Turkiye Klinikleri Journal of Ophthalmology

.: ORIGINAL RESEARCH
Prematüre Retinopatisinde Lazer Fotokoagülasyon Yapılan Hastalarda Uzun Dönem Sonuçlarımız: Retrospektif Kesitsel Çalışma
Our Long-Term Results in Patients with Laser Photocoagulation in Premature Retinopathy: Retrospective Cross-Sectional Study
Hüban ATİLLAa, Ferhad ÖZERa, Pınar BİNGÖL KIZILTUNÇa, Figen ŞERMETa
aAnkara Üniversitesi Tıp Fakültesi, Göz Hastalıkları ABD, Ankara, Türkiye
Turkiye Klinikleri J Ophthalmol. 2023;32(1):35-9
doi: 10.5336/ophthal.2022-91929
Article Language: TR
Full Text
ÖZET
 Amaç: Prematüre retinopatide lazer fotokoagülasyon ile tedavi uygulanan bebeklerde, uzun dönem sonuçları ve olası komplikasyonları vurgulamaktır. Gereç ve Yöntemler: Bu retrospektif kesitsel çalışmaya, 2001-2020 yılları arasında yapılan taramada, prematüre retinopatisi nedeniyle lazer yapılan hastalar ve benzer bulguları gerilemiş olup lazer gerekmeyen 97 hasta dâhil edilmiştir. Hastalar lazer tedavisi uygulanıp uygulanmamasına göre 2 gruba ayrılmıştır. Lazer tedavisi uygulananlar Grup 1, uygulanmayanlar ise Grup 2 olarak sınıflandırılmıştır. Hasta dosyalarından hastaların demografik özellikleri, doğum öyküsü, tekil-çoğul gebelik durumları, ek hastalık durumu, izlem süreleri, takip ve tedavi sonuçları ile son muayenelerindeki kırma kusuru ve şaşılık varlığı kaydedilmiştir. Her iki grup arasında doğum ağırlığı, doğum haftası, ikiz eşi olma durumu, şaşılık gelişimi ve kırma kusuru gelişimi karşılaştırılmıştır. Bulgular: Toplam 97 hastanın 194 gözü çalışmaya dâhil edilmiştir. Hastaların 42'si (%43,3) kız, 55'i (%56,7) erkek idi. Grup 1 için ortalama lazer fotokoagülasyon uygulama yaşı 36,5±3,5 (33-48) hafta idi. Toplam 97 hastanın 50'sinde (%51,5) kırma kusuru mevcuttu. Bu hastaların 36'sı (%72) Grup 1'de, 14'ü (%28) Grup 2'de idi. Hastalar sferik ekivalan değerlerine göre değerlendirildiğinde, Grup 1'de ortalama sferik değer -1,20(-12,0/+8,0)D, Grup 2'de ortalama değer +1,25(-3,0/+4,5)D idi. Grup 1'de şaşılık gelişen 8 hastadan 5'inde (%62,5) ezotropya, 3'ünde (%37,5) ekzotropya saptandı. Grup 2'de ise şaşılık gelişen 6 hastadan 4'ünde (%66,6) ezotropya, 2'sinde (%33,6) ekzotropya saptandı. Sonuç: Prematüre bebeklerde, sadece erken dönemdeki prematüre retinopati tedavisi için değil, sonraki büyüme ve gelişim aşamalarında gelişebilecek ambliyopi, anizometropi, şaşılık gibi diğer problemler için de takibe devam edilmelidir. Kırma kusurları, ametropi, anizometropi, genellikle ambliyopiye ilerlediğinden, düzenli tarama ve erken dönemde kırma kusurlarının düzeltilmesi önemlidir.

Anahtar Kelimeler: Prematüre retinopatisi; lazer; şaşılık; kırma kusuru
ABSTRACT
 Objective: To emphasize the long-term results and possible complications in infants treated with laser photocoagulation in retinopathy of prematurity. Material and Methods: In this retrospective crosssectional study, patients who underwent laser treatment for retinopathy of prematurity in the screening performed between 2001 and 2020 and 97 patients whose similar findings regressed and did not require laser were included. Patients were divided into 2 groups according to whether laser treatment was applied or not. Those who received laser treatment were classified as Group 1, and those who did not receive laser treatment were classified as Group 2. Demographic characteristics, birth history, singlemultiple pregnancy status, additional disease status, follow-up periods, follow-up and treatment results, and refractive error and strabismus at the last examination were recorded from the patient files. Birth weight, week of birth, twin status, strabismus and refractive error were compared between the two groups. Results: A total of 194 eyes of 97 patients were included in the study. Of the patients, 42 (43.3%) were female and 55 (56.7%) were male. The mean age of laser photocoagulation for group 1 was 36.5±3.5 (33-48) weeks. Fifty (51.5%) of 97 patients had refractive errors. Thirty-six (72%) of these patients were in Group 1 and 14 (28%) were in Group 2. When the patients were evaluated according to their spherical equivalent values, the mean spherical value in Group 1 was -1.20(-12.0/+8.0)D, in Group 2 the mean value was +1.25(-3.0/+4, 5)D. In Group 1, esotropia was found in 5 (62.5%) and exotropia in 3 (37.5%) of 8 patients who developed strabismus. In group 2, esotropia was found in 4 (66.6%) of 6 patients who developed strabismus, and exotropia was found in 2 (33.6%) patients. Conclusion: In premature babies, follow-up should be continued not only for the treatment of premature retinopathy in the early period, but also for other problems such as amblyopia, anisometropia, and strabismus that may develop in later growth and development stages. Refractive errors, ametropia, anisometropia often progress to amblyopia, regular screening and correction of refractive errors in the early period are important.

Keywords: Retinopathy of prematurity; laser; strabismus; refractive error
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