Premaküler subhiyaloid hemorajilerin tedavisinde Nd: Yag laser posterior hiyaloidotomi

ASLAN, Lokman; KÜKNER, A. Şahap; çelebi, serdal

Premaküler subhiyaloid hemorajilerin tedavisinde Nd: Yag laser posterior hiyaloidotomi

Serdal ÇELEBİ, (Fırat Üniversitesi, Tıp Fakültesi, Göz Hastalıkları Anabilim Dalı, Elazığ, Türkiye)

A. Şahap KÜKNER, (Girilmedi)

Lokman ASLAN (Girilmedi)

Retina-Vitreus

6 0

Yıl: 2002 Cilt: 10 Sayı: 1 Sayfa Aralığı: 69 - 75 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Premaküler subhiyaloid hemorajilerin tedavisinde Nd: Yag laser posterior hiyaloidotomi

Öz:

AMAÇ : Premaküler subhiyaloid hemoraji (PSH) genellikle zararsız bir durum olup, çoğunlukla kendiliğinden düzelmekte ve nadiren görme kaybına yol açmaktadır. Ancak, PSH kendiliğinden düzelirken, bazı olgularda kalıcı maküler değişikliklere neden olmaktadır. Bu nedenle, bu tür seçilmiş olgularda Nd: YAG laser posterior hiyaloidotomi (NYLPH) ile kanın drenajı yararlı olmaktadır. YÖNTEM : Bu çalışma 1996-1999 tarihleri arasında, bir gözünde değişik nedenlerle PSH olan 2'si kadın, 4'ü erkek toplam 6 hasta üzerinde gerçekleştirilmiştir. PSH'nin büyüklüğü optik disk çapı olarak ifade edilmiş ve bu olgularda PSH'nin tedavisi amacıyla NYLPH işlemi uygulanmıştır. BULGULAR : Tedavi öncesi, görme keskinliği tüm olgularda el hareketleri seviyesinde olup, PSH'nin büyüklüğü ortalama 5.7 (3.5-8.0) disk çapı olarak ölçülmüştür. NYLPH'yi takiben, PSH vitreusa hızla drene olmaya başlamış ve komplet drenaj bir haftada tamamlanmış olup, bu esnada görmede dramatik bir artış gözlenmiştir. Olgular ortalama 26.3 (6-42) ay süresince izlenmiş olup, hiçbir olguda lasere bağlı kanama ve retinal hasar gözlenmemiş; hiçbir olguda vitrektomi gerekmemiştir. SONUÇ : NYLPH, seçilmiş olgularda PSH'nin vitreusa trenajını sağlayarak yararlı olabilmekle birlikte, bu işlemin PSH tedavisinde rutin bir yöntem olabilmesi için, hastaların izlenimleri ve primer vitrektomiyi de içeren randomize çalışmaların yapılması gerekmektedir.

Anahtar Kelime: Kanama Retina dejenerasyonu Görme keskinliği Lazer cerrahisi

Konular: Göz Hastalıkları

Nd: Yag laser posterior hyaloidotomy in the treatment of premacular subhyaloid hemorrhage

Öz:

PURPOSE : Premacular subhyaloid hemorrhage is usually a benign condition that generally improves spontaneously and rarely causes visual loss. However, because premacular hemorrhage may be associated with permanent macular changes before it spontaneously resolves, Nd: YAG laser posterior hyaloidotomy may be indicated in selected cases. This study was undertaken to assess an alternative, Nd: YAG laser treatment, in treating this type of hemorrhage. MATERIAL-METOD : This study was performed between 1996 and 1999. Six patients had a circumscribed premacular hemorrhage in one eye and who were treated with the Nd: YAG laser to drain the entrapped blood into the vitreous cavity. The size of the hemorrhage expressed in disc diameters. RESULTS : The mean size of the pretreatment hemorrhage was 5.7 (3.5-8.0) disc diameters. The visual acuities of all cases before laser treatment was at the level of hand motions. In all eyes, following Nd:YAG laser treatment, the hemorrhage instantaneously was drained into the vitreous cavity, resulting in a rapid improvement of vision. Complete drainage of the premacular hemorrhage was occured in within one week. Visual acuity improved dramatically within one week. The mean period of follow-up was 26.3 (7-42) months. No retinal damage or rebleeding occured due to the laser treatment, any vitrectomy was not required in any eye. CONCLUSION : Nd:YAG laser posterior hyaloidotomy may be useful in drainage of premacular hemorrhage into the vitreous cavity in selected cases. To establish this treatment as a routine procedure, a randomized trial is needed to evaluate observation, primary vitrectomy, and Nd:YAG laser treatment of premacular hemorrhage.

