Turkiye Klinikleri Journal of Ophthalmology

.: ORIGINAL RESEARCH
Yaşa Bağlı Maküla Dejenerasyonunda Gelişen Subfoveal Koroid Neovaskülarizasyonlarının Tedavisinde Fotodinamik Tedavi Uygulamasının Geç Dönem Sonuçları
Long-Term Outcomes of Photodynamic Therapy in Subfoveal Choroidal Neovascularization Developing Due to Age-Related Macular Degeneration
Mehmet ÇITIRIKa, Seda MÜTEVELLİa, Seyhan SONAR ÖZKANa, Naciye KABATAŞa, Orhan ZİLELİOĞLUa
a2. Göz Hastalıkları Kliniği, Ankara Ulucanlar Göz Eğitim ve Araştırma Hastanesi, Ankara
Turkiye Klinikleri J Ophthalmol. 2009;18(4):216-22
Article Language: TR
Full Text
ÖZET
 Amaç: Yaşa bağlı maküla dejenerasyonunda gelişen subfoveal koroid neovaskülarizasyonlu olgularda verteporfin ile uygulanan oküler fotodinamik tedavinin 24 aylık takip süresi sonundaki etkinliğini ortaya koymaktır. Gereç ve Yöntemler: Ocak 2005-Haziran 2008 tarihleri arasında Sağlık Bakanlığı Ankara Ulucanlar Göz Eğitim ve Araştırma Hastanesinde yaşa bağlı maküla dejenerasyonunda gelişen subfoveal koroid neovaskülarizasyonu (KNV) tanısı olan ve Retina Kliniğinde takip altına alınan 85 olgunun 85 gözü çalışma kapsamına alınmıştır. Olguların başlangıç ve takip muayenelerinde görme keskinliği değerleri, göz içi basıncı değerleri, biyomikroskopi bulguları ve pupil dilatasyonu sonrası göz dibi muayenesi, optik koherens tomografi ve floresein anjiyografiyi içeren tüm göz muayene bulguları değerlendirilmiştir. Olgulara standart uygulama şekli ile fotodinamik tedavi yapılmıştır. İşlem sonrası 1. hafta, 1. ay, 3. ay, 6. ay, 12. ay, 18. ay ve 24. aylarda olguların muayeneleri tekrarlanmıştır. Bulgular: Takip edilen olguların 55 (%64.7)'i erkek, 30 (%35.3)'u kadın idi. Hastaların ortalama yaşı 67.1 ± 8.4 yıl (45-82 yıl) idi. Kırk bir (%48.2) gözde baskın klasik, 26 (%30.5) gözde minimal klasik ve 18 (%21.2) gözde gizli subfoveal KNV belirlenmiştir. Olgu başına 1.64 seans fotodinamik tedavi uygulandı. Yirmi dört aylık takip sonrasında tedavi sonrası başarı; baskın klasik tipte 41 gözün 28'inde, minimal klasik tipte 26 gözün 13'ünde ve gizli tipte 18 gözün 8'inde elde edilmiştir. Sonuç: Bu çalışmadaki sonuçlara göre, yaşa bağlı maküla dejenerasyonunda gelişen subfoveal RNV'li olgular arasında fotodinamik tedavi sonrası 24 aylık takip sonrasında ağır görme kaybının önlenmesinde tedaviden en fazla yarar gören grubun baskın klasik grup olduğu belirlenmiştir.

Anahtar Kelimeler: Fotodinamik tedavi, subfoveal koroid neovaskülarizasyonu, verteporfin, yaşa bağlı maküla dejenerasyonu
ABSTRACT
 Objective: To investigate the long-term efficacy of ocular photodynamic therapy with verteporfin in cases with subfoveal choroidal neovascularization developing due to age-related macular degeneration. Material and Methods: Eighty-five eyes of 85 patients with subfoveal choroidal neovascularization developing due to age-related macular degeneration that were followed-up in Turkish Ministry of Health Ankara Ulucanlar Eye Education and Research Hospital Retina Clinic between January 2005 and June 2008 were evaluated in this study. A complete ophthalmological examination including visual acuity, intraocular pressure with applanation tonometry, biomicroscobic examination findings, dilated pupil examination of the posterior segment, optic coherence tomography, and fluorescein angiography were evaluated at baseline and during follow-up period. Photodynamic therapy was performed according to standard protocol. Follow-up examinations were performed for 1st day, 1st, 3rd, 6th, 12th, 18th, and 24th months after therapy. Results: There were 55 (64.7%) male and 30 (35.3%) female. The average age of patients was 67.1 ± 8.4 years (45-82 years). The type of the choroidal neovascularization lesion was predominantly classic in 41 (48.2%) eyes, minimally classic in 26 (30.5%) eyes and occult in 18 (21.2%) eyes. The average number of photodynamic therapy sessions per patient was 1.64. Successful results were obtained in 28 out of 41 eyes with predominantly classic type; 13 out of 26 eyes with minimally classic type; and 8 out of 18 eyes with occult type after follow up period of 24 months. Conclusion: Based on the results that were obtained in this series, predominantly classic group was the most benefit group after photodynamic therapy after 24 months of follow-up in cases with subfoveal choroidal neovascularization developing due to the age-related macular degeneration.

Keywords: Photochemotherapy; choroidal neovascularization; verteporfin; macular degeneration

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30.03.2014

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