1,721,018 research outputs found
CURRENT CONCEPTS AND MODALITIES FOR MONITORING THE FELLOW EYE IN NEOVASCULAR AGE-RELATED MACULAR DEGENERATION
No full textPurpose: The presence of neovascular age-related macular degeneration (nAMD) in one eye is a major risk factor for the development of disease in the fellow eye. Several methods exist to help physicians monitor the fellow eye, with new technologies becoming increasingly available. Methods: We provide an overview of modalities for nAMD monitoring, including advances in home-based options, and review their utility for fellow-eye monitoring, based on a review of the literature and a consensus of retinal experts. Results: Studies demonstrate the importance of early detection of nAMD in the fellow eye so that interventions can be made before significant vision loss occurs. A series of techniques exist for the early detection of nAMD including chart-based methods and imaging devices. The increased availability of home-based methods has presented an opportunity for patients to monitor their vision at home. Conclusion: Frequent monitoring of the fellow eye in patients with unilateral nAMD is of critical importance to prevent vision loss and maintain quality of life. Patients should be examined every 3 to 4 months from the time of choroidal neovascularization diagnosis and encouraged to monitor their vision at home using home-based technologies where available, to provide the best opportunity for early detection
Yaş Tip Yaşa Bağlı Makula Dejenerasyonu Nedeniyle Intravitreal Ranibizumab, Bevacizumab, Pegaptanib veya Bunların Ardışık Tedavileri Uygulanan Hastaların Uzun Dönem Görsel ve Anatomik Sonuçlarının Retrospektif Değerlendirilmesi
No full textThe purpose of this study is investigation of long term visual and anatomic outcomes retrospectively in patients who had undergone intravitreal ranibizumab, bevacizumab, pegaptanib monotherapies or consecutive therapies of these agents because of neovascular age related macular degeneration and followed for more than one year, and evaluation of effect these therapies on vision level and macular thickness. For this purpose, 82 patients who had undergone ranibizumab monotherapy (group 1) and 10 patients who had undergone consecutive therapies with more than 1 agent (group 2), a total of 92 patients were included in the study. Consecutive therapies were bevacizumab and ranibizumab in 7 patients, pegaptanib and ranibizumab in 3 patients. Patients receiving only bevacizumab and only pegabtanib therapy couldn't be included in the study as to all medical data of these patients were not available. Visual acuity and macular thickness of patients were analysed retrospectively. Average age of the patients was 72.3 ± 6.6 months (57-85), average follow-up period was 47.5 ± 13.5 months (24-75) and average number of visits was 25.4 ± 10.1 (8-49). In the follow-up period, for ranibizumab group average 7.7 ± 4.4 (2-21) and for consecutive therapy group average 9.1 ± 3.9 (2-15) injection was performed. In ranibizumab group initial average best corrected visual acuity (BCVA) was 48,4 ± 15 (15-76) letters, it was 51,2 ± 20 (1-80) letters in first year, 45,9 ± 19 (1-80) letters in second year, 43,7 ± 21 (3-80) letters in third year, 47,6 ± 23 (5-80) letters in fourth year, and 48,7 ± 19 (7-75) letters in fifth year. In consecutive therapy group initial average BCVA was found as 52,4 ± 16 (28-78) letters, it was 48,2 ± 15 (31-73) letter in first year, 31,1 ± 22 (2-70) letters in second year, 38,6 ± 2 (5-70) letters in third year, 37,0 ± 24 (15-77) letters in fourth year, and 42,5 ± 18 (30-55) letters in fifth year. The change in the