Intravitrealna injekcija bevacizumaba pre trabekulektomije za lečenje neovaskularnog glaukoma kod bolesnika sa dijabetesom

  • Ivan Marjanović University of Belgrade, Faculty of Medicine, Clinical Center of Serbia, University Eye Clinic, Belgrade, Serbia
  • Marjan Marjanović University Business Academy, Faculty of Stomatology, Pančevo, Serbia
  • Ranko Gvozdenović Clinical Center of Serbia, University Eye Clinic, Belgrade, Serbia
  • Marija Marjanović University of Belgrade, Faculty of Medicine, Clinical Center of Serbia, Cardiology Clinic, Belgrade, Serbia
  • Vujica Marković University of Belgrade, Faculty of Medicine, Clinical Center of Serbia, University Eye Clinic, Belgrade, Serbia
  • Marija Božić University of Belgrade, Faculty of Medicine, Clinical Center of Serbia, University Eye Clinic, Belgrade, Serbia
  • Vesna Marić University of Belgrade, Faculty of Medicine, Clinical Center of Serbia, University Eye Clinic, Belgrade, Serbia
  • Antonio Martinez Science Research and Sports, C linical Research Department, Ames, La Coruna, Spain
DOI: https://doi.org/10.2298/VSP170531137M
Ključne reči: dijabetes melitus, glaukom, neovaskularni, bevacizumab, mitomicini, trabekulektomija, lečenje, ishod

Sažetak


Uvod/Cilj. Neovasularni glaukom (NVG) je sekundarni glaukom uzokovan okluzijom mreže novoformiranih krvnih sudova. Cilj rada bio je procena efikasnosti i sigurnosti intravitrealne injekcije bevacizumaba pre trabekulektomije sa mitomicinom C (MMC) u lečenju NVG. Metode. Prospektivna i open-label studija sprovedena je od maja 2013. do decembra 2014.  na uzorku bolesnika sa NVG, kojima je data intravitrealna injekcija bevacizumaba i koji su bili podvrgnuti primarnoj trabekulektomiji sa MMC. Svi bolesnici su bili praćeni najmanje 12 meseci. Uspeh je bio definisan kao intraokularni pritisak (IOP) od ≤ 21 mm Hg, uz ili bez topikalne okularne hipotenzivne terapije. Rezultati. Četrnaest očiju od 12 bolesnika sa dijabetesom je ispunjavalo odgo­varajuće kriterijume za uključenje u studiju. Prosečni (± standardna devijacija) period praćenja bio je 15,0 (± 2,0) meseci (opseg, 12 do 19 meseci). Posle jedne godine praćenja kod 11 (78,6%) očiju IOP je bio ≤ 21 mmHg. Prosečna vrednost IOP je bila značajno smanjena sa 42,4 (± 9,7) mmHg preoperativno na 18,4 (± 2,9) mmHg postoperativno (p < 0,0001). Što se tiče hirurških komplikacija, šest meseci nakon trabekulektomije, hifema je bila uočena kod 3 (21,4%) oka, makularni edem na 1 (7,1%) oku, a recidiv neovaskularizacije sa potrebom davanja intravitrealne injekcije bevacizumaba kod 2 (14,2%) oka. Zaključak. Preoperativni intravitrealni bevacizumab može biti delotvoran kao pomoćna metoda lečenja trabekulektomijom sa mitomicinom-C kod bolesnika sa neovaskularnim glaukomom.

Biografija autora

Ranko Gvozdenović, Clinical Center of Serbia, University Eye Clinic, Belgrade, Serbia

Doktor Medicine

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Objavljeno
2021/04/19
Broj časopisa
Vol. 77 Br. 6 (2020): Vojnosanit pregl
Rubrika
Kratko saopštenje