.: ORİJİNAL ARAŞTIRMA
Yaşa Bağlı Makula Dejenerasyonunda Dış Retinal Tübülasyon Sıklığı
Prevalence of Outer Retinal Tubulations in Age Related Macular Degeneration
Turkiye Klinikleri J Ophthalmol. 2019;28(4):281-7
doi: 10.5336/ophthal.2018-63873
Makale Dili: TR
Tam Metin
ÖZET
Amaç: Yaşa bağlı maküla dejenerasyonu (YBMD) ile takip edilen hastalarda dış retinal tübülasyon (DRT) sıklığını ve görsel prognoza etkisini belirlemektir. Gereç ve Yöntemler: Ocak 2010- Haziran 2018 tarihleri arasında YBMD'ye ikincil koroid neovaskülarizasyonu (KNV) nedeni ile intravitreal antivasküler endotelyal büyüme faktör (anti-VEGF) enjeksiyonu yapılan 186 hastanın 216 gözüne ait en az altı aylık spektral domain optik koherens tomografi (SD-OKT) taramaları geriye dönük olarak gözden geçirildi. DRT sıklığı belirlendi; subretinal fibrozis, atrofi ve subfoveal fotoreseptör integritesi ile ilişkisi değerlendirildi. Bulgular: Hastaların yaş ortalaması 74,34±9,29 yıl olup, yaşları 60-85 yıl arasında değişmekte idi. Toplam 216 gözün 124 (%57,4)'ü kadın, 92 (%42,6)'si erkek hastalara ait idi. DRT 53 (24,5) gözde izlendi. Başlangıç ve nihai en iyi düzeltilmiş görme keskinliği DRT saptananlarda daha düşüktü. Subfoveal fotoreseptör integrite kaybı açısından istatistiksel olarak anlamlı farklılık vardı. Sonuç: KNV aktivasyonu ve anti-VEGF tedavi ile DRT varlığı ilişkisi net olmasa da DRT tespit edilen hastalarda görme keskinliği daha düşüktü. YBMD hastalarında DRT tespiti ile hem görsel prognoz hakkında bilgi sağlanmış hem de uygunsuz tedaviden kaçınılmış olacaktır.
Anahtar Kelimeler: Yaşa bağlı makula dejenerasyonu; dış retinal tübülasyon; optik koherens tomografi
Amaç: Yaşa bağlı maküla dejenerasyonu (YBMD) ile takip edilen hastalarda dış retinal tübülasyon (DRT) sıklığını ve görsel prognoza etkisini belirlemektir. Gereç ve Yöntemler: Ocak 2010- Haziran 2018 tarihleri arasında YBMD'ye ikincil koroid neovaskülarizasyonu (KNV) nedeni ile intravitreal antivasküler endotelyal büyüme faktör (anti-VEGF) enjeksiyonu yapılan 186 hastanın 216 gözüne ait en az altı aylık spektral domain optik koherens tomografi (SD-OKT) taramaları geriye dönük olarak gözden geçirildi. DRT sıklığı belirlendi; subretinal fibrozis, atrofi ve subfoveal fotoreseptör integritesi ile ilişkisi değerlendirildi. Bulgular: Hastaların yaş ortalaması 74,34±9,29 yıl olup, yaşları 60-85 yıl arasında değişmekte idi. Toplam 216 gözün 124 (%57,4)'ü kadın, 92 (%42,6)'si erkek hastalara ait idi. DRT 53 (24,5) gözde izlendi. Başlangıç ve nihai en iyi düzeltilmiş görme keskinliği DRT saptananlarda daha düşüktü. Subfoveal fotoreseptör integrite kaybı açısından istatistiksel olarak anlamlı farklılık vardı. Sonuç: KNV aktivasyonu ve anti-VEGF tedavi ile DRT varlığı ilişkisi net olmasa da DRT tespit edilen hastalarda görme keskinliği daha düşüktü. YBMD hastalarında DRT tespiti ile hem görsel prognoz hakkında bilgi sağlanmış hem de uygunsuz tedaviden kaçınılmış olacaktır.
Anahtar Kelimeler: Yaşa bağlı makula dejenerasyonu; dış retinal tübülasyon; optik koherens tomografi
ABSTRACT
Objective: To determine the frequency of outer retinal tubulations (ORT), and the influence on visual prognosis in patients followed by senile macular degeneration. Material and Methods: Between January 2010 and June 2018 216 eyes of 186 patients that were injected with antivascular endothelial growth factor (anti-VEGF) for the treatment of choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD) were reviewed with least six months spectral domain optical coherence tomography (SD-OCT) scans retrospectively. The frequency of ORT was determined; the relation between subretinal fibrosis, subfoveal photoreceptor integrity, atrophy and ORTs were evaluated. Results: The ages of the patients ranged between 65 and 85, while the mean age was 74.34±9.29 years; 124 (57.4%) were female and 92 (42.6%) were male. ORTs were observed in fifty-three (24.5%) eyes. Initial and final best corrected visual activity (BCVA) were lower in cases of ORT. There was a statistically significant difference concerning the loss of subfoveal photoreceptor integrity. Conclusion: Although there was no certain relation between occurence of ORT and activation of CNV and anti-VEGF theraphy; in cases of ORT had worse visual acuity. Determination of ORT in AMD patients provides information about visual prognosis and is relevant to avoid overtreatment.
Keywords: Age-related macular degeneration; outer retinal tubulation; optical coherence tomography
Objective: To determine the frequency of outer retinal tubulations (ORT), and the influence on visual prognosis in patients followed by senile macular degeneration. Material and Methods: Between January 2010 and June 2018 216 eyes of 186 patients that were injected with antivascular endothelial growth factor (anti-VEGF) for the treatment of choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD) were reviewed with least six months spectral domain optical coherence tomography (SD-OCT) scans retrospectively. The frequency of ORT was determined; the relation between subretinal fibrosis, subfoveal photoreceptor integrity, atrophy and ORTs were evaluated. Results: The ages of the patients ranged between 65 and 85, while the mean age was 74.34±9.29 years; 124 (57.4%) were female and 92 (42.6%) were male. ORTs were observed in fifty-three (24.5%) eyes. Initial and final best corrected visual activity (BCVA) were lower in cases of ORT. There was a statistically significant difference concerning the loss of subfoveal photoreceptor integrity. Conclusion: Although there was no certain relation between occurence of ORT and activation of CNV and anti-VEGF theraphy; in cases of ORT had worse visual acuity. Determination of ORT in AMD patients provides information about visual prognosis and is relevant to avoid overtreatment.
Keywords: Age-related macular degeneration; outer retinal tubulation; optical coherence tomography
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