.: ORİJİNAL ARAŞTIRMA
Tedavi Uygulanan veya Spontan Regrese Olan Prematüre Retinopatili Hastalarda Refraktif Sonuçlar
Refractive Outcomes in Infants with Treated or Spontaneously Regressed Retinopathy of Prematurity
Turkiye Klinikleri J Ophthalmol. 2020;29(1):19-24
doi: 10.5336/ophthal.2019-64716
Makale Dili: TR
Tam Metin
ÖZET
Amaç: Prematüre retinopatisi (PR) nedeni ile intravitreal bevacizumab (IVB) enjeksiyonu veya lazer fotokoagülasyon (LFK) veya IVB ile birlikte geç dönem LFK uygulanan ya da spontan regrese olduğu görülen olguların refraktif sonuçlarının değerlendirilmesidir. Gereç ve Yöntemler: Kanuni Sultan Süleyman Eğitim ve Araştırma Hastanesi Göz Kliniği PR Tanı ve Tedavi Birimi ve Zeynep Kamil Kadın ve Çocuk Hastalıkları Eğitim ve Araştırma Hastanesi Göz Kliniği PR Tanı ve Tedavi Biriminde tedavi uygulandıktan sonra Bakırköy Dr. Sadi Konuk Eğitim ve Araştırma Hastanesi Göz Kliniği PR Tanı ve Tedavi Biriminde takip edilen hastaların dosyaları retrospektif olarak incelendi. Çalışma kapsamına alınan 133 hasta 4 gruba ayrılarak değerlendirildi. 1. gruba IVB enjeksiyonu yapılan 60 hasta, 2. gruba IVB ile birlikte geç dönem LFK uygulanan 22 hasta, 3. gruba LFK uygulanan 20 hasta ve 4. gruba spontan regrese olduğu görülen 31 hasta dâhil edildi. Refraksiyon değerlendirmesi, çocuklar 18 aylıkken el otorefraktometresiyle yapıldı. Bulgular: LFK grubunda ve IVB ile birlikte geç dönem LFK uygulanan grupta doğum haftası ve doğum kilosu, IVB grubu ve spontan regresyon grubundan anlamlı olarak daha düşük saptandı. IVB ile birlikte geç dönem LFK uygulanan grupta ve IVB grubunda sferik ekivalan spontan regresyon grubundan anlamlı olarak daha düşük bulundu (sırasıyla p=0,002 ve p=0,012). Sonuç: En yüksek miyopi oranı IVB sonrası takip sürecinde geç dönem reaktivasyon saptanarak LFK uygulanan hastalarda görülürken; emetropiye en yakın refraktif değerleri ise spontan regrese olan grupta saptadık ve hastalık aktivitesinin ağırlığı ile refraktif kusurun ilişkili olabileceği sonucuna vardık.
Anahtar Kelimeler: Prematüre retinopatisi; bevacizumab; lazer koagülasyon; miyopi
Amaç: Prematüre retinopatisi (PR) nedeni ile intravitreal bevacizumab (IVB) enjeksiyonu veya lazer fotokoagülasyon (LFK) veya IVB ile birlikte geç dönem LFK uygulanan ya da spontan regrese olduğu görülen olguların refraktif sonuçlarının değerlendirilmesidir. Gereç ve Yöntemler: Kanuni Sultan Süleyman Eğitim ve Araştırma Hastanesi Göz Kliniği PR Tanı ve Tedavi Birimi ve Zeynep Kamil Kadın ve Çocuk Hastalıkları Eğitim ve Araştırma Hastanesi Göz Kliniği PR Tanı ve Tedavi Biriminde tedavi uygulandıktan sonra Bakırköy Dr. Sadi Konuk Eğitim ve Araştırma Hastanesi Göz Kliniği PR Tanı ve Tedavi Biriminde takip edilen hastaların dosyaları retrospektif olarak incelendi. Çalışma kapsamına alınan 133 hasta 4 gruba ayrılarak değerlendirildi. 1. gruba IVB enjeksiyonu yapılan 60 hasta, 2. gruba IVB ile birlikte geç dönem LFK uygulanan 22 hasta, 3. gruba LFK uygulanan 20 hasta ve 4. gruba spontan regrese olduğu görülen 31 hasta dâhil edildi. Refraksiyon değerlendirmesi, çocuklar 18 aylıkken el otorefraktometresiyle yapıldı. Bulgular: LFK grubunda ve IVB ile birlikte geç dönem LFK uygulanan grupta doğum haftası ve doğum kilosu, IVB grubu ve spontan regresyon grubundan anlamlı olarak daha düşük saptandı. IVB ile birlikte geç dönem LFK uygulanan grupta ve IVB grubunda sferik ekivalan spontan regresyon grubundan anlamlı olarak daha düşük bulundu (sırasıyla p=0,002 ve p=0,012). Sonuç: En yüksek miyopi oranı IVB sonrası takip sürecinde geç dönem reaktivasyon saptanarak LFK uygulanan hastalarda görülürken; emetropiye en yakın refraktif değerleri ise spontan regrese olan grupta saptadık ve hastalık aktivitesinin ağırlığı ile refraktif kusurun ilişkili olabileceği sonucuna vardık.
