Ayzın Deniz SERTÖZ, SADULLAH KELEŞ, Orhan ATEŞ, İlknur Akyol SALMAN, Orhan BAYKAL, Ayhan TAŞTEKİN, İBRAHİM CANER

Prematüre retinopatisinde green lazertedavi sonuçlarımız

Prematüre retinopatisi (ROP) gelişen erken doğanlarda tedavi sonuçlarını sunmayı amaçladık. 2005 Eylül ve 2007 Eylül tarihleri arasında Atatürk Üniversitesi Tıp Fakültesi Pediatri bölümünün yeni doğan ünitesinde takip edilen 450 erken doğanın kayıtları ROP açısından retrospektif olarak incelendi. Takiplerinde eşik hastalık gelişen hastalara fotokoagülasyon tedavisi uygulandı. Bebeklerin ortalama gestasyon yaşları 23,,7 hafta (min: 23, mak: -32 hafta), ortalama ağırlıkları 1065 gr (min: 530- mak: 2300 gr) idi. 75 hastada akut faz ROP gelişti. Bunların 16'sının her iki gözü (%3,,5), eşik hastalığa ilerledi. Bu 16 hastanların her iki gözüne indirek oftalmoskop ile green lazer fotoagülasyon uygulandı. Lazer tedavisi yapılan hastalarda %87,,5 oranında anatomik başarı elde edildi. Lazer yapılan 2 hastanın birer gözünde retina dekolmanı gelişti. Bu hastalar başka bir merkeze referesevk edildi. Green lazerden sonra 5 gözde az miktarda perifer retinada preretinal hemoraji görüldü. İndirek lazer fotokoagülas-yon prematüre retinopatisinin neden olduğu kalıcı görme kayıplarının önlenmesinde etkili biçimde kullanılabilir.

Anahtar Kelimeler:

Geriyedönük çalışma, Tedavi sonucu, Lazer tedavisi, Işık koagülasyonu, Tedavi başarısızlığı, Prematüre retinopatisi

Our results of green laser management in retinopathy of prematurity

We aimed to present our patients who were treated with laser photocoagulation for threshold retinopathy of prematurity (ROP). Four hundred and fifty prematur infants who were followed-up in prematurity unit (neonatal intensive care unit önerilir) of pediatrics department of Atatürk University School of MedicineFaculty between september 2005 and september 2007 were examined retrospectively for ROP. Infants who have threshold stage 3+ retinopathy of prematurityin followigng- up were treated with indirect laser photocoagulation. The mean gestastional age of this infantsthese infants was 23..7 weeks (min 23-, max 32 weeks) the mean birth weight was 1065 gr (min:530- mak:2300gr). Acute phase ROP was developed in 75 (16..6%) infants. Bouth eyes of theseis 16 infants progressed to threshold stage 3+ ROP, and. Bout eye of these 16 infantspatients were treated with green laser photocoagulation. Anatomic success achieved in %87..5 of laser-treated eyes. Retinal detachment was developed in one eye inof two patients eye. These infants were referred to an other clinic. Slightly pre-retinal hemorrhage was seen in five patients after green laser. Indirect laser photocoagula-tion can be used to prevent the permanent visual loss associated with ROP efficiently.

Keywords:

Retrospective Studies, Treatment Outcome, Laser Therapy, Light Coagulation, Treatment Failure, Retinopathy of Prematurity,

