Aflibersept ve ranibizumabin yaş tip yaşa bağlı makula dejenerasyonlu hastalardaki optik koherens tomografi bulguları üzerindeki etkilerinin karşılaştırılması
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Tarih
2021
Yazarlar
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Cilt Başlığı
Yayıncı
Dicle Üniversitesi, Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Çalışmamızda; yaş tip yaşa bağlı maküla dejenerasyonu (YBMD) hastalarında iki farklı anti vasküler endotel büyüme faktörü ( anti vascular endothelial growth factor = anti VEGF) olan aflibersept (EyleaTM, Regeneron, NY) ve ranibizumabın (LucentisTM, Genentech, South San Francisco) optik koherens tomografisi (OKT) bulguları üzerindeki etkilerinin karşılaştırılması amaçlanmıştır. Gereç ve Yöntem: Dicle Üniversitesi Tıp fakültesi hastanesi Göz Kliniğimizde Ocak 2013- Kasım 2020 tarihleri arasında yaş tip YBMD tanısı almış hastaların dosyaları retrospektif incelendi. Çalışmaya intravitreal anti VEGF tedavisi almış ve 6 aylık düzenli takibi yapılmış hastalar dahil edildi. Hastaların yaş, cinsiyet, enjeksiyon öncesi ve enjeksiyon sonrası 1. ay ve 6. ay'a ait görme keskinliği, santral foveal kalınlık (SFK) ölçümleri, horizontal pigment epitel dekolman (PED) boyutları, vertikal PED boyutları, hiperreflektif nokta (HRN) ölçümleri, intraretinal kist (İRK) ölçümleri, inner segment/ outer segment (İSOS) bandı defekti, subretinal sıvı (SRS) ölçümleri, epiretinal membran (ERM) ölçümleri, dış limitan membran (DLM) bozukluğu, koroidal neovaskülarizasyon (KNVM) ölçümleri gibi OKT bulguları kaydedildi. Hastalar aflibersept ve ranibizumab grubu olmak üzere 2 gruba ayrıldı. Optikal Koherens Tomografi ölçümlerinde Spektral Domain OKT (Heidelberg Engineering Spectral OCT, USA) cihazı kullanıldı. Bulgular: Çalışmaya yaş tip YBMD tanılı 85 hastanın 103 gözü dahil edildi. Aflibersept grubunun yaş ortalaması 72.96 ± 9.43 yıl idi. Ranibizumab grubunun yaş ortalaması ise 75.0 ± 9.2 yıl idi. Aflibersept grubunda erkek sayısı 32 (%64) , kadın sayısı 18 (%36) iken ranibizumab grubunda ise erkek sayısı 34 (%64.2) , kadın sayısı 19 (%35.8) oranda idi. Yaş ve cinsiyet açısından 2 grup arasında anlamlı fark saptanmadı (p:0.269; p:1 sırasıyla). Elli göze aflibersept, 53 göze ise ranibizumab enjeksiyonu yapıldı. En iyi düzeltilmiş görme keskinliği (EİDGK) ölçümlerinde aflibersept özellikle 1. ayda üstün saptandı (p:0.003), 6.ayda ise EİDGK'de fark saptanmadı (p:0.233). EİDGK ölçümleriyle SFK ölçümleri arasında 1.ayda negatif yönde korelasyon saptandı (r:-0.322, p:0.001 sırasıyla). Aflibersept ile ranibizumabın 6. aydaki karşılaştırılmasında; SFK'ın azalmasında afliberseptin ranibizumaba göre daha etkin olduğu saptandı (p:0.014). Bununla birlikte; horizontal PED, vertikal PED, HRN, İRK, SRS, ERM, DLM, İSOS ve KNVM ölçümlerinde aflibersept ile ranibizumab arasında istatiksel olarak anlamlı fark saptanmadı (p:0.119; p: 0.220; p: 0.167; p: 0.531; p: 0.351, p: 0.844; p: 0.768; p: 0.944; p: 0.703 sırasıyla). Sonuç: Yaş tip YBMD hastalarında yapılan intravitreal aflibersept ve ranibizumab enjeksiyonlarının SFK dışında diğer OKT bulguları üzerine etkilerinin benzer olduğu saptanmıştır. Bu konu hakkında yapılacak uzun takipli ve geniş serili çalışmalar daha fazla bilgi sağlayacaktır.
