.: ORİJİNAL ARAŞTIRMA
Reaktif Retinal Astrositik Tümörlerde Tedavi ve Takip Sonuçlarımız: Kesitsel Araştırma
Treatment and Follow-up of Reactive Retinal Astrocytic Tumors: A Cross-Sectional Study
Turkiye Klinikleri J Ophthalmol. 2023;32(1):1-6
doi: 10.5336/ophthal.2022-91057
Makale Dili: TR
Tam Metin
ÖZET
Amaç: Çalışmanın amacı, kliniğimizde son 20 yıl içinde tanı almış reaktif retinal astrositik tümör (RRAT) hastalarının takip ve tedavi sonuçlarını bildirmektir. Gereç ve Yöntemler: Kliniğimizde RRAT ile takipli 29 ardışık hastanın 30 gözüne ait veriler retrospektif olarak hasta dosyalarından elde edilmiştir. Elde edilen değişkenler demografik bilgiler, tanı anında ve takip süresi sonundaki görme keskinliği düzeyleri, eşlik eden fundus bulguları, tedavi şekli ve sayısı ile takip süresidir. Bulgular: Yirmi dokuz hastanın 16'sı (%55,2) kadın, 13'ü (%44,8) erkek idi. Ortalama yaş 36,1±22,0 yıldı. Bir (%3,4) hastada bilateral RRAT mevcuttu. Üç (%10,3) hastada ikincil RRAT tespit edildi. Yirmi dört (%80,0) göz birincil olarak kriyoterapi ile tedavi edilirken, 6 (%20,0) göz için takip uygulandı. Başlangıç görme keskinliği ortalaması 0,2±0,2 düzeyinde bulundu. Ortalama 33,5±33,3 ay takipten 30 gözde görme keskinliğindeki ortalama değişim 0,02±0,12 idi. Kriyoterapi uygulanan gözlerde ortalama kriyoterapi sayısı 2,0±1,1 (aralık: 1-5) olarak tespit edildi. Toplamda 1 (%3,3) gözde tümör tümüyle kaybolurken, 26 (%86,7) gözde stabil veya gerilemiş hastalık, 3 (%10,0) gözde ise kötüleşme izlendi. Klinik izlem uygulanan 6 gözün 6'sında ortalama 33,7±29,6 ay takip sonunda stabil hastalık veya stabil bulgular görüldü. Sonuç: RRAT'ler ortalama 4. dekadda, unilateral ve sıklıkla alt temporal kadranda izlenen tümörlerdir. Bu tümörlerde ortalama 2 seans kriyoterapi ve/veya klinik izlem anatomik kontrolü sıklıkla sağlasa da (%86,7) tümörün tümüyle gerilemesini sağlayacak metodlar ve faktörler çalışmaya açıktır.
Anahtar Kelimeler: Gözbilim; kriyoterapi
Amaç: Çalışmanın amacı, kliniğimizde son 20 yıl içinde tanı almış reaktif retinal astrositik tümör (RRAT) hastalarının takip ve tedavi sonuçlarını bildirmektir. Gereç ve Yöntemler: Kliniğimizde RRAT ile takipli 29 ardışık hastanın 30 gözüne ait veriler retrospektif olarak hasta dosyalarından elde edilmiştir. Elde edilen değişkenler demografik bilgiler, tanı anında ve takip süresi sonundaki görme keskinliği düzeyleri, eşlik eden fundus bulguları, tedavi şekli ve sayısı ile takip süresidir. Bulgular: Yirmi dokuz hastanın 16'sı (%55,2) kadın, 13'ü (%44,8) erkek idi. Ortalama yaş 36,1±22,0 yıldı. Bir (%3,4) hastada bilateral RRAT mevcuttu. Üç (%10,3) hastada ikincil RRAT tespit edildi. Yirmi dört (%80,0) göz birincil olarak kriyoterapi ile tedavi edilirken, 6 (%20,0) göz için takip uygulandı. Başlangıç görme keskinliği ortalaması 0,2±0,2 düzeyinde bulundu. Ortalama 33,5±33,3 ay takipten 30 gözde görme keskinliğindeki ortalama değişim 0,02±0,12 idi. Kriyoterapi uygulanan gözlerde ortalama kriyoterapi sayısı 2,0±1,1 (aralık: 1-5) olarak tespit edildi. Toplamda 1 (%3,3) gözde tümör tümüyle kaybolurken, 26 (%86,7) gözde stabil veya gerilemiş hastalık, 3 (%10,0) gözde ise kötüleşme izlendi. Klinik izlem uygulanan 6 gözün 6'sında ortalama 33,7±29,6 ay takip sonunda stabil hastalık veya stabil bulgular görüldü. Sonuç: RRAT'ler ortalama 4. dekadda, unilateral ve sıklıkla alt temporal kadranda izlenen tümörlerdir. Bu tümörlerde ortalama 2 seans kriyoterapi ve/veya klinik izlem anatomik kontrolü sıklıkla sağlasa da (%86,7) tümörün tümüyle gerilemesini sağlayacak metodlar ve faktörler çalışmaya açıktır.
