Long-term results of intravitreal ranibizumab, dekzametazon implant and triamcinolone treatment for macular edema due to branch retinal vein occlusion

YÖK Tez ID: 503055Amaç: Retina ven dal tıkanıklığı (RVDT)?na bağlı makula ödeminin tedavisinde intravitreal Ranibizumab, Dekzametazon İmplant ve Triamsinolon (İVTA) enjeksiyonu uygulamalarının uzun dönem etkinlik ve güvenilirliğini karşılaştırmaktır. Gereç ve Yöntem: RVDT?ye bağlı makula ödemi gelişen ve intravitreal enjeksiyon uygulanan 43 hastanın 43 gözü retrospektif olarak incelendi. İntravitreal Ranibizumab (Lucentis®) uygulanan 17, intravitreal Dekzametazon İmplant (Ozurdex®) uygulanan 16 ve İVTA uygulanan 10 hasta çalışmaya alındı. Her üç grup hastada enjeksiyon öncesinde ve sonrası 1. ay, 3. ay, 6. ay ve 12. ayda en iyi düzeltilmiş görme keskinliği (EİDGK), merkezi makula kalınlığı (MMK), subfoveal koroid kalınlığı (SFKK), göz içi basıncı (GİB) ve lens durumu değerlerindeki değişimler incelendi. Bulgular: Hastalar en az bir yıl süresince izlendi. Başlangıç verilerine göre Ranibizumab ve Dekzametazon İmplant grubunda her vizitte; İVTA grubunda ise 1. ve 6. aylarda EİDGK?de anlamlı artış bulundu. MMK her üç grupta da anlamlı olarak azaldı (p=0,007; p=0,001; p=0,044). Ranibizumab grubunda GİB artışı görülmezken; Dekzametazon İmplant grubunda 3 hastada (% 18,8), İVTA grubunda 3 hastada (% 30) GİB artışı görüldü. Ranibizumab grubunda katarakt cerrahisi gerekmezken; Dekzametazon İmplant grubunda 1 hastada (% 6,3) ve İVTA grubunda 3 hastada (% 30) katarakt cerrahisi gerekti. Her üç grupta da SFKK ilk ay anlamlı olarak azalırken diğer aylarda anlamlı değişiklik görülmedi. Sonuç: RVDT?ye bağlı makula ödemi tedavisinde intravitreal Ranibizumab, Dekzametazon İmplant ve Triamsinolon etkili olarak kullanılabilir. Ancak; en güvenilir tedavinin intravitreal Ranibizumab uygulaması ile olduğu söylenebilir. Anahtar Kelimeler: Retina Ven Dal Tıkanıklığı, Makula Ödemi, İntravitreal Ranibizumab, İntravitreal Dekzametazon İmplant, İntravitreal Triamsinolon Asetonid.Purpose:The aim of this study is to evaluate and compare the long-term efficacy and safety of intravitreal Ranibizumab,Dexamethasone Implant and Triamsinolone(IVTA)injections in patients with macular edema due to branch retinal vein occlusion(BRVO). Materials and Methods:A total of 43 eyes of 43 patients who underwent intravitreal injections for macular edema due to BRVO were studied retrospectively.The study group consisted of 17 patients,who underwent intravitreal Ranibizumab(Lucentis®),16 patients who underwent intravitreal Dexamethasone Implants(Ozurdex®)and 10 patients who underwent IVTA.Bestcorrected visual acuity(BCVA),central macular thickness(CMT),subfoveal choroidal thickness(SFCT),intraocular pressure(IOP)and changes in lens status were measured before and after injection at 1st month,3rd month,6th month and 12th month in all three groups. Results:Patients were followed-up at least one year.BCVA increased at all visits in Ranibizumab and Dexamethasone Implant group,whereas significant BCVA increase was only observed at 1st and 6th month during follow-up in IVTA group.CMT was significantly decreased in all three groups(p=0,007,p=0,001,p=0,044).IOP did'nt increase in any patient in Ranibizumab group,but increased in 3 patients(18.8%)in Dexamethasone Implant group and in 3 patients(30%)in IVTA group.No patient had undergone cataract surgery in Ranibizumab group. One patient(6.3%)had undergone cataract surgery in Dexamethasone Implant group and 3 patients(30%)had undergone cataract surgery in IVTA group.SFCT was decreased in first month after the injection in all three groups but there was no significant change in other months. Conclusion:Intravitreal Ranibizumab,Dexamethasone Implant and Triamcinolone can be used effectively in treatment of macular edema due to BRVO.This study shows that intravitreal Ranibizumab injections are more reliable than other groups. Keywords:Branch Retinal Vein Occlusion,Macular Edema,Intravitreal Ranibizumab,Intravitreal Dexamethasone Implant,Intravitreal TriamcinoloneAsetonid

