Research Information System
Thesis Type: Expertise In Medicine
Institution Of The Thesis: Gazi Üniversitesi, Tıp Fakültesi, Turkey
Approval Date: 2012
Student: SİBEL ERYİĞİT
Supervisor: ŞENGÜL ÖZDEK
Abstract:Aim: To evaluate the long term results of anti-VEGF therapy in subfoveal choroidal neovascularization due to age related macular degeneration. The medical records of 226 eyes with neovascular AMD treated with intravitreal anti VEGFs (bevacizumab or ranibizumab) were retrospectively analyzed.The visual and anatomical (OCT) prognosis of the cases and complication rates after treatment were determined. Inclusion criteria were new-onset neovascular AMD with minimum follow-up of 6 months. Visual results at beginning, after loading with anti-VEGF injections , and at last visit; anatomical results; santral foveal thickness and PED dimensions and changes during treatment were determined. Rate of CNV with PED among all NAMD, types of PED, rate of non-responders and baseline characteristics, rate of RPE tear formation in CNV with PED and rate of non responders in CNV with PED were also determined. Visual acuities were examined with ETDRS and Snellen charts and converted to logMAR units. The median of BCVA logMAR in eyes was 0,70 at beginning, which decreased significantly to 0,50 (p<0,001) at after loading treatment and increased significantly to 0,70 at the last visit (p<0.001). Visual acuity was increased 44.3% of eyes and decreased 31,4%of eyes at last visit acording to the beginning. 44/226 eyes (19,4%) were assessed to be non-responder to anti-VEGF treatment. The nonresponder rate in eyes with PED was 32/132 eyes(24,2%) and without PED was 12/94 eyes 12% which was significantly less. (P=0,032) 19/32 (59,3%) eyes which defined as non-responder to anti-VEGF treatment (after at least three anti-VEGF injections), PDT was applied combine with anti-VEGF. 8/19 (42,1%) eyes of these patients which applied PDT, had good visual and anatomical results. The median of BCVA logMAR in eyes with PED was 0,70 at beginning, which decreased significantly to 0,50 (p<0,001) at after loading treatment and increased significantly to 0,70 at the last visit (p<0.001).The median of PED height was 350µm at beginning, which decreased significantly to 230µm after loading treatment and to 150 µm at the last visit ( ? 2=152.222; p<0.001).Rate of ocular and systemic side effects was under 1%.Only rate of RPE Tear formation was 13.2%. RPE tear formation and non-respondents to anti-VEGFs are more prevalent significantly in cases with PED. PED height and precence time of PED are predictor factors for RPE tear formation.