Retinal Ven Dal Tıkanıklığı ve Makula Ödeminde Steroid Tedavisi

Makula ödemi, retinal ven dal tıkanıklığına bağlı görme kaybının en sık nedenidir. Makula ödemi mekanizması multifaktöriyel olup, henüz tam olarak çözülememiştir. Yeni çalışmalar ışığında, mevcut tedavi yaklaşımları, zaman içerisinde değişiklik göstermiştir. Lazer ve intravitreal triamsinolon asetonid tedavilerine ek olarak, günümüzde intravitreal uygulanan anti-vasküler endotelyal büyüme faktörleri ve deksametazon implant tedavileri de kullanıma girmiştir. Bu derlemede retinal ven tıkanıklığına bağlı makula ödeminde, intravitreal steroid tedavisinin irdelenmesi amaçlanmıştır.

Steroid Therapy in Branch Retinal Vein Occlusion and Macular Edema

Macular edema is the most common cause of vision loss in branch retinal vein occlusion. Mechanism of macular edema in branch retinal vein occlusion is multifactorial and it has not yet been fully understood. With the new informations obtained from the new studies, treatment modalities have been changed. Nowadays besides laser and intravitreal triamcinolone acetonide treatments, intravitreal anti–vascular endothelial growth factor and dexamethasone implant therapies are commonly used. In this review, we aimed to evaluate the intravitreal steroid treatment in branch retinal vein occlusion.

Kaynakça

1. Klein R, Klein BE, Moss SE, Meuer SM. The epidemiology of retinal vein occlusion: The Beaver Dam Eye Study. Trans Am Ophthalmol Soc 2000;98:133– 141.

2. Rehak J, Rehak M. Branch retinal vein occlusion: pathogenesis, visual prognosis, and treatment modalities. Curr Eye Res 2008;33:111–131.

3. BVOS. Argon laser photocoagulation for macular edema in branch vein occlusion. The Branch Vein Occlusion Study Group. Am J Ophthalmol. 1984;98(3):271-82.

4. Noma H, Minamoto A, Funatsu H, Tsukamoto H, Nakano K, Yamashita H, et al. Intravitreal levels of vascular endothelial growth factor and interleukin- 6 are correlated with macular edema in branch retinal vein occlusion. Graefes Arch Clin Exp Ophthalmol 2006;244(3):309 –315.

5. Noma H, Funatsu H, Yamasaki M, Tsukamoto H, Mimura T, Sone T, et al. Aqueous humour levels of cytokines are correlated to vitreous levels and severity of macular oedema in branch retinal vein occlusion. Eye 2008;22(1):42– 48.

6. Rabena MD, Pieramici DJ, Castellarin AA, Nasir MA, Avery RL. Intravitreal bevacizumab (Avastin) in the treatment of macular edema secondary to branch retinal vein occlusion. Retina 2007;27(4):419 – 425.

7. Campochiaro PA, Hafiz G, Shah SM, Nguyen QD, Ying H, Do DV, et al. Ranibizumab for macular edema due to retinal vein occlusions: implication of VEGF as a critical stimulator. Mol Ther 2008;16(4):791–799.

8. Yoshimura T, Sonoda KH, Sugahara M, Mochizuki Y, Enaida H, Oshima Y, et al. Comprehensive analysis of inflammatory immune mediators in vitreoretinal diseases. PLoS One. 2009;4(12):8158.

9. Noma H, Funatsu H, Mimura T, Eguchi S, Hori S. Soluble vascular endothelial growth factor receptor-2 and inflammatory factors in macular edema with branch retinal vein occlusion. Am J Ophthalmol. 2011;152(4):669-677.

10. Sivaprasad S, McCluskey P, Lightman S. Intravitreal steroids in the management of macular oedema. Review. Acta Ophthalmol Scand. 2006;84(6):722- 33.

11. Scott IU, Ip MS, VanVeldhuisen PC, Oden NL, Blodi BA, Fisher M, et al. SCORE Study Research Group. A randomized trial comparing the efficacy and safety of intravitreal triamcinolone with standard care to treat vision loss associated with macular Edema secondary to branch retinal vein occlusion: the Standard Care vs Corticosteroid for Retinal Vein Occlusion (SCORE) study report 6. Arch Ophthalmol. 2009;127:1115-28.

12. Kawaji T, Hirata A, Awai N, Takano A, Inomata Y, Fukushima M, et al. Trans-tenon retrobulbar triamcinolone injection for macular edema associated with branch retinal vein occlusion remaining after vitrectomy. Am J Ophthalmol. 2005;140(3):540-2.

13. Robinson MR, Whitcup SM. Pharmacologic and clinical profile of dexamethasone intravitreal implant. Expert Rev Clin Pharmacol. 2012;5(6):629-47.

14. Haller JA, Bandello F, Belfort R Jr, Blumenkranz MS, Gillies M, Heier J, et al. OZURDEX GENEVA Study Group. Randomized, sham-controlled trial of dexamethasone intravitreal implant in patients with macular edema due to retinal vein occlusion. Ophthalmology. 2010;117:1134-46.

15. Capone A Jr, Singer MA, Dodwell DG, Dreyer RF, Oh KT, Roth DB, et al. Efficacy and safety of two or more dexamethasone intravitreal implant injections for treatment of macular edema related to retinal vein occlusion (Shasta study). Retina. 2014;34(2):342-51.

16. Querques L, Querques G, Lattanzio R, Gigante SR, Del Turco C, Corradetti G,et al. Repeated intravitreal dexamethasone implant (Ozurdex®) for retinal vein occlusion. Ophthalmologica. 2013;229(1):21-5.

17. Schmitz K, Maier M, Clemens CR, Höhn F, Wachtlin J, Lehmann F,et al. German Retinal Vein Occlusion Group. Reliability and safety of intravitreal Ozurdex injections. The ZERO study. Ophthalmologe. 2014;111(1):44-52.

18. Hattenbach LO, Hoerauf H, Feltgen N, Lang G, Taylor S, Schmitz-Valckenberg S, et al. Efficacy and safety of 0.5 mg Ranibizumab administered as iIntravitreal injections PRN compared with intravitreal implant containing 0.7 mg Dexamethasone in patients with branch retinal vein occlusion over 6 Months: The COMRADE- B Study Ophthalmologica 2014;232:1-98.

19. Ozkok A, Saleh OA, Sigford DK, Heroman JW, Schaal S. THE OMAR STUDY: Comparison of Ozurdex and Triamcinolone Acetonide for Refractory Cystoid Macular Edema in Retinal Vein Occlusion. Retina. 2015;35(7):1393- 400.

Kaynak Göster