Dergiler / Retina-Vitreus / 2019 / Cilt: 28 - Sayı: 1

Effi cacy of Dexamethasone Implant versus Intravitreal Ranibizumab Treatment for Chronic Diabetic Macular Edema in Type 2 Diabetic Patients

Tip 2 Diyabetik Hastalarda Kronik Diyabetik Makula Ödem Tedavisinde Deksametazon İmplant ve İntravitreal Ranibizumab’ın Etkinliğinin Karşılaştırılması

Sayfa
25–31
DOI
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⚡ TL;DR(1 Cümlede Hızlı Çıkarım)

BCVA and CMT improved signifi cantly as soon as one month and up to 4 months in DEX implant treatment, but were not maintained as well as RAN treatment.

📌 3 Maddede Bu Makale

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Amaç & Hipotez:Purpose: To evaluate the effi cacy of an intravitreal dexamethasone (DEX) implant versus intravitreal ranibizumab (RAN) for chronic diabetic macular edema (DME) in Type 2 Diabetic Patients.
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Temel Bulgular & Veri:Materials and Methods: In this retrospective, comparative, cohort study, 28 eyes of 22 patients were received DEX implant at every 24 weeks.
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Sonuç & Katkı:BCVA and CMT improved signifi cantly as soon as one month and up to 4 months in DEX implant treatment, but were not maintained as well as RAN treatment.
🔬Tür:Araştırma Makalesi
📍Kapsam:Genişletilmiş Akademik Örneklem
⚙️Değişkenler:Alan Parametreleri

Özet

Purpose: To evaluate the effi cacy of an intravitreal dexamethasone (DEX) implant versus intravitreal ranibizumab (RAN) for chronic diabetic macular edema (DME) in Type 2 Diabetic Patients. Materials and Methods: In this retrospective, comparative, cohort study, 28 eyes of 22 patients were received DEX implant at every 24 weeks. Thirty-seven eyes of 30 patients were performed RAN injections on pro re nata (PRN), immediately after three loading doses. Main outcome measures included best-corrected visual acuity (BCVA) and central macular thickness (CMT), intraocular pressure (IOP) and incidence of side effects in both groups. Results: The mean change of BCVA for 12 months was -0, 11 Log MAR in DEX group and -0, 55 Log MAR in RAN group. There was a sta- tistically signifi cant difference in BCVA between the DEX group and RAN group at month 6 and month 12 (p =0.0001 and p=0.0001). Mean CMT was signifi cantly decreased in both groups from the baseline to month 6 and month 12 (DEX: p=0.001 and p=0.0001, RAN: p=0.0001, p=0.0001). Mean changes of CMT for 6 months and 12 months were -80 μm and -127 μm with the DEX group, and -204 μm and -227μm with the RAN group. Mean IOP increased remarkably in the DEX group compared to the RAN group. However, 7 eyes with IOP higher than 21 mmHg were well controlled with topical anti-glaucoma drugs in DEX group. Conclusion: The study demonstrated that more preferable functional and anatomic outcome could be provided by RAN injection than DEX implant for 12 months. BCVA and CMT improved signifi cantly as soon as one month and up to 4 months in DEX implant treatment, but were not maintained as well as RAN treatment.

Abstract

Amaç: Tip 2 diyabetik hastalarda kronik diyabetik makula ödemi (DMÖ) tedavisinde intravitreal ranibizumab (RAN) ile intravitreal deksame- tazon (DEX) implantı’ nın etkinliğini değerlendirmek. Materyal ve Metot: Bu retrospektif, karşılaştırmalı, kohort çalışmasında, 22 hastanın 28 gözüne her 24 haftada bir DEX implant ve 30 has- tanın 37 gözüne, üç yükleme dozundan hemen sonra pro re nata (PRN) protokolüne uygun olarak RAN enjeksiyonu yapıldı. İki grupta, en iyi düzeltilmiş görme keskinliği (EDGK), merkezi makula kalınlığı (MMK), göz içi basıncı (GİB) değerleri ve yan etkiler açısından karşılaştırıldı. Bulgular: On iki aylık EDGK ortalama değişimi DEX grubunda -0, 11 Log MAR ve RAN grubunda -0,55 Log MAR olarak bulundu. DEX grubu ile RAN grubu arasında 6. ay ve 12. ayda EDGK’da istatistiksel olarak anlamlı fark vardı (p = 0,0001 ve p = 0,0001). Ortalama MMK, başlangıç değerlerine göre her iki grupta da 6. ay ve 12. ayda (DEX: p=0.001 ve p=0,0001, RAN: p=0,0001, p = 0,0001) anlamlı şekilde azaldı. MMK’nın 6 ay ve 12 aylık ortalama değişiklikleri -80 μm ve -127 μm idi. DEX grubu ve RAN gruplarında sırasıyla -204 μm ve -227μm ola-rak bulundu. Ortalama GİB, DEX grubunda RAN grubuna göre belirgin olarak arttı. Bununla birlikte, GİB 21 mmHg’ dan yüksek olan DEX grubundaki 7 gözdeki basınç topikal anti-glokomatöz ilaçlarıyla kontrol altına alındı. Sonuç: Bu çalışmada, 12 ay boyunca RAN enjeksiyon tedavisi ile DEX implantasyonuna göre tercihen daha iyi fonksiyonel ve anatomik so- nuçlar görüldü. EDGK ve MMK da, DEX implant tedavisinde bir aydan kısa bir sürede belirgin şekilde iyileşme izlenmesine rağmen, 4 aydan sonra RAN tedavisinde olduğu gibi devamlılık sağlanamamıştır.

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Bu Makaleye Atıf Yap

AYDIN, E., KARABOĞA, N. A., EĞRİLMEZ, E. D., KAZANCI, L. (2019). Effi cacy of Dexamethasone Implant versus Intravitreal Ranibizumab Treatment for Chronic Diabetic Macular Edema in Type 2 Diabetic Patients. Retina-Vitreus, Cilt: 28 - Sayı: 1, 25–31. https://ajindex.com/articles/307568

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