Outcomes of diode laser photocoagulation for zone 1 retinopathy of prematurity

Yıl 2012, , 253 - 256, 01.12.2012

Sema Arvas Solmaz Akar Ahmet Sarıcı Didar Uçar

https://doi.org/10.4274/tpa.137

Öz

Aim: The aim of this study was to establish serum sistatine C urine beta;2 microglobulin gluthatione S transferase pi; and N acetyle beta; D glucosaminidase levels in order to evaluate the effect of total parenteral nutrition on renal function in premature infants In addition we aimed to compare the renal functions between premature infants receiving total parenteral nutrition and control groups receiving enteral feeding Material and Method: A hundred four premature infants with a gestational age between 28 and 34 weeks were included in the study The parenteral nutrition group consisted of 50 infants male female; 23 27 and mean weight 1258 plusmn;212 3 g and the enteral nutrition group consisted of 54 infants male female; 20 34 and mean weight 1608 plusmn;206 1 g In the parenteral nutrition group; total parenteral group nutrition was initiated on the 3rd day in the enteral nutrition group minimal enteral nutrition was started on a mean of 6 3 plusmn;2 4 days and total enteral nutrition was started on a mean of 24 5 plusmn;6 3 days Breastmilk was given orally or by orogastric nasogastric tube at first day of life in the enteral group On the 3rd and 30th day of life blood samples of all patients were obtained for evaluating biochemical parameters and cystatin C and urine samples were obtained for evaluation of N acetyl beta; D glucosaminidase gluthatione S transferase pi; beta;2 microglobulin sodium creatinin levels density and pH of the urine The study was approved by the ethics commite 2008 16 Results: When we compared the patients who received total parenteral nutrition and enteral nutrition on the 3rd and 30th days serum cystatin C urinary beta;2 microglobulin gluthatione S transferase pi; and N acetyl beta; D glucosaminidase excretions were similar on the 3rd day however were significantly higher on the 30th day in samples of the patients receiving total parenteral nutrition p lt;0 05 for each parameter on each day Conclusions: This study shows that total parenteral nutrition in premature infants can have adverse effects on glomerular and tubular functions of the kidney which can be manifested at an early time with cystatin C beta;2 microglobulin gluthatione S transferase pi; and N acetyl beta; D glucosaminidase Turk Arch Ped 2012; 47: 247 52

Anahtar Kelimeler

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Zon 1 prematürite retinopatisi olan hastaların diod lazer fotokoagülasyon ile tedavi sonuçları

Öz

Amaç: Üçüncü basamak sağlık hizmeti veren üniversite hastanesi kliniğimizde Zon 1 prematürite retinopatisi olan hastaların diod lazer fotokoagülasyon DLF ile tedavi sonuçlarını bildirmek. 

Gereç ve Yöntem: Cerrahpaşa Tıp Fakültesi Retina Birimi rsquo;nde Haziran 2007 ile Aralık 2010 tarihleri arasında prematürite retinopatisi için erken tedavi The Early Treatment for Retinopathy of Prematurity Study = ETROP ölçütlerine göre eşik öncesi zon 1 tanısı alarak ve yine ETROP ölçütlerine uygun olarak diod lazer fotokoagülasyon uygulanmış 257 yeni doğanın 452 gözüne ait veri dosyaları geriye dönük olarak incelendi Anatomik ve yapısal başarı prematürite retinopatisinin gerilemesi ve makulanın yatışık olması arka zon 1 grup A ve ön zon 1 grup B için ayrı ayrı değerlendirildi. 

Bulgular: Grup A rsquo;da ortalama doğum ağırlığı 1120 2 g aralık 490 2500 g olup ortalama doğum haftası ise 28 2 hafta aralık 22 35 hafta idi Grup B rsquo;de ise ortalama doğum ağırlığı 1128 9 g 560 1930 ve ortalama doğum haftası 28 4 hafta 24 34 idi Arka zon 1 hastalarda 98 15 ön zon 1 hastalarda ise 98 65 başarı elde edildi. 

