Turkiye Klinikleri Journal of Ophthalmology

.: ORIGINAL RESEARCH
Diyabetik Makula Ödeminde Bilateral Eş Zamanlı ve Unilateral İntravitreal Ranibizumab Tedavisinin Sonuçları
Outcomes of Bilateral and Unilateral Intravitreal Ranibizumab Injections in Diabetic Macular Edema
Sabahattin SÜLa, Aylin KARALEZLİa
aGöz Hastalıkları AD, Muğla Sıtkı Koçman Üniversitesi Tıp Fakültesi, Muğla, TÜRKİYE
Turkiye Klinikleri J Ophthalmol. 2019;28(1):37-42
doi: 10.5336/ophthal.2018-60714
Article Language: TR
Full Text
ÖZET
 Amaç: Diyabetik makula ödeminde bilateral eş zamanlı veya unilateral intravitreal ranibizumab (IVR tedavisinin erken dönem anatomik ve görsel sonuçlarını karşılaştırmaktır. Gereç ve Yöntemler: Çalışmaya yeni tanı DMÖ nedeni ile IVR tedavisi uygulanan 45 hasta alındı. 22 hastaya unilateral (Grup 1), 23 hastaya bilateral eş zamanlı (Grup 2) IVR tedavisi uygulandı. Tedavi öncesi ve 1.,2., ve 3. aylarda santral foveal kalınlık (SFK) ve en iyi düzeltilmiş görme keskinlikleri (EİDGK) ölçüldü. Gruplar arasında ölçülen SFK, EİDGK ve SFK ve EİDGK değişimleri (Δ) karşılaştırıldı. Sistemik ve lokal komplikasyonlar değerlendirildi. Bulgular: Tedavi öncesi Grup 1'de ortalama SFK 457±157μ, Grup 2'de sağ gözlerde: 462±121 μ, sol gözlerde 442±61 μ idi ve ortalama EİDGK Grup 1'de 0,25±0,15, grup 2 sağ gözlerde: 0,24±0,15, sol gözlerde 0,29±0,16 idi. Ardışık 3 enjeksiyon sonrası, Grup 1 ve Grup 2 sağ ve sol gözler arasında SFK (SFK Grup 1: 243±43 μ, Grup 2 sağ gözler: 243±70 μ, sol gözler: 241±58 μ) ve EİDGK (EİDGK Grup 1: 0,56±0,18, Grup 2 sağ gözler: 0,56±0,25, sol gözler: 0,57±0,25) açısından belirgin fark izlenmedi. ΔSFK ve ΔEİDGK gruplar arasında benzerdi. Unilateral veya bilateral ardışık enjeksiyon yapılan hastaların hiçbirinde sistemik veya lokal komplikasyon izlenmedi. Sonuç: Bilateral veya unilateral enjeksiyonlar sonucu benzer anatomik ve görsel sonuçlar elde edilmiştir. Bilateral enjeksiyonların sağladığı ek bir terapötik etki veya komplikasyon izlenmemiştir.

Anahtar Kelimeler: Diyabetik retinopati; makula ödemi; ranibizumab
ABSTRACT
 Objective: To compare the early anatomic and visual outcomes of bilateral simultaneous and unilateral intravitreal ranibizumab (IVR) injections in diabetic macular edema (DME) Material and Methods: 45 naive DME patients who were applied IVR were included in the study. 22 patients were applied unilateral (Group 1) and 23 patients were applied bilateral simultaneous (Group 2) IVR. Central foveal thickness (CFT) and best corrected visual acuity (BCVA) were evaluated before the treatment and at month 1, 2 and 3. CFT, BCVA and change of CFT and BCVA (Δ) were compared between groups. Systemic and local complications were also determined. Results: Mean CFT was 457±157μ in Group 1. 462±121 μ in the right eyes (RE) and 442±61 μ in the left eyes of Group 2 and mean BCVA was 0.25±0.15 in Group 1, 0.24±0.15 in REs and 0.29±0.16 in LEs of Group 2 before the treatment. There was no significant difference between Group 1 and REs and LEs of Group 2 in terms of CFT (CFT in Group 1: 243±43 μ, REs of Group 2: 243±70 μ and LEs of Group 2: 241±58 μ) and BCVA (BCVA in Group 1: 0.56±0.18, Group 2 REs: 0.56±0.25 and LEs: 0.57±0.25) after 3 consecutive injections. ΔCFT was similar between groups. No systemic or local complications were detected in any of the patients. Conclusion: Anatomic and visual outcomes were similar after unilateral or bilateral injections. No additional therapeutic effect or complication of bilateral injections were detected.

Keywords: Diabetic retinopathy; macular edema; ranibizumab
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