Makula ve optik sinir başı parametrelerinin yaşa bağlı değişiminin optik koherens tomografi ve optik koherens tomografi anjiyografi ile değerlendirilmesi
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Tarih
2021
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Yayıncı
Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi
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info:eu-repo/semantics/openAccess
Özet
Bu çalışmada göz muayenesi için kliniğimize müracaat eden hastaların gözlerinin retinasının yapısal ve vasküler değişkenlerinin optik koherens tomografi (OKT) ve optik koherens tomografi anjiyografi (OKTA) ile değerlendirilmesi ve bu değişkenlerin yaş ile ilişkisi araştırıldı. Gereç ve Yöntem: Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi Hastanesi Göz Hastalıkları Kliniği'ne göz muayenesi için Ocak 2019-Kasım 2019 tarihleri arasında başvuran hastaların verileri retrospektif olarak değerlendirildi. 20-73 yaş aralığında sistemik hastalığı bulunmayan, optik disk ve retinada patoloji saptanmayan 153 hastanın bir gözü çalışmaya dahil edildi. Hastalara tam bir oftalmolojik muayene yapıldı; yarık lamba ve fundus muayenesi, en iyi düzeltilmiş görme keskinliği (EİDGK), göz içi basıncı, OKT ve OKTA ölçümleri yapıldı. Veriler 5 ayrı yaş grubuna ayırılarak analizi IBM SPSS 22.0 paket programında yapıldı ve p<0.05 için sonuçlar istatistiksel olarak anlamlı kabul edildi. Bulgular: Araştırmada değerlendirilen 153 hastanın yaş ortalaması 45.14 (±14.11) yıl (Minimum=20-Maksimum=73) olup hastaların 88'i (%57.5) kadındı. Yüzeyel kapiller pleksus (YKP) vasküler dansite (%) değerlerinden tüm alan (p=0.001), parafovea (p=0.038), perifoveanın (p=0.001) yaş ile birlikte değiştiği bulundu. Derin kapiller pleksus (DKP) vasküler dansite (%) değerlerinden tüm alan (p=0.004), parafovea (p=0.001), perifoveanın (p=0.002) yaş ile birlikte değiştiği bulundu. YKP ve DKP'de özellikle 50 yaş ve üzerinde yaşla birlikte azalma saptandı. Foveal avasküler zon (FAZ) alanı (mm²) yaş ile beraber artmıştır ancak bu artış istatistiksel olarak anlamlı bulunmadı (p=0.660). Koryokapillaris akım alanının (mm²) yaş ile beraber azaldığı bulundu (p=0.002). Radial peripapiller kapiller pleksus (RPKP) vasküler dansite değerlerinden iç disk alanının yaş ile beraber azaldığı bulundu (p=0.038). OKT değerlerinden santral makula ve inferior perifovea dışındaki alanların yaş ile birlikte değiştiği bulundu. Özellikle 40 yaş ve üzerinde yaşla birlikte azalma saptandı. Retina sinir lifi tabakası (RSLT) kalınlıklarından temporal inferior (p<0.001), temporal superior (p<0.001), santral (p=0.043) değer ortalamalarının yaş ile birlikte değiştiği bulundu. Santral ve temporal inferiorda 50 yaş ve üzerinde, temporal superiorda 40 yaş ve üzerinde azalma saptandı. Sonuç: 20-73 yaş aralığında sistemik ve oküler patolojisi bulunmayan hastaların OKTA ile ölçülen verilerinde YKP, DKP ve RPKP'de iç disk vasküler dansite, koryokapillaris akım alanı ölçümlerinin yaşla beraber azaldığı, FAZ değerinin yaşla birlikte değişmediği saptandı. OKT ile ölçülen makula ve RSLT kalınlık ölçümlerinin bazı kadralarda yaşla azaldığı gösterildi. Bu yöntemlerin rutin klinik uygulamalarda kullanılmadan önce mevcut yaş grupları dikkate alınarak değerlendirilmesi gerektiği düşünüldü.
