Ágnes Borbándy

Diabeteses kisér-károsodás vizsgálata optikai koherencia tomográfián alapuló angiográfiával

Absztrakt: Bevezetes: Az optikai koherencia tomografian alapulo angiografia uj noninvaziv eszkoz, amely lehetőve teszi a retinalis erhalozat vizsgalatat, es segitseget nyujthat a microangiopathiaval jaro szemfeneki betegsegek nyomon koveteseben. Celkitűzes: Diabeteses betegek mindket szemen optikai koherencia tomografias angiografiaval meghatarozni a retinalis kiser-karosodas merteket az altalanos rizikofaktorok fuggvenyeben. Modszer: Optikai koherencia tomografias angiografia soran 36 diabeteses, valamint 45 kontrollszemely mindket szemen meghataroztuk a retinalis erhalozat sűrűseget. Rogzitettuk a magas vernyomast, a diabetes fennallasi idejet, az inzulinkezelest, a HbA1c-szintet, a dyslipidaemia es a diabeteses retinopathia jelenletet, tovabba a szem tengelyhosszat. A rizikofaktoroknak az erhalozat-sűrűsegre es a ket szem kozotti aszimmetriara kifejtett hatasat tobbvaltozos regresszios modellekben vizsgaltuk. Eredmenyek: Diabeteses betegekben a retinalis erhalozat sűrűsege szignifikansan alacsonyabb vo...INTRODUCTION Optical coherence tomography angiography is a non-invasive imaging technique that is able to visualize the different retinal vascular layers using motion contrast to detect blood flow without intravenous dye injection. This method might help to assess microangiopathy in diabetic retinopathy during screening and follow-up. AIM To quantify retinal microvasculature alterations in both eyes of diabetic patients in relation to systemic risk factors using optical coherence tomography angiography. METHOD Both eyes of 36 diabetic patients and 45 individuals without diabetes were examined. Duration of diabetes, insulin therapy, blood pressure, HbA1c, dyslipidemia, axial length and the presence of diabetic retinopathy were recorded. Retinal vessel density was measured by optical coherence tomography angiography. The effect of risk factors on vessel density and between-eye asymmetry was assessed using multivariable regression analysis. RESULTS Vessel density was significantly lower and between-eye difference was significantly higher in diabetic patients compared to controls (p<0.05). Both vessel density and between-eye asymmetry significantly correlated with diabetes duration (p<0.05) after controlling for the effect of risk factors. The between-eye asymmetry in vessel density was significantly higher in patients without clinically detectable diabetic retinopathy compared to control subjects (p<0.001). CONCLUSIONS There is a decrease in retinal vessel density and an increase in between-eye asymmetry in patients with diabetes compared to healthy subjects. By using optical coherence tomography angiography, the detection of these microvascular alterations is possible before clinically detectable diabetic retinopathy and might serve as a useful tool in both screening and timing of treatment. Orv Hetil. 2018; 159(8): 320-326.

Aphakia korrekciója irisklip műlencse retropupillaris beültetésével

Bevezetés és célkitűzés: Az aphakia műtéti korrekciója sokszor komoly kihívás az operatőr számára. A szerzők célja a retropupillarisan beültetett irisklip műlencsékkel szerzett tapasztalataik ismertetése. Módszer: A 2014. január 1. és 2015. december 31. közötti eseteket gyűjtötték össze retrospektív módon. Azokat a betegeket vonták be a tanulmányba, akiknél retropupillarisan irisklip VRSA 54 (AMO Advanced Medical Optics, Amerikai Egyesült Államok) beültetését végezték el. A betegek követési ideje legalább három hónapos volt. Értékelték a műlencse stabilitását, a műtéti és műtét utáni szövődményeket és a betegek látóélességét. Eredmények: A fenti időszakban 11 esetben (egy nő, tíz férfi) végeztek ilyen beavatkozást. A műtét idején a betegek átlagéletkora 57,7 év volt (25–74 év). Négy esetben primer, hét esetben szekunder beültetést végeztek. A műlencse az irishez minden esetben rögzíthető volt. A műtét előtti legjobb korrigált látóélesség 0,43 (0,1–1,0), a követési idő végén 0,49 (0,04–1,0) volt. Következtetések: A rertopupillarisan beültetett iriskliplencse-implantációval a betegek minden esetben jól rehabilitálhatóak voltak. Orv. Hetil., 2017, 158(1), 20–24.

[Angiography of the ocular fundus without dye: Optical coherence tomography based angiography in exsudative age-related macular degeneration].

