Page 35 - A Magyar Szemorvostársaság 2022. évi kongresszusának programja és az előadások kivonata

Elődáskivonatok/Abstracts

Combined treatment of diabetic macular edema (DME) patients with
intravitreal bevacizumab and Triesence injection (triamcinolon, licenced
to intravitreal administration)
Judit Radnóti , Márton Edelmayer , András Seres , Péter Vámosi
1
1
2
1
1 Péterfy Hospital Ophthalmology Department, Budapest
2 Budapest Retina Institute, Budapest
Purpose and Method: Since 2019, we have treated bevacizumab non-responder diabetic macular edema patients with 2 mg/0.05 ml
ivt. triamcinolone (Triesence, Alcon) injections, administered intermittently, in order to decrease macular edema and increase the treatment
interval. Our main goal was to explore 36 eyes of 24 patients with the best corrected visual acuity (BCVA), central retinal thickness (CRT)
measured by SD-OCT, and the number of treatments needed retrospectively.
Because availability of Triesence injection was limited and a consistent treatment strategy could not be established at this time, data from
each pair of 24 consecutive visits before and after treatment were suitable for analysis of efficacy. The results of the two medications were
analyzed and summarized separately.
Results: In DME patients who did not respond well to bevacizumab, retinal thickness decreased by an average of 66 microns for the next
T&E visit after administration of triamcinolone, and this decreased by an average of 7 microns after administration of Avastin. In both cases,
the BCVA decreased by an average of 1 letter. The mean time between re-treatments was 102 days after Triesence injection and 57 days after
Avastin injection. 17% of patients treated with Triesence injection required eye pressure lowering therapy before treatment and 53% after
treatment. No filtration surgery was needed.
Conclusion: The introduction of Triesence injection registered for intravitreal administration in the treatment of DME patients has made
it possible to reduce the number of patient visits. In the long term, retinal thickness and visual acuity did not differ between the two groups,
despite the fact that the time to the next visit after Triesence administration was twice as long as after Avastin injection. However, the number
of patients requiring anti-glaucoma eye drops treatment has increased significantly. It is very difficult to set up a uniform treatment protocol
for the combined therapy of DME patients, however, it was possible to conclude the effectiveness of the treatment by analyzing consecutive
pairs of visits. Later, prospective studies could be used to determine the optimal treatment strategy, where the lowest possible number of visits
could achieve the desired effect with adequate safety. This would reduce the patient load in ophthalmic care.

Eredményeink a rövidlátás talaján kialakult szubretinális
érújdonképződések anti-VEGF kezelésével
Balogi Fanni, Gáspár Beáta, Seres András
Budapest Retina Intézet, Budapest
Célkitűzés: Rövidlátás talaján kialakult szubretinális érújdonképződés miatt végzett intravitreális anti-VEGF kezeléseink
eredményének áttekintése.
Módszerek: Intézetünk beteganyagában retrospektív módon áttekintettük a 2015–2022 közötti időszakban az ilyen kezelésen
átesett betegek adatait. Azokat az eseteket vettük figyelembe, amikor a követési idő legalább 3 hónap volt. A betegek látóélessé-
gét ETDRS táblán mértük. A refrakció meghatározását, a látóélesség mérését és az OCT vizsgálatokat optometristák végezték.
Eredmények: 12 beteg 13 szemének adatait értékeltük, (6 férfi és 6 nőbeteg, 6 jobb és 7 bal szem). Az első kezeléskor a betegek átlag-
életkora 49 év volt (tartomány: 23-72 év). Az átlagos követési idő 30 hónap volt (3-81, medián: 26 hó). A kezelési stratégia túlnyo-
mórészt PRN (pro re nata) volt, a betegek átlagosan 3,3 kezelést kaptak (1-10, median: 3). A látóélesség átlagos változása 11,8 ETDRS
betű volt, ez az olvasótáblán bő két sornak felel meg (–4 – +27, medián +11 betű). Komolyabb szövődményt nem tapasztaltunk.
Következtetés: Az intravitreális anti- VEGF kezelések biztonságosan és hatékonyan alkalmazhatóak a rövidlátás talaján kiala-
kult szubretinális érújdonképződések kezelésére. A betegek vizsgálatában és a betegutak szervezésében az optometristáknak
jelentős szerepe lehet.

Experiences with anti-VEGF intravitreal injections in cases with
myopic choroidal neovascularization
Fanni Balogi, Beáta Gáspár, András Seres
Budapest Retina Associates, Budapest

Purpose: To review the results of intravitreal anti-VEGF injection treatments in our cases of choroidal neovascularization (CNV) in pat-
hologic myopia.
Methods: Retrospective chart review of our cases between 2015–2022. Only cases with at least 3 months of follow up were considered.
Best corrected visual acuity (BCVA) was measured by using ETDRS chart. Refraction, BCVA and OCT examinations were performed by
optometrists.
Results: 13 eyes of 12 patients were evaluated (6 females, 6 males; 6 right and 7 left eye). The average age of the patients at the first treat-
ment was 49 years (range: 23-72). The mean follow up was 30 months (range 3-81, median 26 months). Treatment strategy was PRN (pro re
nata) for most of the cases, the patients received on average 3,3 injections (range 1-10, median 3 treatments). The mean change of BCVA was
+11.8 ETDRS letters (a bit more than 2 lines on the chart), (range -4 - +27 , median 11 letters). No serious adverse effects were observed.
Conclusion: Intravitreal anti-VEGF treatments can be safely and effectively used in the treatment of CNV in pathologic myopia. Optom-
etrists can play an important role in performing critical examinations and in organizing the patient routes

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