Turkiye Klinikleri Journal of Ophthalmology

.: ORIGINAL RESEARCH
Diyabetik Makuler Ödem Tedavisinde İntravitreal Aflibercept ve Ranibizumab Enjeksiyonunun Kornea Endoteline ve Ön Kamaraya Etkisi
The Effect of Intravitreal Injection of Aflibercept and Ranibizumab on Cornea Endothelium and Anterior Chamber in Patients with Diabetic Macular Edema
Veysel CANKURTARANa, Serdar ÖZATEŞb
aHatay Mustafa Kemal Üniversitesi Tayfur Ata Sökmen Tıp Fakültesi, Göz Hastalıkları ABD, Hatay, TÜRKİYE
bKars Harakani Devlet Hastanesi, Göz Hastalıkları Kliniği, Kars, TÜRKİYE
Turkiye Klinikleri J Ophthalmol. 2020;29(1):1-6
doi: 10.5336/ophthal.2019-64910
Article Language: TR
Full Text
ÖZET
 Amaç: İntravitreal ranibizumab ve aflibercept enjeksiyonu yapılan gözlerdeki kornea endotel sayısı ve morfolojisinin ve ön kamara anatomisinin incelenmesidir. Gereç ve Yöntemler: Bu prospektif ve kesitsel çalışmaya, diyabetik makuler ödem nedeni ile tedavi edilen 51 hastanın 102 gözü dâhil edildi. Hastaların tek gözüne 1 ay ara ile üç doz intravitreal ranibizumab ya da aflibercept enjeksiyonu uygulandı. Ranibizumab enjeksiyonu yapılan hastalar ranibizumab grubuna (n=26), aflibercept enjeksiyonu yapılan hastalar aflibercept grubuna (n=25) dâhil edildi. Her iki grupta da hastaların tedavi edilmeyen gözleri kontrol grubu olarak alındı. Hastaların endotel hücre sayısı (EHS), hücre alanı değişim katsayısı (CV), altıgen şekilli hücre (HKZ) yüzdesi, merkezi kornea kalınlığı (MKK), ön kamara derinliği (ÖKD), ön kamara hacmi (ÖKH), iridokorneal açı (İKA) ve horizontal ön kamara çapı (HÖKÇ) değerlendirmeleri yapıldı. Bulgular: Aflibercept ve ranibizumab grubunda hem tedavi edilen gözlerde hem de kontrol gözlerde tedavi öncesi ve sonrasında ortalama korneal endotel hücre sayısı, CV ve HKZ yüzdesi bakımından istatistiksel olarak anlamlı fark yoktu. Her iki gruptaki ortalama MKK değeri hem tedavi edilen gözlerde hem de kontrol gözlerde tedavi öncesinde tedavi sonrasına göre anlamlı olarak daha fazla idi (p<0,05). Her iki grupta, tedavi edilen ve kontrol gözlerde ortalama ÖKD, ÖKH, İKA ve HÖKÇ değerleri arasında tedavi öncesi ve sonrası anlamlı bir fark izlenmedi. Sonuç: Çalışmamız, intravitreal aflibercept ve ranibizumab enjeksiyonunun kornea endotelinde ve ön kamara yapısında herhangi bir değişikliğe sebep olmadığını göstermiştir.

Anahtar Kelimeler: Aflibercept; ranibizumab; makular ödem; kornea; endotel
ABSTRACT
 Objective: To assess the effect of intravitreal injection of aflibercept and ranibizumab on cornea endothelium and anterior chamber structure in patients with diabetic macular edema. Material and Methods: One hundred and two eyes of the 51 patients with diabetic macular edema were included in this prospective and cross-sectional clinical study. Intravitreal aflibercept or ranibizumab injection was administered for three times with one-month intervals to only one eye of the patients. Patients formed ranibizumab group (n=26) and aflibercept group (n=25) according to administered drug. Contralateral eyes, which were not treated, in both groups formed the control group. Main outcomes were endothelial cell density (ECD), coefficient of variation of cell area (CV), percentage of hexagonal cells (HEX), central corneal thickness (CCT), anterior chamber depth (ACD), anterior chamber volume (ACV), iridocorneal angle (ICA), horizontal anterior chamber diameter (HACD). Results: Mean ECD, CV and HEX before and after treatment were similar in treated and untreated eyes in aflibercept and ranibizumab groups. Mean CCT value before treatment were higher in both treated and untreated eyes than mean CCT value after treatment in both groups (p<0.05). Mean ACD, ACV, ICA and HACD were similar before and after treatment in treated and untreated eyes in both groups. Conclusion: Present study showed that intravitreal injection of aflibercept and ranibizumab did not affect corneal endothelium and anterior chamber morphology.

Keywords: Aflibercept; ranibizumab; macular edema; cornea; endothelium
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