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Prematüre Retinopatisinde uygulanan Diod Lazer Fotokoagülasyon ile İntravitreal Ranibizumab Tedavilerinin Gözün Aksiyel Uzunluğuna ve Refraktif Durumuna Olan Etkilerinin Karşılaştırılması

Year 2019, Volume: 9 Issue: 1, 141 - 147, 20.03.2019

Abstract

Amaç: Prematüre retinopatisi (PR) tedavisinde uygulanan diod lazer fotokoagülasyon (LFK) ile intravitreal ranibizumab(IVR) tedavilerinin gözün aksiyel ve refraktif gelişimi üzerine olan etkilerini değerlendirmektir.

Gereç ve Yöntemler: Kliniğimizde PR nedeniyle primer ve tek tedavi olarak  LFK ve ya  0.25 mg/0.025 ml IVR tedavisi  uygulanmış ve düzeltilmiş olarak bir yaşını doldurmuş 41 infantın 82 gözü çalışmaya dahil edilmiştir. Hastaların biyometri ile aksiyel uzunlukları(AU)  ölçülmüş, sikloplejik muayene sonucu elde edilen refraktif değerleri sferik eküvalan olarak karşılaştırılmıştır.

Bulgular: IVR grubunda 17 hastanın 34 gözü Grup-1, LFK grubunda ise 24 hastanın 48 gözü Grup-2 olarak ayrıldı.
Grup-1’de AU; sağ gözde 19,86 1,104mm; sol gözde 19,73 1,062mm idi. Grup-2’de sağ göz için 19,90 0,83mm sol göz için 19,86  0,842mm idi.(p>0.05) Refraktif değerler Grup-1’de sağ göz için 0.442.053D ; sol göz içinse 0.592.063D idi. Grup-2’de ise sağ göz -0.023.07D , sol göz ise -0.172.8 idi.( p>0.05) Her iki grupta  hem aksiyel uzunluk açısından hem de sferik eküvalan  açısından  istatistiksel olarak anlamlı fark saptanamamıştır
Sonuç: Prematüre retinopatili bebeklerde myopi gelişme oranı sağlıklı bebeklere göre daha yüksektir. Prematüre retinopatisi tedavisinde son yıllarda anti vasküler büyüme faktörü(anti-vebf) kullanımı hızla artmakla beraber LFK tedavisi altın standart tedavi olarak kullanılmaktadır. Çalışmamızda İVR tedavisi ile LFK tedavisinin aksiyel uzunluk ve sferik eküvalan değerleri üzerine yaptıkları etkiyi araştırdık ve bir fark bulamadık ama bu konuda daha fazla bilimsel çalışmaların yapılması gerektiğini düşünüyoruz  