Anahtar Kelimeler: Prematüre retinopatisi; bevacizumab; lazer koagülasyon; miyopi
ABSTRACT
Objective: To evaluate the refractive outcomes of patients with premature retinopathy (PR) treated with intravitreal bevacizumab (IVB) or laser photocoagulation (LFK) or late-term LFK after IVB or that was spontaneously regressed. Material and Methods: Clinic record archives of infants followed up in Bakırköy Dr. Sadi Konuk Training and Research Hospital, Ophthalmology, PR Diagnose and Treatment Department after getting treatment in Kanuni Sultan Süleyman Training and Research Hospital, Ophthalmology, PR Diagnose and Treatment Department and Zeynep Kamil Maternity and Children's Diseases Training and Research Hospital, Ophthalmology, PR Diagnose and Treatment Department were retrospectively evaluated. 133 patients were examined in 4 groups. 1st group included 60 patients who underwent IVB injection, 2nd group included 22 patients who underwent late-term LFK after IVB, 3rd group included 20 patients who underwent LFK and 4th group included 31 infants with spontaneously regressed PR. The refraction assessment was performed at the age of 18 months with a hand autorefractometer. Results: Gestational age and birth weight were significantly lower in infants who underwent LFK or late-term LFK after IVB than the infants with spontaneously regressed PR. Spherical equivalent was significantly lower in the late-term LFK after IVB and IVB monotherapy groups than the infants with spontaneously regressed PR (p=0.002 and p=0.012, respectively). Conclusion: We found the highest incidence of myopia in the late-term LFK after IVB group and the nearest refractive results to emetropia in infants with spontaneously regressed PR. As a result we concluded that the refractive outcomes are correlated with the severity of PR.
Keywords: Retinopathy of prematurity; bevacizumab; laser coagulation; myopia
Objective: To evaluate the refractive outcomes of patients with premature retinopathy (PR) treated with intravitreal bevacizumab (IVB) or laser photocoagulation (LFK) or late-term LFK after IVB or that was spontaneously regressed. Material and Methods: Clinic record archives of infants followed up in Bakırköy Dr. Sadi Konuk Training and Research Hospital, Ophthalmology, PR Diagnose and Treatment Department after getting treatment in Kanuni Sultan Süleyman Training and Research Hospital, Ophthalmology, PR Diagnose and Treatment Department and Zeynep Kamil Maternity and Children's Diseases Training and Research Hospital, Ophthalmology, PR Diagnose and Treatment Department were retrospectively evaluated. 133 patients were examined in 4 groups. 1st group included 60 patients who underwent IVB injection, 2nd group included 22 patients who underwent late-term LFK after IVB, 3rd group included 20 patients who underwent LFK and 4th group included 31 infants with spontaneously regressed PR. The refraction assessment was performed at the age of 18 months with a hand autorefractometer. Results: Gestational age and birth weight were significantly lower in infants who underwent LFK or late-term LFK after IVB than the infants with spontaneously regressed PR. Spherical equivalent was significantly lower in the late-term LFK after IVB and IVB monotherapy groups than the infants with spontaneously regressed PR (p=0.002 and p=0.012, respectively). Conclusion: We found the highest incidence of myopia in the late-term LFK after IVB group and the nearest refractive results to emetropia in infants with spontaneously regressed PR. As a result we concluded that the refractive outcomes are correlated with the severity of PR.
Keywords: Retinopathy of prematurity; bevacizumab; laser coagulation; myopia
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