Korelacija između vidne oštrine, spoljašnje granične membrane i fotoreceptora kod bolesnika sa neovaskularnom senilnom degeneracijom žute mrlje lečenih bevacizumabom

Dragana V Ristić; Miroslav Vukosavljević; Marko Kontić; Petar Ristić; Dubravko Bokonjić; Mirjana Janićijević-Petrović; Antoaneta Adžić Zečević; Katarina Janićijević

doi:10.2298/VSP150709149R

Dragana V Ristić University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia; Military Medical Academy, Clinic for Ophthalmology, Belgrade, Serbia
Miroslav Vukosavljević University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia; Military Medical Academy, Clinic for Ophthalmology, Belgrade, Serbia
Marko Kontić University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia; Military Medical Academy, Clinic for Ophthalmology, Belgrade, Serbia
Petar Ristić University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia; Military Medical A cademy, Endocrinology Clinic, Belgrade, Serbia
Dubravko Bokonjić University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia; Military Medical Academy, National Poison Control Centre, Belgrade, Serbia
Mirjana Janićijević-Petrović Clinical Centre Kragujevac, Clinic for Ophthalmology, Kragujevac, Serbia; University of Kragujevac, Faculty of Medical Sciences, Kragujevac, Serbia
Antoaneta Adžić Zečević Clinic for Ophthalmology, Podgorica, Montenegro; University of Montenegro, Faculty of Medicine, Podgorica, Montenegro
Katarina Janićijević Clinical Centre Kragujevac, Clinic for Ophthalmology, Kragujevac, Serbia; University of Kragujevac, Faculty of Medical Sciences, Kragujevac, Serbia

DOI: https://doi.org/10.2298/VSP150709149R

Ključne reči: retina||, ||retina, macular degeneration||, ||žuta mrlja, degeneracija, neovascularization, pathologic||, ||neovaskularizacija, patološka, bevacizumab||, ||bevacizumab, tomography, optical coherence||, ||tomografija, optička, koherentna, fluorescein angiography||, ||angiografija, fluoresceinska,

Sažetak

Uvod/Cilj. Integritet spoljašnjih struktura mrežnjače, primarno sloja fotoreceptora, važan je zbog njihove direktne povezanosti sa oštrinom vida. Cilj rada bio je da se ispita povezanost između najbolje korigovane vidne oštrine, fovealnih fotoreceptora i spoljašnje granične membrane kod bolesnika sa neovaskularnom senilnom degeneracijom žute mrlje nakon lečenja bevacizumabom, kao i odnos navedenih parametara sa različitim tipovima neovaskularne membrane klasifikovane metodom fluoresceinske angiografije. Metode. Istraživanjem su obuhvaćena 82 bolesnika sa neovaskularnom senilnom degeneracijom žute mrlje lečena intravitealnom primenom bevacizumaba. Svim ispitanicima urađen je osnovni oftalmološki pregled, fluoresceinska angiografija i optička koherentna tomografija. Na osnovu nalaza fluoresceinske angiografije svi bolesnici podeljeni su u dve osnovne grupe, tip I (okultna i minimalno klasična) i tip II (klasična i predominantno klasična) horoidalne neovaskularne membrane. Pomoću optičke koherentne tomografije defisano je prisustvo ili odsustvo fotoreceptora i spoljašnje granične membrane. Rezultati. Prosečna najbolje korigovana vidna oštrina značajno se popravila po završetku lečenja u obe grupe (p < 0,01). Očuvan kontinuitet fotoreceptora i spoljašnje granične membrane registrovan je kod manjeg broja ispitanika u odnosu na stanje pre tretmana (p < 0,01). Prosečna najbolje korigovana vidna oštrina po završetku lečenja bila je značajno bolja kod ispitanika sa očuvanim fotoreceptorima i spoljašnjom graničnom membranom (p < 0,01). Takođe, registrovali smo više ispitanika sa očuvanim kontinuitetom spoljašnje granične membrane u prvoj u odnosu na drugu grupu (p < 0,01), dok se broj ispitanika sa očuvanim kontinuitetom fotoreceptora po završetku lečenja nije značajno razlikovao između grupa (p > 0,05). Zaključak. Kod bolesnika sa očuvanim fotoreceptorima i spoljašnjom graničnom membranom vidna oštrina nakon završetka lečenja bila je značajno bolja u odnosu na ispitanike kod kojih ove strukture nisu bile prisutne. Kod naših ispitanika odsustvo fotoreceptora i spoljašnje granične membrane bilo je češće kod tipa II (klasična i predominantno klasična) u odnosu na tip I (okultna i minimalno klasična) neovaskularne membrane.

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