Özgür YALÇINBAYIR, Gamze UÇAN, Öner GELİŞKEN, Berkant KADERLİ, Ahmet Ali YÜCEL, Enver ÇALIŞKAN, Mustafa RİGAN

Behçet Hastalığı Dışındaki Sebeplerle Oluşan Non-Enfeksiyöz Posterior Üveite Sekonder Makula Ödeminde Deksametazon İmplantın Etkinliği

Amaç İmmünmodülatör tedavi kullanımına rağmen kistoid makula ödemi gelişen Behçet hastalığı dışındaki sebeplerle non-infeksiyoz poste-rior üveiti olan hastalarda adjuvan intravitreal 0,7 mg deksametazon salınım sistemi uygulamasının etkinliğinin araştırılması Materyal-Metod Bu çalışmaya Behçet hastalığı dışında non-enfeksiyöz posterior üveit tanısı almış 13 hastanın 17 gözüne yapılan ve en az 12 ay takip edilen deksametazon implant olguları dahil edilmiştir. Olguların demografik özellikleri, enjeksiyon sırasında kullanılmakta olduğu sistemik im-münmodülatör tedavisi, takip süresi, enjeksiyon öncesi ve enjeksiyon sonrası en iyi düzeltilmiş görme keskinliği, göz içi basınçlar değerleri, optik koherens tomografideki santral makula kalınlığı kaydedilmiştir. İzlem süresince implanta bağlı gelişen glokom, katarakt ve endoftalmi gb. komplikasyonlar ve implant enjeksiyonunun tekrarlanma durumu incelenmiştir. Bulgular Elde edilen veriler olgularda istatistiksel olarak anlamlı seviyede anatomik başarı elde edildiğini ve etkinliğin ilk 2 ay korunduğu göstermektedir. Enjeksiyonu takip eden ilk 2 ay içerisinde görme artışının tepe noktasına ulaşılmasına rağmen istatistiksel olarak anlamlı görme artışı elde edilemediği izlenmektedir. İki olguda gelişen kısa süreli topikal anti-glokomatöz kullanımını gerektiren GİB yüksekliği dışında komplikasyon izlenmemiştir. Sonuç Behçet hastalığı dışındaki non-enfeksiyöz posterior üveit tanılı olgularda sistemik tedaviye rağmen KMÖ gelişen olgularda adjuvan intravitreal deksametazon tedavisi sistemik toksisite oluşturmadan makuler anatominin korunması açısından önem arz etmektedir. Bu çalışmada görmede istenilen seviyede artış elde edilmemiştir.

Efficacy of Dexamethasone Implant in Secondary Macular Edema due to Posterior Non-Infectious Entities Other than Behçet Disease

Purpose Investigation of the efficacy of intravitreal 0,7 mg dexamethasone implant in patients who were diagnosed with posterior non-infectious uveitis entities other than Behçet's disease and had cystoid macular edema despite the immunomodulation. Materials and Methods This study included cases of dexamethasone implantation followed up for at least 12 months. Visual acuity, intraocular pressure, central macular thickness values in optic coherence tomography were recorded before and after. Systemic immunomodulatory treatment agents before the injections were also recorded. Throughout the follow-up, injection related complications and the need for recurrent injection of the implant were noted. Results Anatomical success was achieved at a statistically significant level and the efficacy was maintained for the first 2 months. Despite reaching the peak of visual acuity within the first 2 months following injection, there was no statistically significant in-crease in BCVA outcomes. There was no complication other than IOP elevation requiring short-term topical anti-glaucomatous use. Conclu-sion The use of adjuvant intravitreal 0,7 mg dexamethasone implant in these patients who had cystoid macular edema despite the immuno-modulatory treatment is effective for the preservation of the macular anatomy without causing any systemic toxicity. However, significant increase in BCVA could not be achieved in this study.

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