Çıkarımlar: Zon 1 prematürite retinopatisi yüksek riskli hastaları kapsar Bu hastalığın lsquo;eşik öncesi rsquo; dönemde diod lazer ile tedavisi etkin ve güvenli bir tedavidir Ülkemizde yüksek doğum ağırlıklı erken doğmuş bebeklerde zon 1 prematüre retinopatisinin görülmesi perinatal bakım hizmetlerinin yeniden gözden geçirilmesi ile azaltılabilir.

Anahtar Kelimeler

Diod lazer, erken doğum, retinopati, zon 1

Kaynakça

• Tasman W. Retinopathy of prematurity: do we still have a problem? The Charles L. Schepens lecture. Arch Ophthalmol 2011; 129: 1083-6.
• Phan MH, Nguyen PN, Reynolds JD. Incidence and severity of retinopathy of prematurity in Vietnam, a developing middle-income country. J Pediatr Ophthalmol Strabismus 2003; 40: 208-12.
• Akman I, Demirel U, Yenice O, Ilerisoy H, Kazokoğlu H, Ozek E. Screening criteria for retinopathy of prematurity in developing countries. Eur J Ophthalmol 2010; 20: 931-7.
• Cryotherapy for Retinopathy of Prematurity Cooperative Group. Multicenter trial of cryotherapy for retinopathy of prematurity. Three-month outcome. Arch Ophthalmol 1990: 108: 195-204.
• Cryotherapy for retinopathy of prematurity cooperative group. Multicenter trial of cryotherapy for retinopathy of prematurity: ophthalmological outcomes at 10 years. Arch Ophthalmol 2001 ;119: 1110-8.
• Early Treatment For Retinopathy Of Prematurity Cooperative Group. Revised indications for the treatment of retinopathy of prematurity: results of the early treatment for retinopathy of prematurity randomized trial. Arch Ophthalmol 2003; 121: 1684-94.
• International Committee for the Classification of Retinopathy of Prematurity. The international classification of retinopathy of prematurity revisited. Arch Ophthalmol 2005; 123: 991-9.
• Hunter DG, Repka MX. Diode laser photocoagulation for threshold retinopathy of prematurity. A randomized study. Ophthalmology 1993; 100(2): 238-44.
• Kychenthal A, Dorta P, Katz X. Zone I retinopathy of prematurity: clinical characteristics and treatment outcomes. Retina 2006; 26(Supll 7): 11-5.
• Vander JF, Handa J, McNamara JA, et al. Early treatment of posterior retinopathy of prematurity: a controlled trial. Ophthalmology 1997; 104(11): 1731-5.
• Capone A Jr, Diaz-Rohena R, Sternberg P Jr, Mandell B, Lambert HM, Lopez PF. Diode-laser photocoagulation for zone 1 threshold retinopathy of prematurity. Am J Ophthalmol 1993; 116(4): 444-50.
• Axer-Siegel R, Snir M, Cotlear D, et al. Diode laser treatment of posterior retinopathy of prematurity. Br J Ophthalmol 2000; 84(12): 1383-6.
• Fleming TN, Runge PE, Charles ST. Diode laser photocoagulation for prethreshold, posterior retinopathy of prematurity. Am J Ophthalmol 1992; 114(5): 589-92.
• O'Keefe M, Lanigan B, Long VW. Outcome of zone 1 retinopathy of prematurity. Acta Ophthalmol Scand 2003; 81: 614-6.
• Arrindell EL, Wu JC, Wolf MD, et al. High-resolution magnetic resonance imaging evaluation of blood-retinal barrier integrity following transscleral diode laser treatment. Arch Ophthalmol 1995; 113: 96-102.
• Soh Y, Fujino T, Hatsukawa Y. Progression and timing of treatment of zone I retinopathy of prematurity. Am J Ophthalmol 2008; 146: 369-74.