In this study, the evalution of structural and vascular variability of the retina of the eyes of patients who applied to our clinic for ophthalmic examination using optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) and relationship of these variables with age were identified. Materials and Methods: The clinical data of patients who applied to Necmettin Erbakan University Meram Medical Faculty Ophthalmology Department between January 2019 and November 2019 were evaluated, retrospectively. One eye of 153 patients, who did not have systemic disease in the age range of 20-73, with no optic disc and retina patology was included in the study. A complete ophthalmologic examination was performed on the patients; Slit lamp examination, fundus examination, best corrected visual acuity (BCVA), intraocular pressure, OCT and OCTA measurements were performed. Patients were divided into 5 separate age groups. The analysis was performed in IBM SPSS 22.0 package program and p <0.05 for results were considered statistically significant. Results: The average age of 153 patients evaluated in the study was 45.14 (±14.11) year (Minimum=20-Maximum=73) and 88 (57.5%) of patients were women. Superficial capillary plexus (SCP) vascular density (%) values of whole image (p=0.001), parafovea (p=0.038), perifovea (p=0.001) were found to change with age. Deep capillary plexus (DCP) vascular density (%) values of whole image (p=0.004), parafovea (p=0.001), perifovea (p=0.002) were found to change with age. There was a decrease in YKP and DKP, especially with age 50 and over. Foveal avascular zone (FAZ) area (mm²) increased with age, but this increase was not statistically significant (p=0.660). Choriocapillaris flow area (mm²) was found to decrease with age (p=0.002). Among the Radial peripapillary capillary plexus (RPCP) vascular density (%) values, inside disc area was found to decrease with age (p=0.038). OCT values were found to change with age in areas other than the central macula and ınferior perifovea. Especially with the age of 40 and over, there was a decrease with age. It was found that retinal nerve fiber layer (RNFL) values of temporal inferior (p<0.001) temporal superior (p<0.001) and central (p=0.043) areas changed with age. A reduction of 50 years and over in the central and temporal inferiors, and 40 years and over in the temporal superior were detected. Conclusions: In the data of patients with no systemic and ocular pathology between the ages of 20-73, measured by OCTA, SCP, DCP, RPCP inside disc vascular density and choriocapillaris flow measurements decreased with age and FAZ area did not change with age. The macula and RSLT thickness measurements measured by OCT have been shown to decrease with age in some quadrants. It was thought that these methods should be evaluated by considering existing age groups before being used in clinical applications.
In this study, the evalution of structural and vascular variability of the retina of the eyes of patients who applied to our clinic for ophthalmic examination using optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) and relationship of these variables with age were identified. Materials and Methods: The clinical data of patients who applied to Necmettin Erbakan University Meram Medical Faculty Ophthalmology Department between January 2019 and November 2019 were evaluated, retrospectively. One eye of 153 patients, who did not have systemic disease in the age range of 20-73, with no optic disc and retina patology was included in the study. A complete ophthalmologic examination was performed on the patients; Slit lamp examination, fundus examination, best corrected visual acuity (BCVA), intraocular pressure, OCT and OCTA measurements were performed. Patients were divided into 5 separate age groups. The analysis was performed in IBM SPSS 22.0 package program and p <0.05 for results were considered statistically significant. Results: The average age of 153 patients evaluated in the study was 45.14 (±14.11) year (Minimum=20-Maximum=73) and 88 (57.5%) of patients were women. Superficial capillary plexus (SCP) vascular density (%) values of whole image (p=0.001), parafovea (p=0.038), perifovea (p=0.001) were found to change with age. Deep capillary plexus (DCP) vascular density (%) values of whole image (p=0.004), parafovea (p=0.001), perifovea (p=0.002) were found to change with age. There was a decrease in YKP and DKP, especially with age 50 and over. Foveal avascular zone (FAZ) area (mm²) increased with age, but this increase was not statistically significant (p=0.660). Choriocapillaris flow area (mm²) was found to decrease with age (p=0.002). Among the Radial peripapillary capillary plexus (RPCP) vascular density (%) values, inside disc area was found to decrease with age (p=0.038). OCT values were found to change with age in areas other than the central macula and ınferior perifovea. Especially with the age of 40 and over, there was a decrease with age. It was found that retinal nerve fiber layer (RNFL) values of temporal inferior (p<0.001) temporal superior (p<0.001) and central (p=0.043) areas changed with age. A reduction of 50 years and over in the central and temporal inferiors, and 40 years and over in the temporal superior were detected. Conclusions: In the data of patients with no systemic and ocular pathology between the ages of 20-73, measured by OCTA, SCP, DCP, RPCP inside disc vascular density and choriocapillaris flow measurements decreased with age and FAZ area did not change with age. The macula and RSLT thickness measurements measured by OCT have been shown to decrease with age in some quadrants. It was thought that these methods should be evaluated by considering existing age groups before being used in clinical applications.
Açıklama
Anahtar Kelimeler
Retina, Optik disk, Makula, Optik koherens tomografi, Retina, Optic disc, Macula, Optical coherence tomography
Kaynak
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Scopus Q Değeri
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Künye
Abay, R. N. (2021). Makula ve optik sinir başı parametrelerinin yaşa bağlı değişiminin optik koherens tomografi ve optik koherens tomografi anjiyografi ile değerlendirilmesi. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi Cerrahi Tıp Bilimleri Bölümü Göz Hastalıkları Anabilim Dalı, Konya.
