Year 2019, Volume 58 , Issue 3, Pages 289 - 294 2019-09-20

Photodynamic therapy in ophthalmology
Oftalmolojide fotodinamik tedavi

Sevinç Şahin Atik [1] , Filiz Afrashi [2] , Cezmi Akkın [3]


Aim: To evaluate the results of photodynamic therapy (PDT) using verteporfin in different types of choroidal neovascularization resulting from age-related macular degeneration (AMD).

Materials and Methods: Forty-two eyes of 40 patients were included in the study. Visual acuity, contrast sensitivity and lesion characteristics in fluorescein angiography (FA) of the cases were recorded before and after PDT. The patients were evaluated at the 7th day, 6th week, 12th week, and afterwards, if no problem was observed, every 3 months in a year. We evaluated the success or failure rates of the treatment.

 

Results: Mean age of the patients was 64.50±12.00 years. Eighteen of the lesions (43%) were pure-classical, 4 (9%) minimally-classical, 15 (36%) predominant-classical and 5 occult. Of these lesions, 31 (74%) were subfoveal and 11 (26%) juxtafoveal; 18 (43%) well-defined, and 28 (67%) poorly-defined. When examined in terms of lesion types, success rate was higher in predominant-classical group, but this difference was not statistically significant (p=0.062). Success was achieved in 30 of 31 eyes with subfoveal lesions (97%) and in 8 of 11 (73%) eyes with juxtafoveal lesions (p=0.049). The visual acuity level determined at the last visit in the successful group was significantly higher than that of the unsuccessful group (p=0.015). Statistically significant improvement in contrast sensitivity was achieved after treatment (p=0.028).

Conclusion: PDT reliably reduces the risk of visual loss in subfoveal choroidal neovascularization due to AMD. However, the use of PDT in the treatment of AMD is limited because of the higher success of recently used vascular endothelial growth factor (VEGF) inhibitors. 

Amaç: Yaşa Bağlı Makula Dejeneresansı (YBMD) sonucu gelişen koroid neovaskülarizasyonlarının farklı tiplerinde, verteporfin kullanılarak yapılan fotodinamik tedavinin (FDT) sonuçlarını değerlendirmektir.

Gereç ve Yöntem: Ege Üniversitesi Tıp Fakültesi Göz Hastalıkları Anabilim Dalı’nda YBMD'ye bağlı koroid neovaskülarizasyonlarında FDT uygulanmış 40 hastanın 42 gözü çalışma kapsamına alındı. Olguların tedavi öncesi ve sonrası görme keskinlikleri, kontrast duyarlılıkları ve floresein anjiografideki (FA) lezyon özellikleri kaydedildi. FDT uygulanmış hastaların 7. gün, 6. hafta, 12. hafta ve sonrasında ise bir sorun izlenmediği takdirde 1 yıl süre ile 3 ayda bir olan kontrolleri değerlendirildi. Hastaların 3 ay arayla çekilen FA görüntülerinde lezyonun sızdırma özelliklerine göre tedavinin başarısı değerlendirildi.

Bulgular: Çalışmaya alınan 28 erkek, 12 kadın hastanın yaş ortalaması 64.50±12.00 yıldı.  Lezyonların 18'i (%43) saf klasik, 4'ü (%9) minimal klasik, 15'i (%36) predominant klasik, 5'i ise okkült idi. Bu lezyonlardan 31'i (%74) subfoveal, 11'i (%26) ise juxtafoveal; 18'i (%43) iyi sınırlı, 28'i (%67) ise kötü sınırlıydı. Lezyon türleri açısından predominant klasik grupta başarı oranı daha yüksek bulundu, ancak bu fark anlamlı değildi (p=0.062). Subfoveal yerleşimli 31 gözden 30'unda başarı sağlanırken (%97), juxtafoveal yerleşimli 11 gözün 8'inde (%73) başarı sağlanmıştı (p=0.049). Tedavi öncesi lezyon çapı, görme keskinliği, kontrast duyarlılık ve uygulanan FDT sayısı açısından başarılı ve başarısız grup arasında anlamlı fark yoktu. Başarılı grupta son muayenede saptanan görme keskinliği düzeyi belirgin olarak yüksekti (p=0.015). Kontrast duyarlılıkta tedavi sonrasında istatistiksel olarak anlamlı düzelme saptandı (p=0.028).

