlhan Ö, Coşkun M, İlhan N, Ayıntap E, Keskin U, Tuzcu E, Öksüz H. Diabetik maküler ödemde subtenon triamsinolon ile kombine fokal lazer fotokoagülasyonun etkinliğinin değerlendirilmesi. diclemedj. 2012;39:184–188.
MLA İlhan, Özgür vd. “Diabetik maküler ödemde Subtenon Triamsinolon Ile Kombine Fokal Lazer fotokoagülasyonun etkinliğinin değerlendirilmesi”. Dicle Tıp Dergisi, c. 39, sy. 2, 2012, ss. 184-8, doi:10.5798/diclemedj.0921.2012.02.0124.
Vancouver İlhan Ö, Coşkun M, İlhan N, Ayıntap E, Keskin U, Tuzcu E, Öksüz H. Diabetik maküler ödemde subtenon triamsinolon ile kombine fokal lazer fotokoagülasyonun etkinliğinin değerlendirilmesi. diclemedj. 2012;39(2):184-8.