Purpose: In our study; Optical coherence tomography of aflibercept (EyleaTM, Regeneron, NY) and ranibizumab (LucentisTM, Genentech, South San Francisco), two different anti-vascular endothelial growth factors (anti VEGF) in patients with wet-type age related macular degeneration (AMD). It was aimed to compare the effects of OCT on the findings. Materials and Methods: The files of patients who were diagnosed with wet AMD in our Dicle University Faculty of Medicine Eye Clinic between January 2013 and November 2020 were retrospectively reviewed. Patients who received intravitreal anti-VEGF therapy and were followed up regularly for 6 months were included in the study. Patients' age, gender, visual acuity, central foveal thickness (SFT) measurements, horizontal pigment epithelial detachment (PED) dimensions, vertical PED dimensions, hyperreflective dot (HRD) measurements before and after injection 1 month and 6 months OCT findings such as intraretinal cyst (IRC) measurements, inner segment/outer segment (ISOS) band defect, subretinal fluid (SRF) measurements, epiretinal membrane (ERM) measurements, outer limiting membrane (ELM) disorder, choroidal neovascularization (CNVM) measurements was recorded. The patients were divided into 2 groups as aflibercept and ranibizumab groups. Spectral Domain OCT (Heidelberg Engineering Spectral OCT, USA) device was used for Optical Coherence Tomography measurements. Findings: 103 eyes of 85 patients with wet AMD were included in the study. The mean age of the Aflibercept group was 72.96 ± 9.43 years. The mean age of the ranibizumab group was 75.0 ± 9.2 years. While the number of men was 32 (64%) and 18 (36%) women in the aflibercept group, the number of men was 34 (64.2%) and the number of women was 19 (35.8%) in the ranibizumab group. There was no significant difference between the 2 groups in terms of age and gender (p:0.269; p:1 respectively). Aflibercept was injected into 50 eyes and ranibizumab was injected into 53 eyes. In best corrected visual acuity (BCVA) measurements, aflibercept was found to be superior especially at 1 month (p:0.003), and no difference was found in BCVA at 6 months (p:0.233). A negative correlation was found between BCVA measurements and SFC measurements at 1 month (r:-0.322, p:0.001, respectively). In the comparison of aflibercept and ranibizumab at 6 months; Aflibercept was found to be more effective than ranibizumab in reducing SFT (p:0.014). However, no statistically significant difference was found between aflibercept and ranibizumab in horizontal PED, vertical PED, HRD, IRC, SRF, ERM, ELM, ISOS and CNVM measurements (p:0.119; p:0.220; p:0.167; p:0.531; p:0.351; p:0.844; p:0.768; p:0.944; p:0.703 respectively). Results: Intravitreal aflibercept and ranibizumab injections in wet AMD patients were found to have similar effects on other OCT findings except for SFT. Studies with long follow-up and large series on this subject will provide more information.
Purpose: In our study; Optical coherence tomography of aflibercept (EyleaTM, Regeneron, NY) and ranibizumab (LucentisTM, Genentech, South San Francisco), two different anti-vascular endothelial growth factors (anti VEGF) in patients with wet-type age related macular degeneration (AMD). It was aimed to compare the effects of OCT on the findings. Materials and Methods: The files of patients who were diagnosed with wet AMD in our Dicle University Faculty of Medicine Eye Clinic between January 2013 and November 2020 were retrospectively reviewed. Patients who received intravitreal anti-VEGF therapy and were followed up regularly for 6 months were included in the study. Patients' age, gender, visual acuity, central foveal thickness (SFT) measurements, horizontal pigment epithelial detachment (PED) dimensions, vertical PED dimensions, hyperreflective dot (HRD) measurements before and after injection 1 month and 6 months OCT findings such as intraretinal cyst (IRC) measurements, inner segment/outer segment (ISOS) band defect, subretinal fluid (SRF) measurements, epiretinal membrane (ERM) measurements, outer limiting membrane (ELM) disorder, choroidal neovascularization (CNVM) measurements was recorded. The patients were divided into 2 groups as aflibercept and ranibizumab groups. Spectral Domain OCT (Heidelberg Engineering Spectral OCT, USA) device was used for Optical Coherence Tomography measurements. Findings: 103 eyes of 85 patients with wet AMD were included in the study. The mean age of the Aflibercept group was 72.96 ± 9.43 years. The mean age of the ranibizumab group was 75.0 ± 9.2 years. While the number of men was 32 (64%) and 18 (36%) women in the aflibercept group, the number of men was 34 (64.2%) and the number of women was 19 (35.8%) in the ranibizumab group. There was no significant difference between the 2 groups in terms of age and gender (p:0.269; p:1 respectively). Aflibercept was injected into 50 eyes and ranibizumab was injected into 53 eyes. In best corrected visual acuity (BCVA) measurements, aflibercept was found to be superior especially at 1 month (p:0.003), and no difference was found in BCVA at 6 months (p:0.233). A negative correlation was found between BCVA measurements and SFC measurements at 1 month (r:-0.322, p:0.001, respectively). In the comparison of aflibercept and ranibizumab at 6 months; Aflibercept was found to be more effective than ranibizumab in reducing SFT (p:0.014). However, no statistically significant difference was found between aflibercept and ranibizumab in horizontal PED, vertical PED, HRD, IRC, SRF, ERM, ELM, ISOS and CNVM measurements (p:0.119; p:0.220; p:0.167; p:0.531; p:0.351; p:0.844; p:0.768; p:0.944; p:0.703 respectively). Results: Intravitreal aflibercept and ranibizumab injections in wet AMD patients were found to have similar effects on other OCT findings except for SFT. Studies with long follow-up and large series on this subject will provide more information.
Açıklama
Anahtar Kelimeler
Yaşa bağlı maküla dejenerasyonu, Optik koherens tomografisi, Aflibersept, Ranibizumab, Koroidal neovasküler membran, Age-related macular degeneration, Optical coherence tomography, Aflibercept, Choroidal neovascular membrane
Kaynak
WoS Q Değeri
Scopus Q Değeri
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Künye
Vural, S. (2021). Aflibersept ve ranibizumabin yaş tip yaşa bağlı makula dejenerasyonlu hastalardaki optik koherens tomografi bulguları üzerindeki etkilerinin karşılaştırılması. Yayımlanmamış uzmanlık tezi, Dicle Üniversitesi, Diyarbakır.