visual acuity showed similar pattern in both groups. But, while at the begining of the study 92 patients were evaluated, that number decreased to 66 patients at the third year and to 24 patients at the fifth year. Because of the big difference in patient numbers, statistical analysis for comparing visual acuity change between two groups, could not be performed. The initial average macular thickness was 300 ± 76 (178-552) microns in ranibizumab therapy group, it was found as 273 ± 82 (166-647) microns at first year, 277 ± 90 (131-666) microns at second year, 275 ± 106 (142-734) microns at third year, 262 ± 81 (160-587) microns at fourth year, and 245 ± 49 (138-359) microns at fifth year. In consecutive therapy group, initial average macular thickness was measured as 332 ± 69 (208-403) microns, 320 ± 98 (183-460) microns at first year, 362 ± 148 (200-633) microns at second year, 383 ± 140 (259-677) microns at third year, 363 ± 194 (215-768) microns at fourth year, and 266 ± 44 (236-316) microns at fifth year. At the end of the follow-up period, of 92 patients included in the study, in 62 patients macular scar, in 7 patients macular atrophy developed. In conclusion, with ranibizumab monotherapy or consecutive therapies, visual acuity can be maintained about 3 years, but in most of the patients geographic atrophy or scar developed.Bu çalışmada amaç yaş tip yaşa bağlı makula dejenerasyonu nedeniyle intravitreal ranibizumab, bevacizumab, pegaptanib veya bunların ardışık tedavileri uygulanan ve bir yıldan uzun süredir takipte olan hastaların görsel ve anatomik sonuçları retrospektif olarak incelemek ve bu tedavilerin görme düzeyi ve maküler kalınlık üzerine etkilerini değerlendirmektir. Bu amaçla ranibizumab tedavisi alan 82 hasta (grup 1) ve ardışık tedavi (grup 2) gören 10 hasta olmak üzere toplam 92 hasta çalışmaya alındı. Ardışık tedavi uygulanan 7 hastaya bevacizumab ve ranibizumab, 3 hastaya ise pegaptanib ve ranibizumab uygulanmıştı. Tüm verilerine ulaşılamadığı için sadece bevacizumab ve sadece pegaptanib tedavisi gören hastalar çalışmaya alınamamıştır. Hastaların görme keskinlikleri ve makula kalınlıkları retrospektif olarak incelendi. Hastaların ortalama yaşı 72.3 ± 6.6 (57-85), ortalama takip süresi 47.5 ± 13.5 (24-75) ay olup ortalama vizit sayısı ise 25.4 ± 10.1 (8-49) idi. Takip süresinde ranibizumab tedavi grubuna ortalama 7.7 ± 4.4 (2-21), ardışık tedavi grubuna ise ortalama 9.1 ± 3.9 (2-15) enjeksiyon uygulanmıştı. Ranibizumab tedavi grubunda başlangıç en iyi düzeltilmiş görme keskinliği (EİDGK) 48,4 ± 15 (15-76) harf iken, 1. yıl 51,2 ± 20 (1-80) harf, 2. yıl 45,9 ± 19 (1-80) harf, 3. yıl 43,7 ± 21 (3-80) harf, 4. yıl 47,6 ± 23 (5-80) harf, 5. yıl ise 48,7 ± 19 (7-75) harf olarak bulunmuştur. Ardışık tedavi grubunda ise başlangıç EİDGK 52,4 ± 16 (28-78) harf iken, 1. yıl 48,2 ± 15 (31-73) harf, 2. yıl 31,1 ± 22 (2-70) harf, 3. yıl 38,6 ± 2 (5-70) harf, 4. yıl 37,0 ± 24 (15-77) harf, 5. yıl ise 42,5 ± 18 (30-55) harf olarak bulunmuştur. Her iki grupta da değişimin benzer bir patern izlediği görülmüştür. Fakat başlangıçta 92 hasta değerlendirmeye alınırken bu sayı 3. yılda 66' ya 5. yılda ise 24' e düşmüştür. Hasta sayısı farkı nedeniyle görme keskinliği değişimini iki grup arasında karşılaştırmak için istatistiksel analiz yapılmamıştır. Ranibizumab tedavi gubunda başlangıç makula kalınlığı ortalama 300 ± 76 (178-552) mikron iken, 1. yıl 273 ± 82 (166-647) mikron, 2. yıl 277 ± 90 (131-666) mikron, 3. yıl 275 ± 106 (142-734) mikron, 4. yıl 262 ± 81 (160-587) mikron, 5. yıl ise 245 ± 49 (138-359) mikron olarak bulunmuştur. Ardışık tedavi grubunda ise başlangıç makula kalınlığı ortalama 332 ± 69 (208-403) mikron, 1. yıl 320 ± 98 (183-460) mikron, 2. yıl 362 ± 148 (200-633) mikron, 3. yıl 383 ± 140 (259-677) mikron, 4. yıl 363 ± 194 (215-768) mikron, 5. yıl ise 266 ± 44 (236-316) mikron olarak ölçülmüştür. Takip süresi sonunda çalışmaya alınan 92 gözden 62' sinde skar, 7' inde ise atrofi gelişmiştir. Sonuç olarak ranibizumab tedavisi veya ardışık tedavi ile yaklaşık 3 yıl boyunca görme keskinliği stabilizasyonu sağlanabilmekte hastaların çoğunda coğrafik atrofi ya da skar gelişmektedir
