Turkiye Klinikleri Journal of Ophthalmology

.: ORIGINAL RESEARCH
Kronik Oküler Hipotoni Tanı ve Tedavisinde Ultrason Biyomikroskopinin Yeri
Use of Ultrasound Biomicroscopy in the Diagnosis and Treatment of Chronic Ocular Hypotony
Hilal NALCIa, M. Banu HOŞALa, Nilüfer YALÇINDAĞa
aGöz Hastalıkları AD, Ankara Üniversitesi Tıp Fakültesi, Ankara, TÜRKİYE
Turkiye Klinikleri J Ophthalmol. 2019;28(1):1-6
doi: 10.5336/ophthal.2017-58910
Article Language: TR
Full Text
ÖZET
 Amaç: Kronik oküler hipotoni, çeşitli hastalıklara ikincil oluşan, uzun dönemde kalıcı değişikliklere yol açabilen bir durumdur. Ultrason biyomikroskopinin (UBM) kullanıma girmesiyle hipotoni mekanizmalarının daha doğru değerlendirilmesi mümkün hâle gelmiştir. Bu çalışmada, olgu serisi üzerinden kronik oküler hipotoninin tanısında ve izleminde UBM'nin yerinin gösterilmesi amaçlanmıştır. Gereç ve Yöntemler: Kliniğimizde 2005-2015 yılları arasında kronik hipotoni tanısıyla UBM yapılan hastalar retrospektif olarak değerlendirildi. Hastaların yaşı, cinsiyeti, primer hastalığı, görme keskinliği, göz içi basıncı, hipotoni süresi, UBM bulguları, hipotoni tedavisi ve tedavi sonuçları kaydedildi. Bulgular: 20 hastaya oküler hipotoni tanısıyla UBM görüntüleme yapıldığı belirlendi. Bu hastalardan filtran cerrahi sonrası fazla çalışan bleb nedenli hipotoni gelişenler ekarte edildikten sonra dosya bilgilerine ulaşılabilen 10 hastanın 12 gözü çalışmaya alındı. Hastaların 6 (%60)'sı kadın, 4 (%40)'ü erkekti. Ortalama tanı yaşı 58,5 (47-69) yıl'dı. Ortalama göz içi basıncı 4,25 mmHg (0-6 mmHg) idi. Hipotoni görülen gözlerin 8 (%66,6)'inde tanı kronik nonenfeksiyöz panüveit, 3'ünde (%25) regmatojen retina dekolmanı nedenli geçirilmiş pars plana vitrektomi (PPV) ameliyatı ve 1 (%8,4)'inde künt göz travması idi. UBM ile gözlerin 8 (%66)'inde siliyer cisim dekolmanı, 3 (%25)'ünde siliyer cisim atrofisi ve 1'inde(%8) siklitik membranlar izlendi. Bir (%8) hastada siliyer cisim normal görünümde idi. Sonuç: Oküler hipotoni hastalarında UBM, hipotoni mekanizmasının belirlenmesinde ve hastaların izlemlerinde yardımcı olan önemli bir değerlendirme yöntemidir.

Anahtar Kelimeler: Kronik oküler hipotoni; ultrason biyomikroskopi
ABSTRACT
 Objective: Chronic ocular hypotony is an entity that can occur with different mechanisms secondary to various diseases, leading to permanent changes in long-term follow-up. With use of ultrasound biomicroscopy (UBM), it's possible to accurately identify the etiology of hypotony. The purpose of our study is to show the use of UBM in the diagnosis and follow-up of chronic ocular hypotony through a series of cases. Material and Methods: Patients who underwent UBM due to chronic ocular hypotony within years 2005-2015 were retrospectively evaluated. Age, sex, primary disease, visual acuity, intraocular pressure, duration of hypotony, UBM results, treatments and treatment results were noted. Results: 20 patients who underwent UBM with a diagnosis of hypotony were identified. After ruling out patients with an owerworking bleb after glaucoma surgery, 12 eyes of 10 patients with complete file information were evaluated retrospectively. 6 (60%) of the cases were females,4 (40%) were males. Mean age was 58.5 (47-69) years. Mean intraocular pressure was 4,25 mmHg (0-6 mmHg). Primary disease was chronic non-infectious panuveitis in 8 (66.6%), prior pars plana vitrectomy(PPV) due to regmatogen retinal detachment in 3 (25%), blunt ocular trauma in 1 (8.4) of the cases.UBM revealed ciliary body detachment in 8 (66%) eyes, ciliary body atrophy in 3 (25%) eyes, and cyclitic membranes in 1 (8%) eye. A normal ciliary body was observed in 1 (8%) patient. Conclusion: UBM is an important imaging technique for chronic ocular hypotony which can be used in the determination of the mechanism and patient follow-up.

Keywords: Chronic ocular hypotony; ultrasound biomicroscopy
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