INTRODUCTION Vascular endothelial growth factor antibody therapy is an established treatment of exsudative age-related macular degeneration. AIM The morphologic characterisation of the macular microvasculature after longstanding treatment. METHOD Forty-eight patients (34 women and 14 men; age, 74.4 ± 8.0 years) were enrolled in the study. During follow-up time (53.8 ± 31.0 months), 7.6 ± 4.9 injections were administered in 56 eyes. Optical coherence tomography angiographic examination was performed with AngioVue (Optovue Inc. Fremont, CA, USA). RESULTS Distortion of the superficial retinal plexus and foveal avascular zone enlargement were noted in 5/56 eyes, deep retinal plexus defect was detected in 9/56 cases. Destruction of the choriocapillaries and the former neovascularisation could be found in 4 different patterns: 1. pigment epithelium and choriocapillary atrophy, 2. submacular scar, 3. active leaking choroidal neovascularisation, 4. intraretinal cysts. CONCLUSION Optical coherence tomography angiography is a novel non-invasive method, which enables the follow up of macular degeneration. Orv. Hetil., 2016, 157(42), 1683-1690.Absztrakt Bevezetes: Az időskori maculadegeneracio exsudativ formajanak elfogadott es hatekony kezelese a vascularis endothelialis novekedesi faktort gatlo kezeles. Celkitűzes: Annak morfologiai leirasa, milyen errendszer eszlelhető a macula teruleteben tobb eve tarto tartos kezeles utan. Modszer: A vizsgalatba 48 beteget (34 nő, 14 ferfi, eletkor 74,4 ± 8,0 ev) vontak be, akiknel legalabb 24 honappal korabban kezdtek meg a vascularis endothelialis novekedesi faktort gatlo kezelest (ranibizumab, aflibercept). A kezelt 56 szemnel a kovetesi idő (53,8 ± 31,0 honap) alatt osszesen 7,6 ± 4,9 injekciot alkalmaztak. AngioVue (Optovue Inc., Fremont, CA, Amerikai Egyesult Allamok) keszulekkel optikai koherencia tomografia-angiografia vizsgalatot vegeztek. Eredmenyek: A felszines retinaerek karosodasat 5/56 esetben, a melyebb retinakeringes kieseset 9/56 esetben tapasztaltak. A choriocapillaris karosodasara, az erujdonkepződest kovető elteresekre negyfele kep volt a jellemző: 1. pigmentham- es choriocapillaris-atr...

[Long-term treatment with intravitreal ranibizumab for exudative age-related macular degeneration].

INTRODUCTION The results of intravitreal ranibizumab treatment for exsudative age-related macular degeneration have been favourable until this time. AIM To evaluate the two-year functional and anatomic results of intravitreal ranibizumab treatment. METHOD 46 patients (age: 75 ± 9.1 years) were included in a prospective single center study. Treatment regimen was the following: monthly 0.5 mg ranibizumab was administered in the first 3 months, and later as required (pro re nata). The change of best corrected visual acuity and central retinal thickness was followed. RESULTS The visus change at the end of the follow-up time was not statistically significant compared to baseline (p = 0.760) and the at the end of the first year (p = 0.154). Central retinal thickness decreased significantly compared to baseline (p = 0.000001), but the change was not statistically significant compared to the end of the first year (p = 0.875). CONCLUSIONS Patients with neovascular macular degeneration treated with intravitreal ranibizumab using pro re nata regimen have stable visus for long term, and the exsudation could be reduced efficiently.

Long term intravitreal ranibizumab treatment for exsudative age-related macular degeneration

INTRODUCTION The results of intravitreal ranibizumab treatment for exsudative age-related macular degeneration have been favourable until this time. AIM To evaluate the two-year functional and anatomic results of intravitreal ranibizumab treatment. METHOD 46 patients (age: 75 ± 9.1 years) were included in a prospective single center study. Treatment regimen was the following: monthly 0.5 mg ranibizumab was administered in the first 3 months, and later as required (pro re nata). The change of best corrected visual acuity and central retinal thickness was followed. RESULTS The visus change at the end of the follow-up time was not statistically significant compared to baseline (p = 0.760) and the at the end of the first year (p = 0.154). Central retinal thickness decreased significantly compared to baseline (p = 0.000001), but the change was not statistically significant compared to the end of the first year (p = 0.875). CONCLUSIONS Patients with neovascular macular degeneration treated with intravitreal ranibizumab using pro re nata regimen have stable visus for long term, and the exsudation could be reduced efficiently.

Hosszú távú intravitrealis ranibizumabkezelés exsudativ idoskori maculadegenerációban

INTRODUCTION The results of intravitreal ranibizumab treatment for exsudative age-related macular degeneration have been favourable until this time. AIM To evaluate the two-year functional and anatomic results of intravitreal ranibizumab treatment. METHOD 46 patients (age: 75 ± 9.1 years) were included in a prospective single center study. Treatment regimen was the following: monthly 0.5 mg ranibizumab was administered in the first 3 months, and later as required (pro re nata). The change of best corrected visual acuity and central retinal thickness was followed. RESULTS The visus change at the end of the follow-up time was not statistically significant compared to baseline (p = 0.760) and the at the end of the first year (p = 0.154). Central retinal thickness decreased significantly compared to baseline (p = 0.000001), but the change was not statistically significant compared to the end of the first year (p = 0.875). CONCLUSIONS Patients with neovascular macular degeneration treated with intravitreal ranibizumab using pro re nata regimen have stable visus for long term, and the exsudation could be reduced efficiently.