COVID-19 Kapanmasının Yaşa Bağlı Makula Dejenerasyonu Tedavisine Etkileri

Yıl 2023, , 247 - 251, 31.08.2023

Serdar Bilici , Kardelen Ezgi Şahin-elarslan

https://doi.org/10.29058/mjwbs.1294394

Öz

Amaç: Yaşa bağlı makula dejenerasyonu (YBMD) olgularında COVID-19 kapanması nedeniyle yaşanan
intravitreal anti-vasküler büyüme faktörü (VEGF) tedavisindeki gecikmenin anatomik ve fonksiyonel
etkilerinin değerlendirilmesi amaçlandı.
Gereç ve Yöntemler: COVID-19 nedeniyle anti-VEGF tedavisine ara verilen YBMD olguları çalışmaya
dahil edildi. Olguların yaş, cinsiyet, tedaviye verilen ara süresi ve tekrar tedavi sonrası enjeksiyon
sayısı ile takip süresi kaydedildi. Karantina öncesi son vizitleri (V0), karantina sonrası ilk (V1) ve son
vizitlerindeki (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 sürecinde
tedaviye verilen ara ortalaması 26,4 ± 10,6 haftaydı. Tekrar tedaviye başlanan olguların ortalama takip
süresi 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, ortalama
SMK 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 SMK
değerleri 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 SMK
değerleri 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 olarak
kötüleşme izlenmiştir. Tekrar tedaviye başlanması ile SMK’ da düzelme olmasına rağmen GK kaybı
kalıcı olmuştur.

Anahtar Kelimeler

Anti-vasküler büyüme faktörü, COVID-19, optik koherens tomografi, yaşa bağlı makula dejenerasyonu

Destekleyen Kurum

Yok

Proje Numarası

Yok

Teşekkür

Dr. Esra Gültekin'e istatistiksel analiz yardımı için teşekkür ederiz.

Effects of COVID-19 Lockdown on Age-Related Macular Degeneration Treatment

Öz

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 was
interrupted due to the COVID-19 lockdown were included in the study. Age, gender, the interval time of
the 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 on
delay 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 the
pandemic period was 26.4 ± 10.6 weeks. The average follow-up period after the initiation of retreatment was 32.5 (9-52) weeks, and an
average 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 group
were 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 microns
respectively (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 visits
were 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. Although
there was an improvement in CMT with re-initiation of treatment, the loss of VA was irreversible.

Anahtar Kelimeler

Age-related macular degeneration, anti-vascular growth factor, COVID-19, optical coherence tomography

Proje Numarası

Yok

Kaynakça

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