Yaş Tip Yaşa Bağlı Makula Dejenerasyonunda Kompleman Faktör H Cc ve Tt Polimorfizminin Intravitreal Anti-Vegf Tedavisi
No full textThe purpose of this study is to evaluate the effect of the komplement factor H (CFH) Y402H CC and TT polymorphisms on treatment response to intravitreal ranibizumab injection in patients with wet type Age Related Macular Degeneration (ARMD). 193 patients with CNV secondary to ARMD followed up for at least 6 months of follow up, and with at least 3 ranibizumab injections were included in the study. At the last examination increase in visual acuity (VA) of 5 letters or more compared to the initial VA was regarded as good response, and decrase in VA of 5 letters or more compared to the initial visual acuity was evaluated as poor response. Genetic analysis was done by PCR melting curve analysis. In the statistical evaluation, SPSS version 18 software was employed. The mean age of the patients was 71.01 (55-86), the mean follow-up was 13.34 (6-36) months and the mean number of injections was 4.02 (3-15). There were 96 patients in the good response group (Group 1), and 97 patients in the poor response group (Group 2). The initial VA in group 1 was found to be 41.34 (10-64) letters, the initial central macular thickness (CMT) was 213.40 (126-494) µm, and the initial lesion width was 3760 (1430-6430) µm. The initial VA in group 2 was 52.89 (26-82) letters, the initial CMT was 257.60 (115-882) µm, the initial lesion width was 4460 (1000-7650) µm. There was no statistically significant difference between the two groups in terms of the initial VA and CMT (p= 0.094, p= 0.083). However, there was a statistically significant difference between the groups in terms of the width of the initial lesion (p= 0.003). In group 1, 15 CC, 30 TT, 51 TC, in group 2 49 CC, 2 TT, 46 TC allelles were found and the distribution was significantly different between the two groups (p= 0.012). Change in the distribution of genotypes was not associated with either the lesion size or VA (p= 0.841). Fibrosis developed in 12 patients who were all poor responders. It is observed that CFH Y402H CC accompanied poor response and TT accompanied good response in this series of ARMD patients undergoing ranibizumab therapy.Bu çalışmadaki amacımız yaş tip yaşa bağlı makula dejenerasyonu (YBMD) olan hastalarda intravitreal ranibizumab tedavisine yanıtta kompleman faktör H (CFH) Y402H CC ve TT polimorfizminin etkisini araştırmaktır. Yaş tip YBMD nedeniyle en az 3 kez intravitreal ranibizumab enjeksiyonu yapılmış, en az 6 ay izlenmiş 193 olgu yanıta göre iyi ve kötü olmak üzere iki gruba ayrılıp, periferik kanda CFH Y402H CC ve TT polimorfizmi çalışılmıştır. En son muayenede başlangıca göre görme keskinliği (GK) ETDRS eşeli ile 5 harf ve üzeri artanlar iyi yanıt, 5 harf ve daha fazla azalanlar kötü yanıt olarak sınıflandırılmıştır. Genetik analiz için PCR yöntemi ile erime eğrisi analizi uygulanmıştır. İstatistiksel analizde SPSS 18 programı kullanılmıştır. Hastaların ortalama yaşı 71.01 (55-86), ortalama takip süresi 13.34 (6-36) ay, ortalama enjeksiyon sayısı 4.02 (3-15) olarak saptanmıştır. İyi yanıt grubunda (Grup 1) 