Changes in the choroidal thickness in reproductive-aged women with iron-deficiency anemia

yumusak, erhan/0000-0002-9296-8451WOS: 000367527800002PubMed: 26715579Background: The aim of this study was to investigate the potential significance of the central macular thickness (foveal thickness-FT) and choroidal thickness (CT) in the eyes of patients with iron-deficiency anemia, the most common form of the anemia, via enhanced-depth imaging optical coherence tomography (EDI-OCT). We also investigated whether such changes might serve as an early indicator of underlying hematological disease. Methods: This prospective clinical study compared 96 female patients with iron-deficiency anemia and 60 healthy female control subjects. The macular and choroidal thicknesses in the temporal and nasal subfoveal areas were measured using enhanced-depth imaging optical coherence tomography (EDI-OCT) at 500 and 1500 microns and in five different regions (FCT, T-1500, T-500, N-500, and N-1500). Results: The mean ages of the patients and healthy controls were 34.08 +/- 10.39 years and 32.29 +/- 8.28 years, respectively (P = 0.232). There were no significant changes in macular thickness between the groups (225.58 +/- 19.76 vs. 222.45 +/- 13.51, P = 0.2). The choroidal thickness was significantly reduced in the patient group relative to the controls at all measured points (foveal choroidal thickness, P = 0.042; nasal-500 microns, P = 0.033; temporal-500 microns, P = 0.033; and temporal-1500 microns, P = 0.019). At some points, the choroidal thickness findings correlated with the hemoglobin values (temporal-500 microns, r = -0.287, P = 0.001; nasal-500 microns, r = -0.287, P = 0.005; nasal-1500 microns, r = -0.245, P = 0.016; and temporal-1500 microns, r = -0.280, P = 0.06). Conclusions: Patients with iron-deficiency anemia had a significantly reduced choroidal thickness

The Epidemiology of Open Globe Injuries of the Eye

Amaç: 01.01.2014 ile 01.05.2017 tarihleri arasında açık glob yaralanması nedeniyle başvuran 53 hastanın 53 gözünü epidemiyolojik açıdan retrospektif olarak incelemek. Gereç ve Yöntem: Hasta bilgileri hasta dosyaları taranarak kaydedildi. Çıkarılan hasta verileri yaş, cinsiyet, travma türü (keskin/künt), yer ve travmanın şekli ve hangi gözde olduğu şeklindeydi. Başvuru anındaki ve en son andaki görme keskinliği Snellen'in görme keskinliği çizelgesi kullanılarak kaydedildi. Dilate fundus bulgularını da kapsayan biyomikroskobik muayeneler ayrıntılı olarak not edildi. Bulgular: Hastaların 43’ü (%81,1) erkek, 10’u (%18,9) kadındı. Cinsiyet açısından karşılaştırıldığında açık glob travması erkek hastalarda kadın hastalara göre istatistiksel olarak daha yüksekti (p0.001). Hastaların yaşı arttıkça açık glob yaralanması insidansının azaldığı görüldü. Travmaların %54,7’si iş kazası, %22,6’sı ev kazası, %7,5’i trafik kazası, %13,2’si ev ve iş dışında, %1,9’u ise spor yaparken gerçekleşen kazalardı. Sonuç: Açık glob yaralanmalarının tedavi sonuçları hastalar için yüz güldürücü değildir ve bu tip yaralanmaların çoğunluğu önlenebilir sebeplerden meydana gelmektedir. İş güvenliğine verilecek önem ve toplumun bu konudaki farkındalığını arttıracak eğitimler bu tür yaralanmaların oranını azaltabilir.Objective: Fifty-three eyes of 53 patients with open eye injury who admitted Kırıkkale University Faculty of Medicine Department of Ophthalmology between January 1 2014-May 1 2017 were included in this retrospective study in order to evaluate the epidemiological factors. Material and Methods: Patient data were retrieved from patient’s examination files. Patient data included age, gender, type of trauma (sharp/blunt), location and nature of trauma. Visual acuity at the time of presentation and at discharge were recorded using Snellen’s visual acuity chart. Details of slit lamp examination including fundus examination were noted. Results: Of the patients, 43 (81.1%) were male and 10 (18.9%) were female. Men had a higher rate of open globe trauma than women (p0.001). The incidence of eye injury decreased with increasing age. Work-related injuries constituted 54.7%of traumatic injuries. Home accidents constituted 22.6%, traffic accidents constituted 7.5%, outdoor related activities constituted 13.2%, and sports-related injuries constituted 1.9%of all open globe injuries. Conclusion: The consequences of open globe injuries treatment are not good for patients. Most of these injuries are preventable. Prioritizing job security and educational activities that will raise the public's awareness on this issue can reduce the rate of such injuries