Publication: Persistan Diyabetik Maküla Ödeminde Uygulanan Vitre İçi Deksametazon İmplantasyonunun 12 Ay Takip Sonuçları
Abstract
Amaç: Anti-VEGF ve fotokoagülasyon tedavilerine rağmen perzistan diyabetik maküla ödeminde uygulanan vitre içi deksametazon implantasyonunun 12 ay takip sonuçlarını araştırmak.Gereç ve Yöntem: Fokal/grid lazer ve/veya en az ardışık 3 defa anti-VEGF ajan enjeksiyonu almasına rağmen düzeltilmiş en iyi görme keskinliğinde artış sağlanamayan veya optik koherens tomografide santral maküla kalınlığı >250 ?m devam eden hastalar perzistan diyabetik maküla ödemi kabul edilerek vitre içine tek doz 0,7 mg deksametazon implantı uygulanan hastaların enjeksiyon sonrasındaki 1. ay, 2. ay, 3. ay, 6. ay ve 12. aydaki düzeltilmiş en iyi görme, optik koherens tomografi ve göziçi basıncı sonuçları incelendi.Bulgular: İmplant enjeksiyonundan sonraki ilk ayda en fazla görme artışı ve santral fovea kalınlığı azalması gözlendi (p<.001, her ikisi de). İkinci ve üçüncü aylarda da başlangıca göre hem düzeltilmiş en iyi görme keskinliği anlamlı olarak yüksek (p=.005, p=.011, sırasıyla) hem de santral fovea kalınlığı anlamlı olarak incelmiş olarak gözlendi. (p<.001, p=.016, sırasıyla) Altıncı ve on ikinci aylarda ise ortalama düzeltilmiş en iyi görme keskinliği ve santral fovea kalınlığı başlangıç değerlerinden farklı bulunmadı.Sonuç: Vitre içine uygulanan anti-VEGF ajanlar diyabetik maküla ödeminin tedavisinde etkili ve yan etkileri göreceli olarak azdır, ancak vitre içine uygulanan deksametazon implantı diğer tedavilere yanıt alınamamış perzistan diyabetik hastalarda başarılıdır ve 6 aylık enjeksiyon aralığı tercih edilebilir.
Aim: To investigate the results of intravitreal dexamethasone implantation in patients with persistent diabetic macular edema despite antiVEGF and photocoagulation treatment.Material and Method: The best corrected visual acuity, optical coherence tomography and intraocular pressure at 1st, 2nd, 3rd, 6th and 12th month follow-up in patients who had received grid/focal laser or more than three subsequent injections of anti-VEGF agents but had no improvement in best corrected visual acuity or had a central foveal thickness of >250 ?m were investigated.Results: The highest mean corrected best visual acuity gain and central foveal flattening was obtained at first month. At first and second months the mean best corrected visual acuity was significantly higher (p<.001, both) and also the mean central foveal thickness was significantly flatter. (p<.001, p=.016, correspondingly)Conclusion: Intravitreal anti-VEGF agents are effective and have relatively less side effects. Intravitreal dexamethazone implants on the other hand are successful in treating patients with persistent diabetic retinopathy who are otherwise unrespoınsive to other treatments and preferred injection interval might be 6 months.
Aim: To investigate the results of intravitreal dexamethasone implantation in patients with persistent diabetic macular edema despite antiVEGF and photocoagulation treatment.Material and Method: The best corrected visual acuity, optical coherence tomography and intraocular pressure at 1st, 2nd, 3rd, 6th and 12th month follow-up in patients who had received grid/focal laser or more than three subsequent injections of anti-VEGF agents but had no improvement in best corrected visual acuity or had a central foveal thickness of >250 ?m were investigated.Results: The highest mean corrected best visual acuity gain and central foveal flattening was obtained at first month. At first and second months the mean best corrected visual acuity was significantly higher (p<.001, both) and also the mean central foveal thickness was significantly flatter. (p<.001, p=.016, correspondingly)Conclusion: Intravitreal anti-VEGF agents are effective and have relatively less side effects. Intravitreal dexamethazone implants on the other hand are successful in treating patients with persistent diabetic retinopathy who are otherwise unrespoınsive to other treatments and preferred injection interval might be 6 months.