Anahtar Kelimeler: Gözbilim; kriyoterapi
ABSTRACT
Objective: In this study we aim to report treatment and follow-up results of reactive retinal astrocytic tumors (RRATs) which were diagnosed at our clinic in the last 20 years. Material and Methods: Retrospectively hospital charts of 30 eyes of 29 consecutive patients were reviewed. Recorded data were demographic details, visual acuities at the time of diagnosis and at the end of follow-up, accompanying fundus findings, mode and number of treatment and follow-up time. Results: Out of 29 patients 16 (55.2%) were female, 13 (44.8%) were male. Average age at the time of diagnosis was 36.1±22.0 years. One (3.4%) patient manifested bilateral RRAT. Three (10.3%) patients had secondary RRAT. Twenty four (80.0%) eyes were primarily treated with cryotherapy while 6 (20.0%) eyes were clinically observed. The mean initial visual acuity was 0.2±0.2. Following a mean follow-up of 33.5±33.3 months, the mean change in visual acuity was 0.02±0.12. The mean number of cryotherapy in the eyes which received cryotherapy was found to be 2.0±1.1 (range: 1-5). In one (3.3%) eye the tumor disappeared completely whereas in 26 (86.7%) the disease was either stable or regressed and 3 (10.0%) eyes showed progression. In 6 of 6 eyes which were managed with observation, either stable disease or stable findings were noted at the end of mean 33.7±29.6 months of followup. Conclusion: RRATs are most commonly seen in 4th decade of life as unilateral tumors in the lower temporal quadrant. Even though mean 2 sessions of cryotherapy and/or observation of these tumors most commonly result in anatomic control (86.7%), methods and factors which yield complete regression are to be studied.
Keywords: Ophthalmology; cryotherapy
Objective: In this study we aim to report treatment and follow-up results of reactive retinal astrocytic tumors (RRATs) which were diagnosed at our clinic in the last 20 years. Material and Methods: Retrospectively hospital charts of 30 eyes of 29 consecutive patients were reviewed. Recorded data were demographic details, visual acuities at the time of diagnosis and at the end of follow-up, accompanying fundus findings, mode and number of treatment and follow-up time. Results: Out of 29 patients 16 (55.2%) were female, 13 (44.8%) were male. Average age at the time of diagnosis was 36.1±22.0 years. One (3.4%) patient manifested bilateral RRAT. Three (10.3%) patients had secondary RRAT. Twenty four (80.0%) eyes were primarily treated with cryotherapy while 6 (20.0%) eyes were clinically observed. The mean initial visual acuity was 0.2±0.2. Following a mean follow-up of 33.5±33.3 months, the mean change in visual acuity was 0.02±0.12. The mean number of cryotherapy in the eyes which received cryotherapy was found to be 2.0±1.1 (range: 1-5). In one (3.3%) eye the tumor disappeared completely whereas in 26 (86.7%) the disease was either stable or regressed and 3 (10.0%) eyes showed progression. In 6 of 6 eyes which were managed with observation, either stable disease or stable findings were noted at the end of mean 33.7±29.6 months of followup. Conclusion: RRATs are most commonly seen in 4th decade of life as unilateral tumors in the lower temporal quadrant. Even though mean 2 sessions of cryotherapy and/or observation of these tumors most commonly result in anatomic control (86.7%), methods and factors which yield complete regression are to be studied.
Keywords: Ophthalmology; cryotherapy
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