96 hasta, kötü yanıt grubunda (Grup 2) 97 hasta yer almıştır. Grup 1'de başlangıç GK ortalama 41.34 (10-64) harf, OKT'de santral makula kalınlığı (MMK) 213.40 (126-494) µm, FFA'da lezyon genişliği 3760 (1430-6430) µm olarak saptanmıştır. Grup 2'de başlangıçta GK ortalama 52.89 (26-82) harf, MMK 257.60 (115-882) µm lezyon genişliği 4460 (1000-7650) µm olarak saptanmıştır. İki grup arasında başlangıç GK ve MMK açısından istatistiksel olarak anlamlı fark saptanmamıştır (p= 0.094, p= 0.083). Gruplar arasında başlangıç lezyon genişliği açısından ise anlamlı fark saptanmıştır (p= 0.003). Grup 1'de alel dağılımı 15 CC, 30 TT, 51 TC, grup 2'de ise 49 CC, 2 TT, 46 TC olup iki grup arasında dağılım anlamlı farklı bulunmuştur (p= 0.012). Genotip dağılımı ile lezyon genişliği ilişkili bulunmamıştır (p= 0.841). Tedavi sonucunda kötü yanıt grubunda 12 olguda fibrozis gelişmiştir. Yaş tip YBMD'nin intravitreal ranibizumab tedavisine yanıta etkisinde CFH Y402H CC'nin kötü yanıta, TT'nin ise iyi yanıta eşlik ettiği görülmektedir. Kötü yanıt için bir diğer risk faktörünün de lezyon genişliği olduğu saptanmıştır
Retina Pigment Epitel Dekolmanı Olan Yaşa Bağlı Makula Dejenerasyonu Olgularında Anti-Vegf Tedavinin Etkileri
No full textPurpose: To evaluate the effect of anti-VEGF therapy on anatomical
and visual results in pigment epithelial detachment (PED) secondary to agerelated
macular degeneration (AMD).
Materials and Methods: 111 eyes of 106 patients followed in Retina
Unit of our clinic, who had PED secondary to AMD, treated with intravitreal
bevacizumab, ranibizumab or aflibercept as monotherapy or consecutive
therapy was evaluated retrospectively. Best corrected visual acuity (BCVA)
evaluated on the ETDRS chart; central macular thickness (CMT), lesion type
and width, PED height and width, subtype of PED measured with optical
coherence tomography (OCT); number of injections, follow-up duration and
number of visits were assessed from patients medical records and imaging
system records. Baseline and final findings were evaluated.
Results: 59 of the patients were female (55.7%), 47 were male (44.3%).
The mean age at diagnosis was 75.4 ± 9.6 (49-77), the mean follow-up
duration was 43.3±21.18 (12-84) months and the mean number of visits were
26.9±17.7 (4-101). While the mean baseline BCVA was found 53.26 ± 16.8
(12-88) letters, at the end of the follow-up period it was 35.1±19.63 (10-80)
letters. The mean baseline CMT was found 269 ± 93.2 (116-595) microns, at
last follow-up was found 245 ± 49 (138-359) microns. Among the whole PEDs,
48 (43%) cases were fibrovascular, 36 (32.5%) were serous, sixteen (14%)
were hemorrhagic and 11 (10%) cases were drusenoid. The mean baseline
PED height was 440.24±178.56 (134-1021) microns, the mean PED width was
2161±864.103 (1010- 4612) microns and the mean PED height decrease time
was found 8.71±8.4 (2-46) months. 62 eyes (55.8%) of 111 eyes were treated
with ranibizumab, 15 (13.5%) eyes were treated with aflibercept and 6 (5.4%)
eyes were treated with bevacizumab monotherapy, while 28 (25.3%) eyes
were treated with anti-VEGF agents consecutively. Among the consecutively
treated group, 20 (18.01%) eyes were treated with ranibizumab followed by
vi
aflibercept, 8 (7.2%) eyes were treated with bevacizumab followed by
ranibizumab. During the follow-up period, the mean number of anti-VEGF
injections were 7.06±5.4 (1-36). At the end of the follow-up period, scar
formation was seen in 47 (42.5%) of 111 eyes, while in 39 (35%) eyes macular
atrophy was developed. Both anatomical and functional improvements were
observed. In 19 (17.1%) eyes, PED persisted without scar or atrophy
development.