Anahtar Kelime: Laser Surgery Hemorrhage Retinal Degeneration Visual Acuity

Konular: Göz Hastalıkları

Belge Türü: Makale Makale Türü: Diğer Erişim Türü: Bibliyografik

1. Gabel VP, Birngruber R, Gunter-Koszka H et al: Nd:YAG laser photodistruption of hemorrhagic detachment of the internal limiting membrane. Am J Oph-thalmol 1989, 107:33-37.
2. Kaynak S, Eryıldırım A, Kaynak T el al: Nd:YAG laser posterior hyaloidotomy in subhyaloid hemorrhage. Ophthalmic Surgery 1994,25:474-476.
3. Chau P, Reich JA: Use of neodymium-YAG laser to manage subinternal limiting membrane haemorrhage. Aust N Z J Ophthalmol 1991, 19:81-83.
4. Schipper I: Valsalva's manuever: not always benign. Klin Monatsbl Augenheilkd 1991, 198:457-459.
5. Chew Ey, Klein ML, Murphy RP et al: Effects of aspirin on vitreous/preretinal hemorrhage in patients with diabetes mellitus. Early treatment diabetic retinopathy study report no. 20. Arch Ophthalmol 1995, 113:52-55.
6. Saito K, Iijima H: Visual prognosis and macular pathology in eyes with retinal macroaneurysms. Nippon GankaZasshi 1997, 101:148-151.
7. Spalton DJ, Marshall J: The Normal Retina. In Spal-ton DJ, Hitchings RA, Hunter PA et al: Atlas of clinical ophthalmology. Wolfe. London 1994; chapter 13.
8. Gass JDM: Stereoscopic atlas of macular disease: Diagnosis and treatment. The CV Mosby Co. St Louis, 1987, P: 560-564.
9. 0'Hanley GP, Canny CLB: Diabetic dense pre-macular hemorrhage. A possible indication for prompt vitrectomy. Ophthalmology 1985, 92:507-511. j
10. Raymond LA: Neodymium: YAG laser treatment for hemorrhages under the internal limiting membrane and posterior hyaloid face in the macula. Ophthalmology 1995, 102:406-411.
11. Ezra E, Dowler JGF, Burgess F et al: Identififing maculopathy after neodymiuirr.YAG membranotomy for dense diabetic premacular hemorrhage. Ophthalmology 1996,103:1568-1574.
12. Ulbig MW, Mangouritsas G, Rothbacher HH et al: Long-term results after drainage of premacular subh-yaloid hemorrhage into the vitreous with a pulsed Nd:YAG laser. Arch Ophthalmol 1998,116:1465-1469.
13. Alward WLM: Laser iridotomy. In Weingeist TA, Sneed SR: Laser Surgery in Ophthalmology: Practical Applications. Appleton&Lange. Connecticut 1994; P:139-147.
14. Brown GC, Benson WE: Treatment of diabetic traction retinal detachment with the pulsed neodymium-YAG laser. Am J Ophthalmol 1985,99:258-262.
15. Hrisomalos NF, Jampol LM, Moriarty BJ et al: Ne-odymium-YAG laser vitreolysis in sickle cell re-tinopathy. Arch Ophthalmol 1987,105:1987-1091.
16. Adel B, Friedman Z: Dense subhyaloid hemorrhage or subinternal limiting membrane hemorrhage in the macula treated by Nd:YAG laser. Arch Ophthalmol 1998,116:1542-1543.
17. Charles S, Varley MP: Laser capsulotomy. In March WM: Practical Laser Surgery. Ophthalmology Clinics of North America 1989,2:555-563.
18. Thach AB, Lopez PF, Snady-McCoy LC: Accidental Nd:YAG laser injuries to the macula. Am J Ophthalmol 1995,119:763-773.
19. Boldrey EE, Little HL, Flocks M: Retinal injury due to industrial laser burns. Ophthalmology 1981, 88:101-107.
20. Alhalel A, Glovinskky Y, Treister G: Long-term follow up of accidental parafoveal laser burns. Retina 1993;13:152-154.
21. Wolf MD, Folk JC, Rivers MB: Proliferative vit-reoretinopathy. In Weingeist TA, Sneed SR: Laser Surgery in Ophthalmology: Practical Applications. Appleton&Lange. Connecticut 1994; P:53-54.
22. Mansour A: Nd:YAG laser photodisruption of he-morrhagic detachment of the internal limiting membrane. Am J Ophthalmol 1989,107:566-567.
23. Kimura AE: Contact and noncontact lenses in pho-tocoagulation therapy. In Weingeist TA, Sneed SR: Laser Surgery in Ophthalmology: Practical Applications. Appleton&Lange. Connecticut 1994; P:7-24.