Sonuç: FDT, YBMD'ye bağlı gelişen özellikle subfoveal koroid neovaskülarizasyonlarında görme kaybı riskini azaltmaktadır. Ancak son yıllarda yaygın kullanılan vasküler endotelyal büyüme faktörü̈ inhibitörlerinin başarılı sonuçları nedeniyle FDT'nin YBMD tedavisinde sınırlı bir kullanımı mevcuttur.

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Primary Language tr
Subjects Health Care Sciences and Services
Journal Section Research Articles
Authors

Orcid: 0000-0003-2566-8691
Author: Sevinç Şahin Atik (Primary Author)
Institution: Kâtip Çelebi Üniversitesi Atatürk EAH, Göz Hastalıkları Anabilim Dalı, İzmir
Country: Turkey


Orcid: 0000-0001-6359-1600
Author: Filiz Afrashi
Institution: Ege Üniversitesi Tıp Fakültesi, Göz Hastalıkları Anabilim Dalı, İzmir
Country: Turkey


Orcid: 0000-0002-7048-9599
Author: Cezmi Akkın
Institution: Ege Üniversitesi Tıp Fakültesi, Göz Hastalıkları Anabilim Dalı, İzmir
Country: Turkey


Dates

Publication Date : September 20, 2019

Bibtex @research article { etd610824, journal = {Ege Tıp Dergisi}, issn = {1016-9113}, eissn = {2147-6500}, address = {}, publisher = {Ege University}, year = {2019}, volume = {58}, pages = {289 - 294}, doi = {10.19161/etd.610824}, title = {Oftalmolojide fotodinamik tedavi}, key = {cite}, author = {Şahin Atik, Sevinç and Afrashi, Filiz and Akkın, Cezmi} }
APA Şahin Atik, S , Afrashi, F , Akkın, C . (2019). Oftalmolojide fotodinamik tedavi. Ege Tıp Dergisi , 58 (3) , 289-294 . DOI: 10.19161/etd.610824
MLA Şahin Atik, S , Afrashi, F , Akkın, C . "Oftalmolojide fotodinamik tedavi". Ege Tıp Dergisi 58 (2019 ): 289-294 <http://egetipdergisi.com.tr/en/issue/47742/610824>
Chicago Şahin Atik, S , Afrashi, F , Akkın, C . "Oftalmolojide fotodinamik tedavi". Ege Tıp Dergisi 58 (2019 ): 289-294
RIS TY - JOUR T1 - Oftalmolojide fotodinamik tedavi AU - Sevinç Şahin Atik , Filiz Afrashi , Cezmi Akkın Y1 - 2019 PY - 2019 N1 - doi: 10.19161/etd.610824 DO - 10.19161/etd.610824 T2 - Ege Tıp Dergisi JF - Journal JO - JOR SP - 289 EP - 294 VL - 58 IS - 3 SN - 1016-9113-2147-6500 M3 - doi: 10.19161/etd.610824 UR - https://doi.org/10.19161/etd.610824 Y2 - 2018 ER -
EndNote %0 Ege Tıp Dergisi Oftalmolojide fotodinamik tedavi %A Sevinç Şahin Atik , Filiz Afrashi , Cezmi Akkın %T Oftalmolojide fotodinamik tedavi %D 2019 %J Ege Tıp Dergisi %P 1016-9113-2147-6500 %V 58 %N 3 %R doi: 10.19161/etd.610824 %U 10.19161/etd.610824
ISNAD Şahin Atik, Sevinç , Afrashi, Filiz , Akkın, Cezmi . "Oftalmolojide fotodinamik tedavi". Ege Tıp Dergisi 58 / 3 (September 2019): 289-294 . https://doi.org/10.19161/etd.610824
AMA Şahin Atik S , Afrashi F , Akkın C . Oftalmolojide fotodinamik tedavi. Ege Tıp Dergisi. 2019; 58(3): 289-294.
Vancouver Şahin Atik S , Afrashi F , Akkın C . Oftalmolojide fotodinamik tedavi. Ege Tıp Dergisi. 2019; 58(3): 294-289.