Conclusion: During the follow-up, the overall BCVA decrease from
baseline was 15 letters. In the first 4 year while BCVA remained stable, it
showed a detoriation in the last year. The crucial prognostic factors for visual
outcome were scar and atrophy development. These results reveal that PEDs
are resistant to therapy.
Key Words: Age-related macular degeneration, pigment epithelial
detachment, intravitreal anti-VEGF treatment.Amaç: Yaşa bağlı makula dejenerasyonu (YBMD) ile ilişkili retina pigment
epitel dekolman (PED) olgularında anti-VEGF tedavinin anatomik ve görsel sonuçlar
üzerine etkisini değerlendirmektir.
Gereç ve Yöntem: Kliniğimiz Retina Birimince Ocak 2006 veAralık 2015
tarihleri arasında takip edilen YBMD ile ilişkili PED’i olan, intravitreal bevacizumab,
ranibizumab ya da afliberceptin ayrı ayrı monoterapi veya ardışık olarak uygulandığı
106 olgunun 111 gözüne ait veriler retrospektif olarak incelendi. Dosya verilerinden
ve görüntüleme sistemi kayıtlarındanETDRS eşeli ile ölçülmüş en iyi düzeltilmiş
görme keskinliği (EİDGK), optik koherens tomografi (OKT) ile ölçülmüş santral
retina kalınlığı (SRK), lezyon tipi, lezyon genişliği, PED yüksekliği ve genişliği,
PED’in alt tipi, enjeksiyon sayısı, takip süresi ve vizit sayısı değerlendirildi. Başlangıç
ve takip sonundaki değerler incelendi.
Bulgular: Hastaların 59’u kadın (%55.7), 47’si erkek (%44.3)’ti. Ortalama
tanı yaşı 75.4 ± 9.6 (49-77), ortalama takip süresi 43.3±21.18 (12-84) ay, ortalama
vizit sayısı ise 26.9±17.7 (4-101) bulundu. Başlangıç görme keskinliği ortalama 53.26
± 16.8 (12-88), izlem süresinin sonunda ortalama 35.1±19.63 (10-80) harfti.
Başlangıç SRK ortalama 269 ± 93.2 (116-595) mikron, izlem süresinin sonunda ise
ortalama 245 ± 49 (138-359) mikron olarak bulunmuştur. Tüm PED’lerin 48’sı (%43)
fibrovasküler, 36’ü (%32,5) seröz, 16’sı (%14) hemorajik, 11’i (%10) ise drusenoid
tipte idi. Başlangıçta PED yüksekliği ortalama 440.24±178.56 (134-1021) mikron,
PED genişliği ortalama 2161±864.103 (1010- 4612) mikron olarak saptandı. PED’in
ortalama düzleşme zamanı 8.71±8.4 (2-46) ay bulundu. 111 gözün 62’sine (%55.8)
ranibizumab, 15’ine (%13.5) aflibercept, 6’sına (%5.4) bevacizumabtedavisi
monoterapi olarak uygulanmıştır. 28’ine (%25.3) ise anti-VEGF ajanlar ardışık olarak
uygulanmıştı. Ardışık tedavi uygulanan 28 gözün 20’sine (%18.01) önce ranibizumab,
sonraaflibercept, 8’ine (%7.2) önce bevacizumab, sonar ranibizumab tedavileri
uygulanmıştı. İzlem süresi boyunca hastalara ortalama 7.06±5.4 (1-36) kez anti-VEGF
tedavi yapılmıştı. Takip süresi sonunda 111 gözün 47’sinde (%42.5) skar gelişirken 39
iv
(%35) gözde atrofi saptanmıştır. Altı gözde (%5.4) iyileşme sağlandı. On dokuz gözde
ise (%17.1) skar ya da atrofi gelişmemiş olup, PED devam ediyordu.
Sonuç: Görme keskinliği izlem süresi boyunca 15 harf azalma gösterdi. İlk
dört senede görme stabil seyretmesine rağmen sonuncu yılda azalma gösterdi. Görsel
prognozu belirleyen en önemli faktörler skar ve atrofi gelişmesidir. Bu sonuçlar
PED’in tedaviye ne kadar dirençli olduğunu göstermektedir
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Get PDFWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Get PDFWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
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