| Abstract | Cilj istraživanja: Utvrditi koliko vremenski interval između indikacije i primjene anti-VEGF terapije utječe na ishod liječenja na Klinici za očne bolesti u Kliničkom bolničkom centru Split.
Ispitanici i metode: Provedeno je retrospektivno istraživanje koje je uključivalo ukupno 172 bolesnika koji su primili intravitrealno bevacizumab. 116 bolesnika je liječeno zbog AMD te 56 zbog DME. Period obuhvata studije je od ožujka 2016. do studenog 2019. Istraživanje je provedeno na Klinici za očne bolesti KBC-a Split. Bolesnici su bili liječeni s tri doze bevacizumaba svakih mjesec dana uz kontrolu mjesec dana nakon primitka zadnje doze lijeka. OCT nalaz (analizirane vrijednosti: CST, Tmax ,CV i CAT) je napravljen kod postavljanja indikacije i nakon liječenja.
Rezultati: Rezultati naše retrospektivne studije pokazuju da je došlo do smanjenja analiziranih vrijednosti (CST, Tmax, CV, CAT) i kod bolesnika s AMD i DME dijagnozom. U prosjeku je smanjenje vrijednosti nakon terapije CST (-34,91 µm), T-max (-81,12 µm), CV (-0,48 µm) i CAT (-13,52 µm) kod bolesnika s AMD , a kod bolesnika s DME u prosjeku je smanjenje vrijednosti CST (-38,18 µm), T-max (-54,71 µm), CV (-0,61 µm) i CAT (-11,07 µm). Utvrđena je povezanost između vremenskog intervala i CST, CV i CAT vrijednosti kod bolesnika s dijagnozom DME, povećanje vremenskog intervala između indikacije i primjene anti-VEGF terapije dovodi do povećanja CST, CV i CAT u bolesnika s DME. Kod bolesnika s AMD vremenski interval nije bio u korelaciji s ishodom liječenja: CST (r=0.02; P=0.397), Tmax (r=0.09; P=0.161), CV (r=0,04; P=0,346), CAT (r=0,05; P=0,289). Kod bolesnika s DME utvrđena je učinkovitost terapije kod primjene unutar 130 dana od indikacije.
Zaključci: Tromjesečna intravitrealna injekcija bevacizumaba dovodi do poboljšanja u analiziranim vrijednostima OCT nalaza bolesnika sa dijagnozom senilne makularne degenercije i dijabetičnog makularnog edema. Također, bolesnicima s DME dijagnozom važno je pravovremeno primijeniti anti-VEGF terapiju te je učinkovitost veća ukoliko je terapija primijenjena unutar 130 dana od indikacije. Kod bolesnika s AMD vremenski interval nije bio u korelaciji s ishodom liječenja. |
| Abstract (english) | Objectives: The aim of this study was to determine the impact of intravitreal injection timing (i.e. the time interval from indication to application of anti-VEGF therapy) on treatment outcome at the Department of Ophthalmology, University Hospital Centre Split.
Subjects and Methods: A retrospective study involving 172 patients who received intravitreal bevacizumab was performed. 116 patients were treated for AMD and 56 were treated for DME. Patients were treated between March 2016 and November 2019 at the Department of Ophthalmology, University Hospital Centre Split. Patients were treated with three (3) monthly doses of bevacizumab and follow-up was scheduled a month after receiving the last dose. OCT parameters analysed (CST, Tmax , CV and CAT) before and after therapy.
Results: The results of our retrospective study has shown decline in CST, Tmax, CV and CAT values for both, AMD and DME patients. On average, there was a decline in values of CST (-34,91 µm), T-max (-81,12 µm), CV (-0,48 µm) and CAT (-13,52 µm) for AMD patients and for DME patients average decline was for CST (-38.18 µm), T-max (-54.71 µm), CV (-0.61 µm ) and CAT (-11.07 µm). Significant correlation between time interval and CST, CV and CAT values was found in DME patients, increasing the time interval between indication and application of anti-VEGF therapy leads to CST, CV, and CAT increase in patients with DME. The intravitreal injection timing is not in a significant correlation with the treatment outcome for AMD patients: CST (r=0.02; P=0.397), Tmax (r=0.09; P=0.161), CV (r=0,04; P=0,346), CAT (r=0,05; P=0,289). In patients with DME, the efficacy of the therapy is confirmed if applied within 130 days after indication.
Conclusions: Three-month intravitreal injection of bevacizumab leads to an improvement of the analyzed OCT values in all patients. Also, for patients with DME diagnosis is important to apply timely anti-VEGF therapy and efficacy is higher if therapy is applied within 130 days after indication. The intravitreal injection timing wasn't in a significant correlation with the treatment outcome for AMD patients. |