APA	çelebi s, KÜKNER A, ASLAN L (2002). Premaküler subhiyaloid hemorajilerin tedavisinde Nd: Yag laser posterior hiyaloidotomi. , 69 - 75.
Chicago	çelebi serdal,KÜKNER A. Şahap,ASLAN Lokman Premaküler subhiyaloid hemorajilerin tedavisinde Nd: Yag laser posterior hiyaloidotomi. (2002): 69 - 75.
MLA	çelebi serdal,KÜKNER A. Şahap,ASLAN Lokman Premaküler subhiyaloid hemorajilerin tedavisinde Nd: Yag laser posterior hiyaloidotomi. , 2002, ss.69 - 75.
AMA	çelebi s,KÜKNER A,ASLAN L Premaküler subhiyaloid hemorajilerin tedavisinde Nd: Yag laser posterior hiyaloidotomi. . 2002; 69 - 75.
Vancouver	çelebi s,KÜKNER A,ASLAN L Premaküler subhiyaloid hemorajilerin tedavisinde Nd: Yag laser posterior hiyaloidotomi. . 2002; 69 - 75.
IEEE	çelebi s,KÜKNER A,ASLAN L "Premaküler subhiyaloid hemorajilerin tedavisinde Nd: Yag laser posterior hiyaloidotomi." , ss.69 - 75, 2002.
ISNAD	çelebi, serdal vd. "Premaküler subhiyaloid hemorajilerin tedavisinde Nd: Yag laser posterior hiyaloidotomi". (2002), 69-75.

APA	çelebi s, KÜKNER A, ASLAN L (2002). Premaküler subhiyaloid hemorajilerin tedavisinde Nd: Yag laser posterior hiyaloidotomi. Retina-Vitreus, 10(1), 69 - 75.
Chicago	çelebi serdal,KÜKNER A. Şahap,ASLAN Lokman Premaküler subhiyaloid hemorajilerin tedavisinde Nd: Yag laser posterior hiyaloidotomi. Retina-Vitreus 10, no.1 (2002): 69 - 75.
MLA	çelebi serdal,KÜKNER A. Şahap,ASLAN Lokman Premaküler subhiyaloid hemorajilerin tedavisinde Nd: Yag laser posterior hiyaloidotomi. Retina-Vitreus, vol.10, no.1, 2002, ss.69 - 75.
AMA	çelebi s,KÜKNER A,ASLAN L Premaküler subhiyaloid hemorajilerin tedavisinde Nd: Yag laser posterior hiyaloidotomi. Retina-Vitreus. 2002; 10(1): 69 - 75.
Vancouver	çelebi s,KÜKNER A,ASLAN L Premaküler subhiyaloid hemorajilerin tedavisinde Nd: Yag laser posterior hiyaloidotomi. Retina-Vitreus. 2002; 10(1): 69 - 75.
IEEE	çelebi s,KÜKNER A,ASLAN L "Premaküler subhiyaloid hemorajilerin tedavisinde Nd: Yag laser posterior hiyaloidotomi." Retina-Vitreus, 10, ss.69 - 75, 2002.
ISNAD	çelebi, serdal vd. "Premaküler subhiyaloid hemorajilerin tedavisinde Nd: Yag laser posterior hiyaloidotomi". Retina-Vitreus 10/1 (2002), 69-75.