Eksudatif tip yaşa baʇli maküla dejenerasyonu sonucu oluşan koroid neovaskülarizasyonun intravitreal anti-VEGF ile tedavisinde gerçek hayattaki uygulama sonuçlari

Purpose: To determine efficacy and complications of intravitreal anti-VEGF treatment for choroidal neovascularization induced by exudative age-related macular degeneration (eARMD). Materials and Methods: The medical records of 197 patients (226 eyes) diagnosed as eARMD who received intravitreal anibizumab and/or bevacizumab initially in our retina clinic between 2007-2012 were reviewed retrospectively. The follow-up duration, number of injections, treatment intervals, visual acuity (VA) after initial-loading dose (3rd month) and at final control, and optical coherence tomography findings were recorded. The change in VA is described as one line or five letters decrease or increase in Snellen or ETDRS limits, the change in central foveal thickness (CFT) is described as mininum 100 μm decrease or increase. Results: Mean follow-up was 22.5±15.9 months (6-60 months) and number of injections was 5.7±2.6. The VA increased in 119 (52.7%), decreased in 17 (7.5%) and unchanged in 90 eyes (39.8%) following the first three injections (p<0.001). Between initial and final evaluations, VA increased in 100 (44.3%), decreased in 71 (31.4%) and unchanged in 55 eyes (24.3%) (p=0.114). CFT decreased in 183 (81.3%), increased in 9 (4%) and unchanged in 33 eyes (14.7%) after loading injections (p<0.001). In final evaluation, CFT decreased in 197 (87.6%), increased in 18 (8.0%), and unchanged in 55 eyes (24.3%) compared to baseline (p<0.001). Twenty-eight eyes (12.3%) had retinal pigment epithelial tear, two had endopthalmie, one had serious uvetic reaction, one had intraocular pressure increase, one had cataract due to intraocular injection. One patient had myocardial infarction, one had stroke, and two had hypertension. Conclusion: Anti-VEGF treatment of eARMD is a safe form of treatment that increases VA, but long-term follow-up results in clinical practice are not satisfactory as much as short-term results.