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Background/Aim: Diabetic macular edema (DME) is the main cause of visual loss in diabetic patients. Aflibercept and ranibizumab are among the most commonly used intravitreal agents in the DME. This study aims to compare the short-term anatomic and functional results of aflibercept and ranibizumab in the treatment of DME. Methods: This retrospective cohort study included newly diagnosed and treatment-naive DME patients. The patients were administered intravitreal aflibercept (IVA) or intravitreal ranibizumab (IVR) as a loading dose throughout 3 months. Pre-treatment and 1-and 3-month examinations were made of best corrected visual acuity (BCVA)and central macular thickness (CMT). After the treatment, the patients were classified in the 3 rd month as those with good or poor response according to the early anatomic response. A good response to the treatment was considered the formation of foveal contour and full recovery of macular edema. Patients where macular edema was not fully resolved and/or foveal contour had not formed were classified as having poor response. Later, IVA and IVR were compared with each other in terms of response to treatment. Results: Evaluation was made of 67 eyes of 54 patients, comprising 31 (57.4%) females and 23 (42.6%) males with a mean age of 62.7 (7.3) years (range, 46-78 years). IVA was applied to 33 (49.3%) eyes and IVR to 34 (50.7%) eyes. In the IVA group, BCVA was determined as 0.75 (0.39) LogMAR pre-treatment, 0.53 (0.37) LogMAR at 1 month and 0.38 (0.30) LogMAR at 3 months (P<0.001 for each). CMT was measured as 400 (82) µm pre-treatment, 349 (95) µm at 1 month and 313 (79) µm at 3 months (P<0.001 for each). In the IVR group, BCVA was determined as 0.71 (0.34) LogMAR pre-treatment, 0.52 (0.34) LogMAR at 1 month and 0.39 (0.30) LogMAR at 3 months (P<0.001 for each). CMT was measured as 426 (92) µm pre-treatment, 365 (74) µm at 1 month and 323 (60) µm at 3 months (P<0.001 for each). A good response to treatment was determined in 24 eyes (72.7%) in the IVA group, and in 18 eyes (52.9%) in the IVR group. Although a good response to treatment was achieved at a higher rate in the IVA group, the difference was not statistically significant (P=0.09). Conclusion: Both visual and anatomic success was achieved with a 3-month loading dose in both the IVA and IVR groups. No statistically significant superiority was determined of one drug over the other in the 3month period.

Dünyada en sık görülen oküler enfeksiyon, bakteriyel konjonktivitlerdir. Bakteriyel konjonktivitlerde etken mikroorganizma üretilmeden ve antibiyotik duyarlılık testleri yapılmadan geniş spektrumlu ampirik tedavi kullanımı yaygındır. Biz bu çalışmada, bakteriyel konjonktivit etkenlerini izole ederek invitro şartlarda antibiyotik duyarlılık yüzdelerini saptayarak etkin ampirik tedaviyi bulmayı amaçladık. Gereç ve Yöntem: Bakteriyel konjonktivit tanısı almış 65 hastanın mukopürülan akıntılarından eküvyon çubuğu ile transport besiyeri içerisine kültür örnekleri alındı. Kültür örneklerinin ekimleri yapılarak üreyen bakteri kolonileri BD Phoenix (Becton Dickinson, USA) tam otomatize sistem kullanılarak tanımlandı. Üreyen bakterilerin herbirine; netilmisin, tobramicin, ofloksasin, tetrasiklin, kloramfenikol, gentamisin, lomefloksasin, moksifloksasin, siprofloksasin diskleri ile Kirby-Bauer disk difüzyon yöntemi uygulandı. Bulgular: Çalışmaya dahil edilen yaşları 21 ile 86 (yaş ortalaması: 48.23 ±10.47) aralığında bakteriyel konjonktivit tanısı almış 30 kadın 35 erkek toplam 65 bakteriyel konjonktivitli hastanın 46'sında (%70,7) etken bakteri izole edildi. Üreyen bakterilerin %86,9'u gram pozitif koklar olup bunlardan da koagülaz negatif stafilokoklar en sık izole edildi. Çalışılan antibiyotiklerin duyarlılık yüzdeleri sırasıyla netilmisin %93,3, kloramfenikol %92,5, tobramisin %90,0, gentamisin %88,2 moksifloksasin %84,3, ofloksasin %80,9, tetrasiklin75,0, siprofloksasin %70,5 lomefloksasin %63,3 olarak bulundu. Sonuç: Yapmış olduğumuz çalışmamızın sonuçlarıyla bakteriyel konjonktivitli hastaların ampirik tedavisinde geniş spekturumlu florokinolonların yerine aminoglikozid türevi antibiyotiklerin ilk sırada kullanılmasının tedavi sürecinde olumlu etki yaratacağı kanaatindeyiz.

How to cite/Atıf için: Aşgın N, Çakmaklıoğulları M. Bacterial profile and antibiotic susceptibility pattern in patients with chronic dacryocystitis.

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