PDF

___

4. Özkan H, Köksal N. Prematüre Retinopatisi. Güncel Pediatri 2005;2: 24�8.
5. Arsan S. Prematüre Retinopatisi. T Klin Pediatri 2004;2: 382�6.
6. Steinmetz RL, Brooks HL Jr. Diode laser photocoagulation to the ridge and avascular retina in threshold retinopathy of prematurity. Retina 2002;22: 48�52.
7. Cryotherapy for Retinopathy of Prematurity Cooperative Group. M Multicenter trial of cryotherapy for retinopathy of prematurity: three-month outcome. Arch Ophthalmol
1990;108: 195�204.
87. Nagata M, Kobayashi Y, Fukuda H, Suekane K. Photocoagulation for the treatment of retinopathy of prematurity. Jpn J Clin Ophthalmol 1968;22: 419�27.
98. Pierce EA, Foley ED, Smith LEH. Regulation of vascular endothelial growth factor by oxygen in a model of retinopathy of prematurity. Arch Ophthalmol 1996;114: 1219�28.
109. Stone J, Chan-Ling T, Pe'er J, Itin A, Gnessin H, Keshet E, et al. Roles of endothelial growth factor and astrocyte degeneration in the genesis of retinopathy of prematurity. Invest Ophthalmol Vis Sci 1996;37: 290�9.
110. Landers MB, Toth CA, Semple HC, Morse LS. Treatment of retinopathy of prematurity with argon laser fotocoagulation. Arch Ophthalmol 1992;110: 44�7.
121. McNamara JA, Tasman W, Brown GC, Federman JL. Laser photocoagulation stage 3+ retinopathy of prematurity. Ophthalmology 1991;98: 576�580.
132. Hunter DG, Repka MX. Diode laser photocoagulation for threshold retinppathy of prematurity: A randomized study. Ophthalmology 1993;100: 238-44.
143. Iverson DA, Trese MT, Orgel IK, Williams GA. Laser photocoagulation for threshold retinopathy of prematurity. Arch Ophthalmol 1991;109:1342-1943.
154. Axer-Siegel R, Snir M, Cotlear D, Maayan A, Frilling R, Rosenbaltt I, et al. Diode laser treatment of posterior retinopathy of prematurity. Br J Ophthalmol 2000;84: 1383- 6.
165. Banach MJ, Breinstein DM. Laser therapy for retinopathy of prematurtiy. Curr Opin Ophthalmol 2001;12: 164-70.
176. Noonan CP, Clark DI. Trends in the management of stage 3 retinopaty of prematurity. Br J Ophthalmol 1996;80: 278-81.
187. McNamara JA, Tasman W, Vander JF, Brown GC. Diode laser photocoagulation for retinopathy of prematurity. Preliminary results. Arch Ophthalmol 1992;110: 1714�6.
198. Tsitsis T, Tasman W, McNamara JA, Brown G, Vander J. Diode laser photocoagulation for retinopathy of prematurity. Trans Am Ophthalmol Soc 1997;95: 231�6.
Öner A, Özkırış A, Güneş T, Karaküçük S, Erkılıç K, Çetin N. Prematüre Retinopatisi: 2 Yıllık Tarama Sonuçlarımız. Erciyes Tıp Dergisi 2005; 27: 104- 09.
2. Yalaz M, Aslanoğlu S, Erakgün E.T ve ark. Prematüre Retinopatisi risk faktörleri ve koruyucu önlemler. Türkiye Klinikleri 2003; 12: 1-8.
3. Yaman A, Çetin E, Berk A.T, Kaynak S. Prematür Retinopatisinde Tedavi Sonuçlarımız. Ret - Vit 2004; 12 :122-5.
4. Özkan H, Köksal N. Prematüre Retinopatisi. Güncel Pediatri 2005; 2 :24-8.
5. Arsan S. Prematüre Retinopatisi. T Klin Pediatri 2004;2: 382-6.
6. Steinmetz RL, Brooks HL Jr. Diode laser photocoagulation to the ridge and avascular retina in threshold retinopathy of prematurity. Retina 2002;22: 48-52.
7. Nagata M, Kobayashi Y, Fukuda H, Suekane K. Photocoagulation for the treatment of retinopathy of prematurity. Jpn J Clin Ophthalmol 1968; 22: 419�27.
8. Pierce EA, Foley ED, Smith LEH. Regulation of vascular endothelial growth factor by oxygen in a model of retinopathy of prematurity. Arch Ophthalmol 1996; 114: 1219�28.
9. Stone J, Chang-Ling T, Pe'er J, et al. Roles of endothelial growth factor and astrocyte degeneration in the genesis of retinopathy of prematurity. Invest Ophthalmol Vis Sci 1996; 37: 290�9.
10. Landers MB, Toth CA, Semple HC, et al. Treatment of retinopathy of prematurity with argon laser fotocoagulation. Arch Ophthalmol 1992;110: 44-7.
11. Mc Namara JA, Tasman W, Brown GC, et al. Laser photocoagulation stage 3+ retinopathy of prematurity. Ophthalmology 1991; 98: 576-580.
12. Hunter DG, Repka MX. Diode laser photocoagulation for threshold retinppathy of prematurity: A randomized study. Ophthalmology 1993;100: 238- 44.
13. Iverson DA, Trese MT, Orgel IK, et al. Laser photocoagulation for threshold retinopathy of prematurity. Arch Ophthalmol 1991; 109:1342- 1943.
14. Axer-Siegel R, Snir M, Cotlear D, et al. Diode laser treatment of posterior retinopathy of prematurity. Br J Ophthalmol 2000;84: 1383- 6.
15. Banach MJ, Breinstein DM. Laser therapy for retinopathy of prematurtiy. Curr Opin Ophthalmol 2001;12:164- 70.
16. Noonan CP, Clark DI. Trends in the management of stage 3 retinopaty of prematurity. Br J Ophthalmol 1996; 80: 278- 81.
17. McNamara JA, Tasman W, Vander JF, et al. Diode laser photocoagulation for retinopathy of prematurity. Preliminary results. Arch Ophthalmol 1992;110:1714�6.
18. Tsitisis T, Tasman W, McNamara JA, et al. Diode laser photocoagulation for retinopathy of prematurity. Trans Am Ophthalmol Soc 1997; 95: 231�6.