ANTİANGİOGEN TERAPİYANIN GÖZÜN TOPO-MORFOLOJİ VƏ FUNKSİONAL PARAMETRLƏRİNƏ TƏSİRİ

Xülasə

SUMMARY

Aim – to value the effciacy of the antiangiogenic therapy (AT) and its infuence on the topo-morphological and functional eye parameters in diabetic macular edema (DME), wet form of the age-related macular degeneration (wAMD) and neovascular glaucoma (NVG) taking into consideration the regional and national peculiarities of Azerbaijan Republic.

Material and methods
156 patients were examined (44,2% men, 55,8% women, men age 62,5±9,3 years). The patients were divided into 3 comparable by sex and age groups: group i – patients with established diagnosis of DME (76 eyes); group ii – with wAMD (48 eyes); group iii –with NVG (32 eyes). Each group was subdivided into 2 subgroups– themain and control. (The subgroups reliably didn’t differ due to the pointed parameters) in the main subgroup the RB (Lucentis) was introduced to the patients, in the control subgroup – the preparation wasn’t injected. The research included the patients with TMO from 300 mkm, according to the OCT data, for groups i, ii with 1-2 stages of NVG for the group iii. All patients were subjected to the complex examination including anamnesis and complaints, standard ophthalmological examination and also the special methods of investigations: in groups i and ii – OCT / on apparatus spectral Cirrus HD OCT, Carl Zeiss Meditec, USA, PHAG (on apparatus FF 450 plus, Zeiss, Germany), microperimetry (on device MAiA, Center View Spa, italy), in group iii – gonioscopy, perimetry (on apparatus Humphrey Field Analyzer 745i), Heidelberg retinal tomography (on apparatus Heidelberg retinotomograph HRT ii, Germany. LC was performed with apparatus SL 1000 (Ellex Medical Pty Ltd, Australia)).

Results
Results of investigation of DME patients demonstrated that on the 12th month in association of AT and lasercoagulation (LC) as compared with LC monotherapy, we tried to get the reliably more important increase of maximal corrigated visual acuity (MCVA), decrease of the thickness of macular zone (OCT) hyperfuorescence foci. The results of investigations of patients with wAMD witnesses that using AT as compared with conservative therapy, we achieved the reliably more important increase of MCVA, decrease of the thickness of macular (OCT) zone, the full suppression of the membrane activity, decrease of the hyperfuorescence foci nember and defects of pigment epithelium of retina (according to the FAG data). The results of iOP, biomicroscopy and perimetry investigations in NVG patients witnesses that at 12 th month in association with LC with antiangiogenic therapy as compared with LC monotherapy, we have got the reliably more important decrease of iOP, increase of MD and lowering of PSD. The results of measure of eritropoetin of blood serum indicated the increase of its level in DME and wAMD. The role of activation of complement system in the pathogenesis of neovascular diseases confrms the increase of CZ level in wAMD, NVG and DME. The optimal scheme of DME, wAMD and NVG treatment due to the number of ranibizumab injections was elaborated and inculcated to the practice (3 injections by 0,5 mg (0,5 ml) with interval 1 month, then PRN 7 injections for 12 months in average) and also NVG (1 injection by 0,5 mg (0,05 ml) with the following examination).

Conclusion
So, the present investigation confrmed the effciacy of RB in DME andwAMD patients, indicated the perspectivity of its use in patiens with NVG at the Azerbaijan Republic according to the scheme of treatment, and also showed the importance of investigation of erythropoietin level and components of complement system in patients with the given diseases.