İntravitreal Deksametazon İmplantın Retinal Vasküler Hastalıklara Bağlı Maküla Ödeminde Etkinliği ve Güvenliği

Öz

Amaç: Diyabetik retinopati ve retinal ven tıkanıklığı en sık görülen retinal vasküler hastalıklardır. Bu çalışmada retinal vasküler hastalıklara bağlı makula ödemi üzerine tek doz intravitreal deksametazon implant enjeksiyonunun etkinliği ve güvenliği araştırılmıştır. Materyal ve metod: Retinal vasküler hastalıklara bağlı makula ödemi olan ve en az 6 ay takip edilen 30 (13 retinal ven dal tıkanıklığı-BRVO, 7 santral retinal ven tıkanıklığı-CRVO ve 10 diyabetik makula ödemi-DME) hastanın tıbbi kayıtları retrospektif olarak değerlendirildi. En iyi düzeltilmiş görme keskinliği (BCVA), santral makula kalınlığı (CMT), göz içi basıncı (GİB) ve katarakt ilerlemesi birinci hafta, 1., 2., 3. ve 6. aylarda ölçüldü. Bulgular: Gruplar demografik özellikler açısından benzerdi (p>0,05). BRVO’da, tüm vizitlerde BCVA’da başlangıç değerine göre istatistiksel olarak anlamLı bir iyileşme görülmedi (p>0,05). Başlangıç değerine göre 1., 2. ve 3. aylarda CMT azalmasında istatistiksel olarak anlamLı fark vardı (p<0,05). CRVO’da, 1. ve 2.aylarda BCVA'da istatistiksel olarak anlamLı iyileşme gözlendi(p<0,05). Başlangıç değerine göre CMT azalmaları, CRVOgrubunda tüm vizitlerde istatistiksel olarak anlamLı farklılıkgösterdi (p<0,05). DME grubunda, BCVA, 2. ve 3. aylarda başlangıçdeğerine göre anlamLı şekilde daha yüksekti (p<0,05) ve 1., 2.,3.ve 6. aylardaki CMT azalmaları istatistiksel olarak anlamLıydı(p<0,05). Ortalama GİB değerleri, tüm hastalarda 1. ve 2. aylardaanlamLı şekilde daha yüksekti. GİB artışları geçiciydi ve topikalantiglokomatöz ilaçlarla tedavi edildi. Fakik çalışma gözlerinde 6aylık katarakt insidansı %17 idi ve 6. ayda opere edildi. Sonuç: Deksametazon implantının intravitreal enjeksiyonu etkilive güvenli bir yöntemdir ve retinal ven tıkanıklıkları ve DMEnedeniyle makula ödemi olan hastalarda BCVA’da artma, CMT’deazalma sağlar. 6. ayın sonunda geçici GİB artışı ve kataraktilerlemesi beklenen yan etkilerdir.

Anahtar Kelimeler

• Deksametazon intravitreal implant
• Retinal ven tıkanıklığı
• Diyabetik retinopati
• Maküla ödemi

Safety and Efficacy of Intravitreal Dexamethasone Implant on Macular Edema Due to Retinal Vascular Diseases

Öz

Background: Diabetic retinopathy and retinal vein occlusion are the most common retinal vascular diseases. This study investigates the efficacy and safety of a single dose intravitreal dexamethasone implant injection on macular edema due to retinal vascular diseases. Materials and Methods: The medical records of 30 (13 with branch retinal vein occlusion-BRVO, 7 with central retinal vein occlusion-CRVO and 10 with diabetic macular edema-DME) patients with macular edema secondary to retinal vascular diseases and at least 6 months follow-up, were evaluated retrospectively. Best corrected visual acuity (BCVA), central macular thickness (CMT), intraocular pressure (IOP) and cataract progression were performed at first week, 1st, 2nd, 3rd and 6th months. Results: The groups were similar in terms of demographic characteristics (p>0,05). In BRVO, there were no statistically significant improvement in BCVA from baseline at all visits (p>0.05). There were statistically significant difference at CMT reduction at 1st, 2nd and 3rd months from baseline (p<0.05). In CRVO, statistically significant improvement in BCVA was observed at 1st and 2nd months (p<0.05). CMT reductions from baseline were statistically significant different at all visits in CRVO group (p<0.05). In DME group, BCVA was significantly higher at 2nd and 3rd months from baseline (p<0.05) and CMT reductions at 1st, 2nd, 3rd and 6th months were statistically significant (p<0.05). The mean IOP values were significantly higher at 1st and 2nd months in all patients. IOP increases were transient and treated with topical antiglaucomatous medicine. The 6-month incidence of cataract in phakic study eyes was 17% and cataracts were extracted at 6th month. Conclusion: Intravitreal injection of dexamethasone implant is an effective and safe method and provides increased BCVA, decreased CMT in patients with macular edema due to retinal vein occlusions and DME. Transient IOP increase and cataract progression at the end of 6th month are expected side effects.

Anahtar Kelimeler

• Dexamethasone intravitreal implant
• Retinal vein occlusion
• Diabetic retinopathy
• Macular edema

Kaynakça

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