Serkan DEMİRYÜREK, Zafer ONARAN, Tevfik OĞUREL, Nesrin BÜYÜKTORTOP, Nurgül ÖRNEK

İntravitreal ranibizumab enjeksiyonunun optik sinir üzerine etkisinin patern VEP ile değerlendirilmesi

Amaç: Koroid neovaskülarizasyonu tedavisi için sık olarak kullanılan anti-VEGF ajan olan ranibizumabın intravitreal enjeksiyonunun optik sinir üzerine etkisinin patern VEP testi ile değerlendirilmesidir.Gereç ve Yöntem: Yaşa bağlı makula dejenerasyonu nedeniyle koroid neovaskülarizasyonu gelişmiş ve 0,5mg intravitreal ranibizumab enjeksiyonu yapılan 20 hastanın 20 gözüne ve diğer gözlerine enjeksiyon öncesi ve sonrası 1. ve 6. haftalarda patern VEP testi yapıldı. Aynı yaş grubunda 10 kontrol grubu hastasına patern VEP testi yapılarak sonuçlar karşılaştırıldı. Bulgular: Yaşları 64 ve 82 arasında olan 20 yaşa bağlı maküla dejenerasyonlu hastanın yaş ortalaması 73,45 idi. Enjeksiyon yapılan gözlerin başlangıç en iyi görme keskinliği ortalaması 9/100 idi ve son olarak 6. haftadaki en iyi görme keskinliği 14/100' dü. Enjeksiyon yapılan gözlerde başlangıç göziçi basıncı ortalaması 13,85mmHg idi. 1. haftadaki göziçi basınca ortalaması 16,75mmHg ve son olarak 6. haftadaki göziçi basıncı ortalaması ise 14mmHg idi. Hasta grubu ve kontrol grubu VEP dalga boyları ve latansları arasında istatistiksel olarak anlamlı bir fark saptanmadı (p>0.05). Enjeksiyon yapılan ve diğer gözlerde enjeksiyon sonrası 1. ve 6. haftalardaki VEP dalga boylarında ve latanslarında istatistiksel olarak anlamlı bir gerileme yoktu (p>0.05). Sonuç: Çalışmamızda VEP incelemesi ile 0.5 mg ranibizumabın intravitreal enjeksiyonunun optik sinire dolaylı hasarı olmadığı gösterilmiştir.

Anahtar Kelimeler:

Ranibizumab, optik sinir, göziçi basınç

Evaluation of the effect of intraocular ranibizumab injection on optic nerve by pattern VEP

Purpose: To evaluate the effect of intravitreal injection of ranibizumab, an anti-VEGF agent commonly used for the treatment of choroidal neovascularization, on optic nerve by pattern VEP test.Material and Method: Pattern VEP test was applied to 20 eyes of 20 patients who received 0.5 mg of ranibizumab injection because of age related choroidal neovascularization maculopathy and also to other non-injected eyes of the same patients in 1st and 6th weeks. Results are compared with 10 control patients of same age distribution. Results: Mean age was 73.45 in 20 age related maculopathy patients ranging between 64 and 82. Mean best corrected visual acuity of eyes receiving injection was 9/100 before injection and 14/100 finally on 6th week. Mean intraocular pressure was 13.85mmHg in eyes receiving before the injection, 16.75mmHg at 1st week and finally 14mmHg at 6th week. There was no statistically significant difference between the VEP wavelengths and latencies of the patient group and the control group (p> 0.05). There was no statistically significant difference between VEP wavelengths and latencies in 1st and 6th weeks between injection receiving eyes and the other eyes (p> 0.05). Conclusion: As a result of VEP evaluation it is concluded that 0.5 mg intravitreal ranibizumab injection does not have an indirect toxic effect to the optic nerve.

Keywords:

Ranibizumab, optic nerve, intraocular pressure,

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