Neovasküler tip yaşa bağlı makula dejenerasyonunda intravitreal ranibizumab uygulamalarında tedavi etkinliği ve rekürrens üzerinde etkili olan faktörler

Abstract

Objective: To evaluate the efficacy of intravitreal ranibizumab treatment and factors affecting the treatment in neovascular type age-related macular degeneration Methods: Ranibizumab injected 60 eyes of 60 patients with the diagnosis of neovascular age-related macular degeneration in our clinic were analyzed retrospectively. After three consecutive 3-month follow-up dose injection, decision to perform re-injections was according to best corrected visual acuity, fundus fluorescein angiography and optical coherence tomography findings in consecutive month follow-up. Patients were evaluated in terms of number of ranibizumab injections, pre-treatment and follow-up best-corrected visual acuity, central macular thickness, factors affecting the treatment and recurrence.Results: 30 (50%) of patients were male and 30 (50%) were women with a mean age of 67 ± 9.14 (50-84). While pretreatment visual acuity average of the cases was 1.12 ± 0.69 logMAR, at the end of 12th month was 0.92 ± 0.63 logMAR. While pre-treatment mean central macular thickness was 343.1 ± 97 µm, in the 12 th month was 286 ± 75.5 µm. While the first 3 injections were enough in 20 (33.3%) eyes, but 40 (66.7%) eyes had to be re-injected. Average number of injections was 4.23 ± 1.21. While there was no significant correlation between recent functional and anatomical success with age, gender, type of lens and membrane type, more vision gain was obtained in patients with initial lower visual acuity. The age of patients, pre-treatment visual acuity, membrane type were found to have no significant effect on recurrence rate. Membranes with classic component required more injection than occult type. Conclusion:After intravitreal injection of ranibizumab which is safe and effective in neovascular type of age-related macular degeneration more vision gain was obtained in patients with initial lower visual acuity and presence of classic component initial higher visual acuity, lower age required more injection.Key words: Age-related macular degeneration, ranibizumab, vascular endothelial growth factor ÖZET Amaç: Neovasküler tip yaşa bağlı maküla dejenerasyonu (YBMD) nedeniyle uygulanan intravitreal ranibizumab enjeksiyonunun etkinliğini ve tedavi üzerinde etkili olan faktörleri değerlendirmek Yöntemler: Kliniğimizde neovasküler tip YBMD'de intravitreal ranibizumab enjeksiyonu uygulanan 60 hastanın 60 gözü retrospektif olarak incelendi. Hastalara birer ay arayla 3 doz enjeksiyon yapıldıktan sonra aylık takiplerde en iyi düzeltilmiş görme keskinliği (EİDGK), fundus fluoresein anjiografi (FFA) ve optik kohorens tomografi (OKT) bulgularına göre enjeksiyon tekrarı uygulandı. Hastalar; enjeksiyon sayısı, takip süresi, tedavi öncesi ve kontrollerdeki EİDGK, santral makula kalınlığı (SMK), başarıda, rekürrens üzerinde etkili olan faktörler açısından değerlendirildi. Bulgular: 30'u (%50) erkek 30'u (%50) kadın olan hastaların ortalama yaşı 67±9,14 (50-84) yıl idi. Olgulardaki tedavi öncesi ortalama görme keskinliği 1,12 ± 0,69 logMAR iken 12. ayda ise, 0,92 ± 0,63 lo...