References

  • 1) Gilbert C. Retinopathy of prematurity: A global perspective of the epidemics, population of babies at risk and implications for control. Early Hum Dev. 2008;84:77– 82.
  • 2) Hartnett ME. Pathophysiology and mechanisms of severe retinopathy of prematurity. Ophthalmology. 2015;122:200-210.
  • 3) Early Treatment For Retinopathy Of Prematurity Cooperative Group. Revised indications for the treatment of retinopathy of prematurity: results of the early treatment for retinopathy of prematurity randomized trial. Arch Ophthalmol. 2003;121:1684–1694.
  • 4) Zhou Y, Jiang Y, Bai Y, Wen JCL (2016) Vascular endothelial growth factor plasma levels before and after treatment of retinopathy of prematurity with ranibizumab. Graefes Arch Clin Exp Ophthalmol 254(1):31–36.
  • 5) Sukgen, Emine Alyamaç, and Yusuf Koçluk. "Results of intravitreal ranibizumab treatment for retinopathy of prematurity in infants." Cutaneous and Ocular Toxicology (2017): 1-6.
  • 6) Ozdemi O, Tunay ZO, Acar DE, Erol MK, Sener E, Acar U. "The relationship of birth weight, gestational age, and postmenstrual age with ocular biometry parameters in premature infants." Arquivos brasileiros de oftalmologia 78.3 (2015): 146-149.
  • 7) Connolly BP, Ng EY, McNamara JA, Regillo CD, Vander JF, Tasman W. A comparison of laser photocoagulation with cryotherapy for threshold retinopathy of prematurity at 10 years: part 2. Refractive outcome. Ophthalmology 2002;109:936–941.
  • 8) Geloneck MM, Chuang AZ, Clark WL, Hunt MG, Norman AA, Packwood EA, et al. ; BEAT-ROP Cooperative Group. Refractive outcomes following bevacizumab monotherapy compared with conventional laser treatment: a randomized clinical trial. JAMA Ophthalmol 2014;132:1327–1333.
  • 9) Chen YH, Chen SN, Lien RI, Shih CP, Chao AN, Chen KJ, et al. Refractive errors after the use of bevacizumab for the treatment of retinopathy of prematurity: 2-year outcomes. Eye (Lond) 2014;28:1080–1087.
  • 10) International Committee for the Classification of Retinopathy of Prematurity (2005) The International Classification of Retinopathy of Prematurity revisited. Arch Ophthalmol 123:991–999.
  • 11) Axer-Siegel R, Maharshak I, Snir M, Friling R, Ehrlich R,Sherf I, et al. Diode laser treatment of retinopathy of prematurity: anatomical and refractive outcomes. Retina 2008; 28: 839–846.
  • 12) Dhawan A, Dogra M, Vinekar A, Gupta A, Dutta S. Structural sequelae and refractive outcome after successful laser treatment for threshold retinopathy of prematurity. J Pediatr Ophthalmol Strabismus 2008; 45: 356–361.
  • 13) Sahni J, Subhedar NV, Clark D. Treated threshold stage 3 versus spontaneously regressed subthreshold stage 3 retinopathy of prematurity: a study of motility, refractive, and anatomical outcomes at 6 months and 36 months. Br J Ophthalmol 2005; 89: 154–159.
  • 14) Katoch D, Sanghi G, Dogra MR, Beke N, Gupta A. Structural seque¬lae and refractive outcome 1 year after laser treatment for type 1 prethreshold retinopathy of prematurity in Asian Indian eyes. Indian J Ophthalmol. 2011;59(6):423–426.
  • 15) Davitt BV, Quinn GE, Wallace DK, Dobson V, Hardy RJ, Tung B, et al.; Early Treatment for Retinopathy of Prematurity Cooperative Group. Astigmatism progression in the early treatment for retinopathy of prematurity study to 6 years of age. Ophthalmology. 2011;118(12):2326–2329.
  • 16) Paysse EA, Hussein MAW, Miller AM, Brady McCreery KM, Coats DK. Pulsed mode versus near-continuous mode delivery of diode laser photocoagulation for high-risk retinopathy of prematurity. J AAPOS 2007;11:388–392.
  • 17) Lee GA, Hilford DJ, Gole GA. Diode laser treatment of pre-threshold andthreshold retinopathy of prematurity. Clin Experiment Ophthalmol 2004;32:164–169.
  • 18) Salman, Abdelrahman G., and Aza M. Said. "Structural, visual and refractive outcomes of intravitreal aflibercept injection in high-risk prethreshold type 1 retinopathy of prematurity." Ophthalmic research 53.1 (2015): 15-20.
  • 19) Harder, B. C., Schlichtenbrede, F. C., von Baltz, S., Jendritza, W., Jendritza, B., & Jonas, J. B. (2013). Intravitreal bevacizumab for retinopathy of prematurity: refractive error results. American journal of ophthalmology, 155(6), 1119-1124.
  • 20) Martínez-Castellanos MA, Schwartz S, Hernández- Rojas ML, Kon-Jara VA, García-Aguirre G, Guerrero-Naranjo JL, Chan RV, et al. Long-term effect of antiangiogenic therapy for retinopathy of prematurity up to 5 years of follow-up. Retina 2013;33:329–338.
  • 21) Gunay, M., Sekeroglu, M. A., Bardak, H., Celik, G., Esenulku, C. M., Hekimoglu, E., et al. (2016). Evaluation of refractive errors and ocular biometric outcomes after intravitreal bevacizumab for retinopathy of prematurity. Strabismus, 24(2), 84-88.
  • 22) Hwang CK, Hubbard GB, Hutchinson AK, Lambert SR. Outcomes after intravitreal bevacizumab versus laser photocoagulation for retinopathy of prematurity: a 5-year retrospective analysis. Ophthalmology 2015;122:1008–1015
  • 23) Gunay, M., Sukgen, E. A., Celik, G., & Kocluk, Y. (2017). Comparison of bevacizumab, ranibizumab, and laser photocoagulation in the treatment of retinopathy of prematurity in Turkey. Current eye research, 42(3), 462-469.
  • 24) Kabataş, E. U., Kurtul, B. E., Altıaylık Özer, P., & Kabataş, N. (2017). Comparison of intravitreal bevacizumab, intravitreal ranibizumab and laser photocoagulation for treatment of type 1 retinopathy of prematurity in Turkish preterm children. Current eye research, 42(7), 1054-1058.
  • 25) Cook A, White S, Batterbury M and Clark D. Ocular growth and refractive error development in premature infants with or without retinopathy of prematurity. Invest Ophthalmol Vis Sci 2008; 49: 5199-5207.
  • 26) Laws DE, Haslett R, Ashby D, O’Brien C, Clark D. Axial length biometry in infants with retinopathy of prematurity. Eye (Lond). 1994;8(4):427-30.
  • 27) Yang, C. S., Wang, A. G., Shih, Y. F., & Hsu, W. M. (2013). Astigmatism and biometric optic components of diode laser-treated threshold retinopathy of prematurity at 9 years of age. Eye, 27(3), 374.
  • 28) Iwase, S., Kaneko, H., Fujioka, C., Sugimoto, K., Kondo, M., Takai, Y., et al. (2014). A long-term follow-up of patients with retinopathy of prematurity treated with photocoagulation and cryotherapy. Nagoya journal of medicalscience, 76(1-2), 121.
  • 29) LIN, Chun-Ju; TSAI, Yi-Yu. Axial length, refraction, and retinal vascularization 1 year after ranibizumab or bevacizumab treatment for retinopathy of prematurity. Clinical ophthalmology (Auckland, NZ), 2016, 10: 1323.

