Hidroksiklorokin kullanan hastalarda optik sinir ve makula değişiklikleri
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Dosyalar
Tarih
2015
Yazarlar
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Yayıncı
Trakya Üniversitesi Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Hidroksiklorokin kullanımının peripapiller retina sinir lifi tabakası, makula ve ganglion hücre tabakası kalınlıklarında neden olduğu değişimleri optik koherens tomografi ile değerlendirmek amacıyla, Mayıs 2012-Ağustos 2014 tarihleri arasında 1 yıldan uzun süreli hidroksiklorokin kullanan 40 olgunun 80 gözü çalışmaya alındı. Olguların sistemik hastalıkları, ilaç kullanım süreleri, total ilaç kullanım dozları kaydedilerek tam oftalmolojik muayeneleri yapıldı. Renkli görme ve görme alanı muayeneleri yapıldı. Peripapiller retina sinir lifi tabakası ve malüla kalınlıkları optik koherens tomografi ile değerlendirildi. Peripapiller alan total, üst yarıalan ve alt yarıalan, üst, nazal, alt ve temporal olarak ayrılarak değerlendirildi. Makula; fovea, parafovea ve perifovea olmak üzere 3 bölgeye ayrılarak, ganglion hücre tabakası; parafovea ve perifovea olmak üzere 2 bölgeye ayrılarak incelendi. Elde edilen sonuçlar yaş ve cins uyumlu kontrol grubu ile karşılaştırıldı. Olgu grubunun 38'i (%95) kadın, 2'si (%5) erkekti. Ortalama yaşı 48.4±14.4 idi. 4 olguda parasantral skotom izlendi. Ortalama renk görme hata skoru 5.03±3.4 idi. Olgu ve kontrol grubunun makula, ganglion hücre tabakası ve peripapiller retina sinir lifi tabakası kalınlıkları karşılaştırıldığında; iki grup arasında ortalama retina sinir lifi kalınlığında, alt yarıalan ve nazal kadran retina sinir lifi kalınlığında anlamlı fark izlendi (p=0,012, p=0,009, p=0,005). Ganglion hücre tabakası kalınlık ölçümlerinde ise perifoveal alanda üst nazal, üst temporal, alt nazal ve alt temporal kadranlarda olgu grubunda anlamlı incelme saptandı (p=0,017, p=0,001, p=0,019, p=0,001). Diğer kalınlık ölçümlerde ise iki grup arasında anlamlı fark izlenmedi (p>0,05). Sonuç olarak; hidroksiklorokin kullanımına bağlı toksik makulopatinin erken tanısında optik koherens tomografi ile retina sinir lifi ve ganglion hücre tabakası kalınlığı değişiklikleri yardımcı testler olarak kullanılabilir.
abstract
In this study, it was aimed to evaluate the macular and retina nerve fibre layer thickness changes with optic coherence tomography in patients who were use hydroxychloroquine. Eighty eyes of 40 cases who were using hydroxychloroquine within a long-term more than a year between May 2012 and August 2014 were included. A full ophthalmic examinations of patients were made with recording their demographics, duration of drug use and total doses of drug use. Color vision test and central 10-2 visual field test was performed. All subjects underwent macular, ganglion cell layer and peripapillary retina nerve fibre layer thickness assessment using optic coherence tomography. Peripapillary area divided into the total, süperior hemifield, inferior hemifield, süperior, nasal, inferior and temporal. Macular thickness measurements was seperated to 3 region as fovea, parafovea and perifovea, ganglion cell layer measurements was seperated to 2 region as parafovea and perifovea. The results obtained were compared with age and sex matched control group. The case's group was consisted of 38 (95%) female, 2 (5%) male. Mean age was 48.4±14.4 years. Paracantral scotoma was determined on 4 cases. Macular, ganglion cell layer and retina nerve fibre layer thickness measurements of the case and control groups compared; average, inferior hemifield and nasal retina nerve fibre layer thickness measurements were statistically significant (p=0,012, p=0,009, p=0,005). Ganglion cell layer measurements, perifovea superior nasal, perifovea superior temporal, perifovea inferior nasal, perifovea inferior temporal area were significantly different between two groups (p=0,017, p=0,001, p=0,019, p=0,001). There was no significant difference among other measurement between two groups (p>0,05). As a result; early diagnosis of toxıc maculopathy due to hydroxychloroquine, retina nerve fibre layer thickness and ganglion cell layer thickness measurements changes using optic coherence tomography can be used as supporting tests.
abstract
In this study, it was aimed to evaluate the macular and retina nerve fibre layer thickness changes with optic coherence tomography in patients who were use hydroxychloroquine. Eighty eyes of 40 cases who were using hydroxychloroquine within a long-term more than a year between May 2012 and August 2014 were included. A full ophthalmic examinations of patients were made with recording their demographics, duration of drug use and total doses of drug use. Color vision test and central 10-2 visual field test was performed. All subjects underwent macular, ganglion cell layer and peripapillary retina nerve fibre layer thickness assessment using optic coherence tomography. Peripapillary area divided into the total, süperior hemifield, inferior hemifield, süperior, nasal, inferior and temporal. Macular thickness measurements was seperated to 3 region as fovea, parafovea and perifovea, ganglion cell layer measurements was seperated to 2 region as parafovea and perifovea. The results obtained were compared with age and sex matched control group. The case's group was consisted of 38 (95%) female, 2 (5%) male. Mean age was 48.4±14.4 years. Paracantral scotoma was determined on 4 cases. Macular, ganglion cell layer and retina nerve fibre layer thickness measurements of the case and control groups compared; average, inferior hemifield and nasal retina nerve fibre layer thickness measurements were statistically significant (p=0,012, p=0,009, p=0,005). Ganglion cell layer measurements, perifovea superior nasal, perifovea superior temporal, perifovea inferior nasal, perifovea inferior temporal area were significantly different between two groups (p=0,017, p=0,001, p=0,019, p=0,001). There was no significant difference among other measurement between two groups (p>0,05). As a result; early diagnosis of toxıc maculopathy due to hydroxychloroquine, retina nerve fibre layer thickness and ganglion cell layer thickness measurements changes using optic coherence tomography can be used as supporting tests.
Açıklama
Tıpta Uzmanlık Tezi
Anahtar Kelimeler
Optik Koherens Tomografi, Retina Sinir Lifi Kalınlığı, Antimalaryal İlaçlar, Toksik Makulopati, Optic Coherence Tomography, Retina Nerve Fibre Layer Thickness, Antimalarial Drugs, Toxic Maculopathy
