Retina ven kök tıkanıklıklarında klinik seyir ve prognoz
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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
Bu çalışmada; retina ven kök tıkanıklığı olan olgularda genel demografik özelliklerin, sonuç görme keskinliğini etkileyen lokal ve genel etmenlerin belirlenmesi ve tedavi seçeneklerinin karşılaştırılması amaçlanmıştır. Çalışmaya; Trakya Üniversitesi Tıp Fakültesi Göz Hastalıkları Anabilim Dalı'nda 1983-2013 yılları arasında retina ven kök tıkanıklığı tanısı almış 294 hastanın 310 gözü dahil edildi. Hastaların dosya kayıtlarından; demografik veriler, eşlik eden sistemik ve oküler hastalıklar, oftalmolojik muayene bulguları, takip süresi, ve uygulanan tedaviler kayıt edildi. Hastaların yaş ortalaması 63,61 ± 12,8 idi. 136'sı kadın, 158'i erkek idi. 139 hastada sadece sağ, 139 hastada sadece sol, 16 hastada ise her iki gözde hastalık tespit edildi. Hastaların ortalama takip süreleri 38,56 ± 49,45 ay idi. %61,9'unda hipertansiyon, %23,46'sında diyabetus mellitus ve %15,98'inde hiperlipidemi saptandı. %65,8'inin iskemik, %34,2'sinin ise iskemik olmayan tipte olduğu belirlendi. Olguların %45,88'inde glokom tespit edildi, %24,42 oranında neovasküler glokom saptandı. Tıkanma öncesinde veya sonrasında oral antiagreagan ve antikoagulan kullanımının ya da tıkanma sonrası pentoksifilin tedavisinin sonuç görmeyi etkilemediği belirlendi. İskemik tipteki olgularda, intravitreal bevacizumab, ranibizumab ve triamsinolon enjeksiyonlarının, makuler grid ve panretinal lazer fotokoagulasyon uygulanmış olmasının sonuç görmeyi değiştirmediği görüldü. İskemik olmayan olgularda; görme keskinliği 0,05 ve altında ise, intravitreal bevacizumab veya ranibizumab enjeksiyonunun tedavisiz olgulara oranla sonuç görme keskinliğini arttırdığı, 0,05'in üzerinde ise; sonuç görme keskinliği bakımından birbirlerine üstünlüklerinin olmadığı görüldü. Sonuç olarak; retina ven kök tıkanıklığı ile birliktelik gösteren risk faktörlerinin tespiti ve tedavi edilmesi, hastalığın oluşum ve ilerleyişini engellemede önemli bir yaklaşımdır. Hastalığın kontrolü ve hastaların yaşam kalitelerinin arttırılması için yeni tedavi yöntemlerine ve önleyici mekanizmaların geliştirilmesine ihtiyaç duyulmaktadır.
Abstract
In this study, aimed to determine general demographic characteristics, local and general factors affecting final visual acuities and comparison of treatment options in patients with central retinal vein oclussions. Three hundred and ten eyes of 294 patients had been diagnosed with central retinal vein occlusion between 1983-2013 in Trakya University Faculty of Medicine Department of Ophthalmology were included. Demographic datas, concomitant systemic and ocular diseases, ophthalmic examination, follow-up duration, and treatments were recorded from the file records of patients. The mean age of the patients was 63,61 ± 12,8 years. 136 female and 158 were male. 139 patients had in the right eye, 139 had in the left eye and 16 patients had in both eyes the disease. The mean follow-up period was 38,56 ± 49,45 months. 61,9% of patients had hypertension, 23,46% had diabetes mellitus and 15,98% had hyperlipidemia. 65,8% of patients were ischemic and 34,2% were non-ischemic type. Glaucoma 48% was observed and among patients in detected 24,42% of neovascular glaucoma. It was determined that oral antiagreagans and anticoagulants usage before or after the occlusion and pentoxifylline therapy after the occlusion that not affect the final visual acuities. These results showed that, in patients with ischemic type, intravitreal bevacizumab, ranibizumab and triamcinolone injections, macular grid and panretinal laser photocoagulations were not changing the visual outcomes. In non-ischemic patients; which visual acuity was 0,05 and under, intravitreal bevacizumab or ranibizumab injections increase the visual outcome compared to untreated cases, and which visual acuity was over 0,05; final visual acuity did not differed between this injections and untreated cases. In conclusion; detection and treatment of coexisting risk factors, is an important approach in preventing the occurrence and recurrence of central retinal vein occlusions. For improving quality of patients life and to control the disease, required to develop new treatments and preventive modalities.
Abstract
In this study, aimed to determine general demographic characteristics, local and general factors affecting final visual acuities and comparison of treatment options in patients with central retinal vein oclussions. Three hundred and ten eyes of 294 patients had been diagnosed with central retinal vein occlusion between 1983-2013 in Trakya University Faculty of Medicine Department of Ophthalmology were included. Demographic datas, concomitant systemic and ocular diseases, ophthalmic examination, follow-up duration, and treatments were recorded from the file records of patients. The mean age of the patients was 63,61 ± 12,8 years. 136 female and 158 were male. 139 patients had in the right eye, 139 had in the left eye and 16 patients had in both eyes the disease. The mean follow-up period was 38,56 ± 49,45 months. 61,9% of patients had hypertension, 23,46% had diabetes mellitus and 15,98% had hyperlipidemia. 65,8% of patients were ischemic and 34,2% were non-ischemic type. Glaucoma 48% was observed and among patients in detected 24,42% of neovascular glaucoma. It was determined that oral antiagreagans and anticoagulants usage before or after the occlusion and pentoxifylline therapy after the occlusion that not affect the final visual acuities. These results showed that, in patients with ischemic type, intravitreal bevacizumab, ranibizumab and triamcinolone injections, macular grid and panretinal laser photocoagulations were not changing the visual outcomes. In non-ischemic patients; which visual acuity was 0,05 and under, intravitreal bevacizumab or ranibizumab injections increase the visual outcome compared to untreated cases, and which visual acuity was over 0,05; final visual acuity did not differed between this injections and untreated cases. In conclusion; detection and treatment of coexisting risk factors, is an important approach in preventing the occurrence and recurrence of central retinal vein occlusions. For improving quality of patients life and to control the disease, required to develop new treatments and preventive modalities.
Açıklama
Tıpta Uzmanlık Tezi
Anahtar Kelimeler
Retina Ven Kök Tıkanıklığı, Neovasküler Glokom, Görme Keskinliği, Risk Faktörleri
