Öz
Amaç
Gebelik haftası (GH) <32 hafta olan prematüre bebeklerde, prematüre retinopatisinin (PR) şiddetini, görülme sıklığını ve son 6 yıldaki tedavi yöntemlerini araştırmaktır.
Yöntem
Bu çift merkezli, retrospektif çalışma PR tarama ve tedavisi için iki sevk merkezinde gerçekleştirildi. Çalışmaya dahil edilen tüm hastalar için; GH, doğum ağırlığı (DA), cinsiyet, ırk, hastanede kalış süresi, PR tipi ve uygulanan tedaviler kaydedildi.
Bulgular
Çalışmaya GH <32 hafta olan 755 (%48,5) kız ve 802 (%51,5) erkek erken doğmuş bebek olmak üzere toplam 1557 hasta dahil edildi. Tüm hastalarda herhangi bir evrede PR ve şiddetli PR gelişmesi görülme oranı sırasıyla %59,3 ve %19,0 idi. Bu oranlar aşırı preterm bebeklerde (<27 hafta) sırasıyla %87 ve %44,3 idi. GH ve DA ile herhangi bir evre PR gelişimi ile şiddetli PR arasında istatistiksel olarak anlamlı negatif korelasyon belirlendi (r=-0,299, r=-0,298, p<0,001; r=-0,338, r=-0,309, p<0,001). PR taraması yapılan bebeklerin 296’sında (%19) tedavi gerekti. Bu hastaların 163’üne (%55,1) lazer fotokoagülasyon (LF), 103’üne (%34,8) intravitreal anti-vasküler endotelyal büyüme faktörü (VEBF) tedavisi uygulanırken, 27’sine (%9,1) intravitreal anti-VEBF ve ardından LF tedavisi uygulandı.
Sonuç
Bu çalışmada bebeklerde PR görülme sıklığının artması, PR oluşumunu önlemek için yenidoğan yoğun bakım ünitesinin kalite standartlarının yükseltilmesine yönelik daha ciddi önlemlerin alınması gerekliliğini vurgulamaktadır. Anti-VEBF tedavisi, özellikle agresif PR ve arka bölge yerleşimli PR’li hastalarda LF’ye kıyasla güvenli ve etkili bir tedavi alternatifi sağlamıştır.
Anahtar Kelimeler: Prematüre retinopatisi, tedavi yöntemleri, prevalans
Kaynakça
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