Comparison of intravitreal ranibizumab and diod laser photocoagulation treatment for retinopathy of prematurity; effects on axial lenght and refractive status

Year 2019, Volume: 9 Issue: 1, 141 - 147, 20.03.2019

Abstract

Objective: To
evaluate the effects of diode laser photocoagulation and intravitreal

ranibizumab (IVR) treatments
on axial lenght and refractive status development in the

treatment of retinopathy of
premautrity (ROP).

 

Materials
and methods:
The study included 82 eyes of 41 patients who were 1
year

adjusted age, underwent
primarily diode laser photocoagulation or 0.25 mg/0.025 ml

IVR. Axial lenght (AL) and
spherical equivalent (SE) parameters were compared. 

Results:
Patients divided into two groups. Group 1 had 34 eyes of 17 patients who
underwent IVR treatment and group 2 had 48 eyes of 24  patients who underwent diode laser
photocoagulation treatment. In group 1, AL were detected 19,86
±1,104mm in right eyes and
19,73
±1,062mm
in left eyes. In group 2, AL were detected 19,90
± 0,83mm in right eyes and 19,86 ± 0,842mm in left eyes
(p>0.05). In group1 and 2, SE values were detected 0.44
±2.053D and -0.02±3.07D  in right eyes and 0.59±2.063D and -0.17±2.8 in left eyesD,
respectively ( p>0.05). 
There was  no statistically significant differences
between two groups about AL and SE values.

 



















Conclusion: Myopia is seen higher in patients with ROP than healthy patients. Although using anti vascular
growth factor in ROP has been increased last years,
diode
laser photocoagulation is the gold standart
therapy. In our study we compared
the effects of diode laser photocoagulation and IVR on AL and SE. We did not
find any statistically significant difference. Further evaluation is needed.  

