The Effect of Dexamethasone Implant on Retinal Nerve Fiber Layer and Optic Nerve Cup-to-Disk Ratio in Patients with Diabetic Macular Edema

Yıl 2022, Cilt: 6 Sayı: 2, 143 - 148, 31.08.2022

Numan Küçük , Atilla Alpay

https://doi.org/10.25048/tudod.1142334

Cited By: 1

Öz

Aim: The aim of this study is to investigate the effect of single-dose intravitreal Dexamethasone (DEX) implant on peripapillary retinal
nerve fiber layer (RNFL) thickness and cup-to-disc (C/D) ratio in patients with diabetic macular edema.
Material and Methods: Peripapillary RNFL thickness measurements and colored fundus photographs were compared before and
6 months after intravitreal DEX implant injection. The cup-to-disc ratios of fundus photographs were calculated using the Image-J
program.
Results: Fifty-eight eyes of 43 patients were treated with intravitreal DEX implants. The mean global and sectoral peripapillary RNFL
thickness value had a slight thinning over the basal value. The global and nasal thinning was statistically significant (respectively;
p=0.021, p=0.036). A small increase in C/D value was observed 6 months after the DEX implant injection; however, these changes
were not statistically significant (p=0.285). The intraocular pressure was over 25 mmHg in 17% of the patients and it was controlled by
medical treatment.
Conclusion: In this study, in patients with diabetic macular edema, a mild but significant thinning of the global and nasal peripapillary
retinal nerve fiber layer was observed 6 months after single-dose intravitreal implant treatment. This reduction did not cause a significant
morphological change in the C/D value.

Anahtar Kelimeler

Dexamethasone implant, Diabetic macular edema, Intravitreal injection, Optic disc and nerve fiber layer imaging and analysis, Vascular endothelial growth factor (VEGF)

Diyabetik Makula Ödemli Hastalarda Deksametazon İmplantının Retina Sinir Lifi Tabakası ve Optik Sinir Çukurluk/Disk Oranı Üzerine Etkisi

Öz

Amaç: Bu çalışmanın amacı diyabetik maküla ödemi bulunan hastalarda tek doz intravitreal Deksametazon (DEX) implantının
peripapiller retina sinir lifi tabakası (RNFL) kalınlığına ve optik sinir çukurluk/disk (C/D) oranına etkisini araştırmaktır.
Gereç ve Yöntemler: İntravitreal DEX implant enjeksiyonu öncesi peripapiller RNFL kalınlık ölçümleri ve renkli fundus fotoğrafları
enjeksiyondan 6 ay sonrası ile karşılaştırıldı. Fundus fotoğraflarının C/D oranları Image-J programı kullanılarak hesaplandı.
Bulgular: Kırk üç hastanın 58 gözüne intravitreal DEX implant enjeksiyonu yapıldı. Ortalama global ve sektörel RNFL kalınlık değerleri
bazal değere göre hafif bir incelme gösterdi. Global ve nazal incelme istatistiksel olarak anlamlıydı (sırasıyla; p=0,021, p=0,036). DEX
implant enjeksiyonundan 6 ay sonra C/D değerinde hafif bir artış gözlendi, ancak bu artış istatistiksel olarak anlamlı değildi (p=0,258).
Hastaların %17’sinde göz içi basıncı 25 mmHg’nin üzerindeydi ve medikal tedavi ile kontrol altına alındı.
Sonuç: Bu çalışmada diyabetik maküla ödemi olan hastalarda tek doz intravitreal DEX tedavisinden 6 ay sonra global ve nazal peripapiller
retina sinir lifi tabakasında hafif fakat belirgin bir incelme gözlemlendi. Bu azalma, C/D değerinde önemli bir morfolojik değişikliğe
neden olmadı.

Anahtar Kelimeler

Deksametazon implant, Diyabetik maküler ödem, İntravitreal enjeksiyon, Optik disk ve retina sinir lifi tabakası analizi, Vasküler endotelyal büyüme faktörü

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