Prematüre Retinopatisinde uygulanan Diod Lazer Fotokoagülasyon ile İntravitreal Ranibizumab Tedavilerinin Gözün Aksiyel Uzunluğuna ve Refraktif Durumuna Olan Etkilerinin Karşılaştırılması

Abstract

Amaç: Prematüre retinopatisi (PR) tedavisinde uygulanan diod lazer fotokoagülasyon (LFK) ile intravitreal ranibizumab(IVR) tedavilerinin gözün aksiyel ve refraktif gelişimi üzerine olan etkilerini değerlendirmektir.

Gereç ve Yöntemler: Kliniğimizde PR nedeniyle primer ve tek tedavi olarak  LFK ve ya  0.25 mg/0.025 ml IVR tedavisi  uygulanmış ve düzeltilmiş olarak bir yaşını doldurmuş 41 infantın 82 gözü çalışmaya dahil edilmiştir. Hastaların biyometri ile aksiyel uzunlukları(AU)  ölçülmüş, sikloplejik muayene sonucu elde edilen refraktif değerleri sferik eküvalan olarak karşılaştırılmıştır.

Bulgular: IVR grubunda 17 hastanın 34 gözü Grup-1, LFK grubunda ise 24 hastanın 48 gözü Grup-2 olarak ayrıldı.

Grup-1’de AU; sağ gözde 19,86 1,104mm; sol gözde 19,73 1,062mm idi. Grup-2’de sağ göz için 19,90 0,83mm sol göz için 19,86  0,842mm idi.(p>0.05) Refraktif değerler Grup-1’de sağ göz için 0.442.053D ; sol göz içinse 0.592.063D idi. Grup-2’de ise sağ göz -0.023.07D , sol göz ise -0.172.8 idi.( p>0.05) Her iki grupta  hem aksiyel uzunluk açısından hem de sferik eküvalan  açısından  istatistiksel olarak anlamlı fark saptanamamıştır

Sonuç: Prematüre retinopatili bebeklerde myopi gelişme oranı sağlıklı bebeklere göre daha yüksektir. Prematüre retinopatisi tedavisinde son yıllarda anti vasküler büyüme faktörü(anti-vebf) kullanımı hızla artmakla beraber LFK tedavisi altın standart tedavi olarak kullanılmaktadır. Çalışmamızda İVR tedavisi ile LFK tedavisinin aksiyel uzunluk ve sferik eküvalan değerleri üzerine yaptıkları etkiyi araştırdık ve bir fark bulamadık ama bu konuda daha fazla bilimsel çalışmaların yapılması gerektiğini düşünüyoruz  

Keywords

• Prematüre retinopatisi; Lazer Fotokoagülasyon; Ranibizumab; Aksiyel Uzunluk; Refraksiyon

Comparison of intravitreal ranibizumab and diod laser photocoagulation treatment for retinopathy of prematurity; effects on axial lenght and refractive status

Abstract

Objective: To evaluate the effects of diode laser photocoagulation and intravitreal

ranibizumab (IVR) treatments on axial lenght and refractive status development in the

treatment of retinopathy of premautrity (ROP).

 

Materials and methods: The study included 82 eyes of 41 patients who were 1 year

adjusted age, underwent primarily diode laser photocoagulation or 0.25 mg/0.025 ml

IVR. Axial lenght (AL) and spherical equivalent (SE) parameters were compared. 

Results: Patients divided into two groups. Group 1 had 34 eyes of 17 patients who underwent IVR treatment and group 2 had 48 eyes of 24  patients who underwent diode laser photocoagulation treatment. In group 1, AL were detected 19,86 ±1,104mm in right eyes and 19,73 ±1,062mm in left eyes. In group 2, AL were detected 19,90± 0,83mm in right eyes and 19,86 ± 0,842mm in left eyes (p>0.05). In group1 and 2, SE values were detected 0.44±2.053D and -0.02±3.07D  in right eyes and 0.59±2.063D and -0.17±2.8 in left eyesD, respectively ( p>0.05).  There was  no statistically significant differences between two groups about AL and SE values.

 

Conclusion: Myopia is seen higher in patients with ROP than healthy patients. Although using anti vascular growth factor in ROP has been increased last years, diode laser photocoagulation is the gold standart therapy. In our study we compared the effects of diode laser photocoagulation and IVR on AL and SE. We did not find any statistically significant difference. Further evaluation is needed.  

Keywords

• Retinopathy of Prematurity; Laser Photocoagulation; Ranibizumab; Axial Lenght; Refraction

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