References

  • 1) Gilbert C. Retinopathy of prematurity: A global perspective of the epidemics, population of babies at risk and implications for control. Early Hum Dev. 2008;84:77– 82.
  • 2) Hartnett ME. Pathophysiology and mechanisms of severe retinopathy of prematurity. Ophthalmology. 2015;122:200-210.
  • 3) Early Treatment For Retinopathy Of Prematurity Cooperative Group. Revised indications for the treatment of retinopathy of prematurity: results of the early treatment for retinopathy of prematurity randomized trial. Arch Ophthalmol. 2003;121:1684–1694.
  • 4) Zhou Y, Jiang Y, Bai Y, Wen JCL (2016) Vascular endothelial growth factor plasma levels before and after treatment of retinopathy of prematurity with ranibizumab. Graefes Arch Clin Exp Ophthalmol 254(1):31–36.
  • 5) Sukgen, Emine Alyamaç, and Yusuf Koçluk. "Results of intravitreal ranibizumab treatment for retinopathy of prematurity in infants." Cutaneous and Ocular Toxicology (2017): 1-6.
  • 6) Ozdemi O, Tunay ZO, Acar DE, Erol MK, Sener E, Acar U. "The relationship of birth weight, gestational age, and postmenstrual age with ocular biometry parameters in premature infants." Arquivos brasileiros de oftalmologia 78.3 (2015): 146-149.
  • 7) Connolly BP, Ng EY, McNamara JA, Regillo CD, Vander JF, Tasman W. A comparison of laser photocoagulation with cryotherapy for threshold retinopathy of prematurity at 10 years: part 2. Refractive outcome. Ophthalmology 2002;109:936–941.
  • 8) Geloneck MM, Chuang AZ, Clark WL, Hunt MG, Norman AA, Packwood EA, et al. ; BEAT-ROP Cooperative Group. Refractive outcomes following bevacizumab monotherapy compared with conventional laser treatment: a randomized clinical trial. JAMA Ophthalmol 2014;132:1327–1333.
  • 9) Chen YH, Chen SN, Lien RI, Shih CP, Chao AN, Chen KJ, et al. Refractive errors after the use of bevacizumab for the treatment of retinopathy of prematurity: 2-year outcomes. Eye (Lond) 2014;28:1080–1087.
  • 10) International Committee for the Classification of Retinopathy of Prematurity (2005) The International Classification of Retinopathy of Prematurity revisited. Arch Ophthalmol 123:991–999.
  • 11) Axer-Siegel R, Maharshak I, Snir M, Friling R, Ehrlich R,Sherf I, et al. Diode laser treatment of retinopathy of prematurity: anatomical and refractive outcomes. Retina 2008; 28: 839–846.
  • 12) Dhawan A, Dogra M, Vinekar A, Gupta A, Dutta S. Structural sequelae and refractive outcome after successful laser treatment for threshold retinopathy of prematurity. J Pediatr Ophthalmol Strabismus 2008; 45: 356–361.
  • 13) Sahni J, Subhedar NV, Clark D. Treated threshold stage 3 versus spontaneously regressed subthreshold stage 3 retinopathy of prematurity: a study of motility, refractive, and anatomical outcomes at 6 months and 36 months. Br J Ophthalmol 2005; 89: 154–159.
  • 14) Katoch D, Sanghi G, Dogra MR, Beke N, Gupta A. Structural seque¬lae and refractive outcome 1 year after laser treatment for type 1 prethreshold retinopathy of prematurity in Asian Indian eyes. Indian J Ophthalmol. 2011;59(6):423–426.
  • 15) Davitt BV, Quinn GE, Wallace DK, Dobson V, Hardy RJ, Tung B, et al.; Early Treatment for Retinopathy of Prematurity Cooperative Group. Astigmatism progression in the early treatment for retinopathy of prematurity study to 6 years of age. Ophthalmology. 2011;118(12):2326–2329.
  • 16) Paysse EA, Hussein MAW, Miller AM, Brady McCreery KM, Coats DK. Pulsed mode versus near-continuous mode delivery of diode laser photocoagulation for high-risk retinopathy of prematurity. J AAPOS 2007;11:388–392.
