. 2019; 49(5): 258-269 | |||
Neovasküler Tip Yaşa Bağlı Makula Dejenerasyonu Tedavisinde Risk Odaklı Tedavi ProtokolüMurat Karacorlu, Mumin Hocaoglu, Serra Arf, M. Giray Ersoz, Isıl Sayman Muslubasİstanbul Retina Enstitüsü, İstanbul, TürkiyeAmaç: Neovasküler tip yaşa bağlı makula dejenerasyonu tedavisinde uygulanan risk odaklı tedavi protokolün etkinliğinin değerlendirilmesi. Risk-Based Algorithm-Guided Treatment Protocol in the Management of Neovascular Age-Related Macular DegenerationMurat Karacorlu, Mumin Hocaoglu, Serra Arf, M. Giray Ersoz, Isıl Sayman MuslubasIstanbul Retina Institute, Istanbul, TurkeyObjectives: To assess outcomes of a risk-based algorithm-guided treatment protocol for neovascular age-related macular degeneration. Materials and Methods: Two hundred and ten eyes of 184 patients managed with anti-vascular endothelial growth factor (anti-VEGF) agents according to a protocol consisting of one of three initial regimens depending on risk with at least 2 years of follow-up were retrospectively evaluated. The ‘’short-term monthly injections’’ protocol was used for low-risk patients with low-risk lesions and good fellow-eye vision. Patients with low-risk lesions but without good fellow-eye vision, or those with good fellow-eye vision and high-risk lesions were managed according to the ‘’short-term treat-and-extend (TREX)’’ protocol. The ‘’extended TREX’’ protocol was for patients with high-risk lesions and low fellow-eye visual acuity. Results: The initial treatment plan consisted of short-term monthly injections in 62 eyes (30%), the short-term TREX regimen in 120 eyes (57%), and the extended TREX regimen in 28 eyes (13%). Overall, 63% of cases met the criteria for cessation of treatment. Approximately 58% of these cases had recurrence, at a mean of 13 months. The mean change in VA from baseline was +9.0 letters at 12 months and +8.0 letters at 24 months. VA improved during a mean follow-up of 46.8±22 months, with a mean number of 3.4±1.6 anti-VEGF injections per year. Conclusion: The risk-based algorithm-guided treatment protocol was able to achieve visual outcomes similar to those of the common alternative treatment and monitoring regimens, with a dramatically reduced number of injections, as required by the individual lesion and vision in the fellow eye. Keywords: Anti-vascular endothelial growth factor, individualized medicine, neovascular age-related macular degeneration, treat and extend dosingMurat Karacorlu, Mumin Hocaoglu, Serra Arf, M. Giray Ersoz, Isıl Sayman Muslubas. Risk-Based Algorithm-Guided Treatment Protocol in the Management of Neovascular Age-Related Macular Degeneration. . 2019; 49(5): 258-269 Sorumlu Yazar: Murat Karacorlu, Türkiye |
|