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Journals / Güncel Retina Dergisi / 2019 / Cilt: 3 - Sayı: 1

Nonresponsiveness, Resistance to the Treatment, Drug Switch And Combined Treatments in Macular Edema Secondary To Central Retinal Vein Obstruction

Santral Retinal Ven Tıkanıklığına Bağlı Makula Ödeminde Tedaviye Yanıtsızlık, Tedaviye Direnç, İlaç Değişimleri ve Kombine Tedaviler

BURAK TURGUT
Feyza ÇALIŞ KARANFİL
Onur ÇATAK
Pages
47–51
DOI
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Positive results on visual acuity, central macular thickness and number of injections can be obtained by replacing one Anti- VEGF agent with another and/or by combined treatments with steroids in treatment of the resistant/non-responsive cases.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Retinal vein occlusion (RVO) is the second most common retinal vascular disease following diabetic retinopathy.
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Key Findings & Data:In CRVO, macular edema can develop due to increased vascular permeability due to inflammation and elevated VEGF levels, and breakdown of the blood-retina barrier.
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Conclusion & Impact:Positive results on visual acuity, central macular thickness and number of injections can be obtained by replacing one Anti- VEGF agent with another and/or by combined treatments with steroids in treatment of the resistant/non-responsive cases.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Abstract

Retinal vein occlusion (RVO) is the second most common retinal vascular disease following diabetic retinopathy. Visual loss in central retinal vein occlusion (CRVO) may occur due to retinal ischemia, macular ischemia, macular edema or neovascular complications. In CRVO, macular edema can develop due to increased vascular permeability due to inflammation and elevated VEGF levels, and breakdown of the blood-retina barrier. In cases with CRVO, resistance and/or nonresponsiveness to the treatment develops in about one of three of the cases. The presence of relative afferent pupillary defect, vitreoretinal traction, poor macular and peripheral retinal perfusion, high blood urea and creatinine levels, ineffectiveness to other cytokines and factors, delay in the initiation of the treatment, VEGF receptor up-regulation, advanced age are risk factors for non-responsiveness. Positive results on visual acuity, central macular thickness and number of injections can be obtained by replacing one Anti- VEGF agent with another and/or by combined treatments with steroids in treatment of the resistant/non-responsive cases.

Özet

Retinal ven tıkanıklıkları (RVT), diyabetik retinopatiyi takiben ikinci en sık görülen retinal vasküler hastalıktır. Santral retinal ven tıkanıklığı (SRVT)’nda görme kaybı retinal iskemi, makular iskemi, makula ödemi veya neovasküler komplikasyonlara bağlı olarak ortaya çıkabilmektedir. SRVT’nda makula ödemi, inflamasyon ve yükselen VEGF düzeylerine bağlı olarak vasküler geçirgenliğin artması ve kan-retina bariyerinin bozulmasına bağlı olarak gelişebilmektedir. SRVT olgularında tedaviye direnç ve/ veya yanıtsızlık olguların yaklaşık 1/3’ünde gelişmektedir. Rölatif afferent pupil defekti, vitreomaküler traksiyon, azalmış makuler ve periferal retinal perfüzyon varlığı, yüksek kan üre ve kreatinin değerleri, diğer sitokin ve faktörlere etkisizlik, tedaviye geç başlanması, VEGF reseptör regülasyon artışı, ileri yaş, santral makula kalınlığının yüksek olması daha önce tedavi uygulanmış olması tedaviye direnç ve/veya yanıtsızlık için risk faktörleridir. Tedaviye dirençli/yanıtsız olgularda bir Anti-VEGF’in diğeriyle değiştirilmesi veya ve/veya steroidlerle kombine tedaviler ile görme keskinliği, santral makula kalınlığı ve enjeksiyon sayısı üzerine olumlu sonuçlar elde edilebilmektedir.

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Cite This Article

TURGUT, B., KARANFİL, F. Ç., ÇATAK, O. (2019). Nonresponsiveness, Resistance to the Treatment, Drug Switch And Combined Treatments in Macular Edema Secondary To Central Retinal Vein Obstruction. Güncel Retina Dergisi, Cilt: 3 - Sayı: 1, 47–51. https://ajindex.com/articles/159653

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