  • 17) Lee GA, Hilford DJ, Gole GA. Diode laser treatment of pre-threshold andthreshold retinopathy of prematurity. Clin Experiment Ophthalmol 2004;32:164–169.
  • 18) Salman, Abdelrahman G., and Aza M. Said. "Structural, visual and refractive outcomes of intravitreal aflibercept injection in high-risk prethreshold type 1 retinopathy of prematurity." Ophthalmic research 53.1 (2015): 15-20.
  • 19) Harder, B. C., Schlichtenbrede, F. C., von Baltz, S., Jendritza, W., Jendritza, B., & Jonas, J. B. (2013). Intravitreal bevacizumab for retinopathy of prematurity: refractive error results. American journal of ophthalmology, 155(6), 1119-1124.
  • 20) Martínez-Castellanos MA, Schwartz S, Hernández- Rojas ML, Kon-Jara VA, García-Aguirre G, Guerrero-Naranjo JL, Chan RV, et al. Long-term effect of antiangiogenic therapy for retinopathy of prematurity up to 5 years of follow-up. Retina 2013;33:329–338.
  • 21) Gunay, M., Sekeroglu, M. A., Bardak, H., Celik, G., Esenulku, C. M., Hekimoglu, E., et al. (2016). Evaluation of refractive errors and ocular biometric outcomes after intravitreal bevacizumab for retinopathy of prematurity. Strabismus, 24(2), 84-88.
  • 22) Hwang CK, Hubbard GB, Hutchinson AK, Lambert SR. Outcomes after intravitreal bevacizumab versus laser photocoagulation for retinopathy of prematurity: a 5-year retrospective analysis. Ophthalmology 2015;122:1008–1015
  • 23) Gunay, M., Sukgen, E. A., Celik, G., & Kocluk, Y. (2017). Comparison of bevacizumab, ranibizumab, and laser photocoagulation in the treatment of retinopathy of prematurity in Turkey. Current eye research, 42(3), 462-469.
  • 24) Kabataş, E. U., Kurtul, B. E., Altıaylık Özer, P., & Kabataş, N. (2017). Comparison of intravitreal bevacizumab, intravitreal ranibizumab and laser photocoagulation for treatment of type 1 retinopathy of prematurity in Turkish preterm children. Current eye research, 42(7), 1054-1058.
  • 25) Cook A, White S, Batterbury M and Clark D. Ocular growth and refractive error development in premature infants with or without retinopathy of prematurity. Invest Ophthalmol Vis Sci 2008; 49: 5199-5207.
  • 26) Laws DE, Haslett R, Ashby D, O’Brien C, Clark D. Axial length biometry in infants with retinopathy of prematurity. Eye (Lond). 1994;8(4):427-30.
  • 27) Yang, C. S., Wang, A. G., Shih, Y. F., & Hsu, W. M. (2013). Astigmatism and biometric optic components of diode laser-treated threshold retinopathy of prematurity at 9 years of age. Eye, 27(3), 374.
  • 28) Iwase, S., Kaneko, H., Fujioka, C., Sugimoto, K., Kondo, M., Takai, Y., et al. (2014). A long-term follow-up of patients with retinopathy of prematurity treated with photocoagulation and cryotherapy. Nagoya journal of medicalscience, 76(1-2), 121.
  • 29) LIN, Chun-Ju; TSAI, Yi-Yu. Axial length, refraction, and retinal vascularization 1 year after ranibizumab or bevacizumab treatment for retinopathy of prematurity. Clinical ophthalmology (Auckland, NZ), 2016, 10: 1323.
There are 29 citations in total.

Details

Primary Language English
Journal Section Articles
Authors

Emine Alyamaç Sukgen

Selim Cevher

Yusuf Koçluk This is me

Publication Date March 20, 2019
Submission Date September 4, 2018
Published in Issue Year 2019 Volume: 9 Issue: 1

Cite

AMA Alyamaç Sukgen E, Cevher S, Koçluk Y. Comparison of intravitreal ranibizumab and diod laser photocoagulation treatment for retinopathy of prematurity; effects on axial lenght and refractive status. Sakarya Tıp Dergisi. March 2019;9(1):141-147.

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