Gambaran Karakteristik Dan Tajam Penglihatan Pada Pasien Diabetic Macular Edema (DME) Yang Mendapat Injeksi Bevacizumab Di Klinik Spesialis Mata SMEC Siantar Tahun 2021
DOI:
https://doi.org/10.11594/ojkmi.v4i3.38Keywords:
Diabetic macular edema (DME), anti-VEGF, bevacizumabAbstract
Pendahuluan: Retinopati diabetik adalah komplikasi diabetes yang paling umum. Diabetic Macula Edema (DME) adalah komplikasi independen dari retinopati diabetik dan terjadi pada sekitar 6,8% pasien DM. Salah satu patogenesis pada DME adalah karena peningkatan ekspresi VEGF. Selama beberapa tahun terakhir,anti Vaskular Endothelial Growth Factor (anti-VEGF) telah menjadi terapi lini pertama. Bevacizumab adalah anti-VEGF yang dapat meningkatkan Best Corrected Visual Acuity (BCVA) dan mengurangi Central Macular Thickness (CMT) pada pasien DME.
Tujuan: mengetahui gambaran karakteristik pasien DME yang mendapat terapi injeksi intravitreal serta
apakah terdapat perbaikan tajam penglihatan pasca operasi pada pasien (DME) yang mendapat terapi injeksi intravitreal di Klinik Spesialis Mata SMEC Siantar tahun 2021.
Metode: Penelitian ini menggunakan metode observasional analitik dengan pendekatan studi cross sectional secara retrospektif dengan mencatat data pasien DME yang mendapat injeksi bevacizumab intravitreal pada 1 Januari 2021 sampai 31 Desember 2021 yaitu sebanyak 20 sampel yang sudah disaring termasuk kriteria inklusi dan eksklusi, serta dilakukan uji normalitas Shapiro-wilk dan uji analisis menggunakanpaired T-test.
Hasil:Jenis Kelamin laki-laki mempunyai jumlah yang lebih banyak (52.1%) daripada perempuan (47.9%). Rerata umur pasien yang mendapat injeksi bevacizumab intravitreal 62.12±9.22.Tajam penglihatan pasien mengalami perbaikan pada semua kelompok rawatan yaitu yang mendapat injeksi 1x,2x dan 3xselama rawatan
Simpulan: terdapat perbaikan tajam penglihatan pada pasien yang menjalani injeksi bevacizumab intravitreal
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References
Diana V, Julia A. Anti-VEGF theraphy as an emerging treatment for diabetic retinopathy. Dalam: Haller, editor (penyunting). Diabetic retinopathy. USA: Humana Press; 2009. hlm. 401- 17.
Rosenfield, M. Logan, N. Optometry Science Techniques And Clinical Management. Elsevier Health Sciences; 2009.
Setiati S, Alwi I, Sudoyo AW. Ilmu Penyakit Dalam Edisi VI Jilid II. Jakarta: Interna Publishing; 2014.
Ilyas, Sidarta dan Sri Rahayu Yulianti. Ilmu Penyakit Mata Edisi Kelima. Jakarta: FKUI; 2015.
Chen Y, Jianfang L, Xi Shen. Diabetic macular morphology changes may occur in the early stage of diabetes. J of BMC Ophthalmology. 2016; 16 (12):1-7
Wu, L., Martinez-Castellanos, M.A., Quiroz- Mercado, H., Arevalo, J.F., Berrocal, M.H., Farah, M.E., et al. 2008. Twelve-month Safety of Intravitreal Injections of Bevacizumab (Avastin®): Results of the Pan-American Collaboration Retina Study Group (PACORES). Graefes Arch Clin Exp Ophthalmol 2008, 246:81-87.
Khan, A., Choudhry, A.A., Siddiq, Z., Hussain, M. and Mubaruk, B. 2012. Intravitreal Bevacizumab for Treatment Diabetic Macular Edema. Pak J Ophthalmol 2012, vol 28 (1): 3-9.
Singer MC, Daniel SK, Jana W. Diabetic macular edema: it is more than just VEGF. J of F1000 research. 2016;27(5):1-6
Marashi A. Using anti-VEGF in diabetic retinopathy. J of adv ophthalmol vis syst. 2016;4(4):1-5.
Shima, C. Sakaguchi, H., Gomi, F., Kamei, M., Ikuno, Y., Oshima, Y., et al. 2008. Complications in Patients after Intravitreal Injections of Bevacizumab. Acta Ophthalmol 2008; 86: 372- 376.
Kimoto, K. and Kubota, T. 2012. Anti-VEGF Agents for Ocular Angiogenesis and Vascular Permeability. Journal of Ophthalmology vol 2012: 1-11.
Raman R, Muna B. Diabetic macular edema. Sci J med &vis res foun. 2015;2(6):50-6.
Cantor LB, Rapuano CJ, Cioffi GA. Diagnostic approach to retinal disease. Dalam: Cantor LB, editor (penyunting). American Academy of Ophthalmology. Basic and Clinical Science Course. Section 2. Singapore: FSC; 2014-2015. hlm 20-29.
Krohne, T.U., Eter, N., Holz, F.G. and Meyer, C.H. 2008. Intraocular Pharmacokineticsof Bevacizumab after a Single Intravitreal Injection in Humans. Am J Ophthalmol 2008; 146: 508-512.
Razmju, H., Akhlaghhi, M.R. and Tavakoli, M. 2012. Evaluation of Intravitreal Injection of Bevaciizumab (Avastin) in Treatment of Diabetic Macular Edema. Journal of Research in Medical Science, March 2012 Special Issue (1): S79-S82
Fang, K., Tian, J., Qing, X., Li, S., Hou, J., Li, J., et al. 2013. Predictors of Visual Response to Intravitreal Bevacizumab for Treatment of Neovascular AgeRelated Macular Degeneration. Journal of Ophthalmology vol 2013: 1-9
Kolar, P. 2014. Risk Factors for Central and Branch Retinal Vein Occlusion – a Meta-Analysis of Published Clinical Data. Czech Republic. pp. 1-13.
Lang GE, Stahl A, Voegeler J, et al. Efficacy and safety of ranibizumab with or without panretinal laser photocoagulation versus laser photocoagulation alone in proliferative diabetic retinopathy–the PRIDE study. Acta Ophthalmol. 2020;98(5):530–539. doi:10.1111/aos.14312
Sivaprasad S, Prevost AT, Vasconcelos JC, et al. Clinical efficacy of intravitreal aflibercept versus panretinal photocoagulation for best corrected visual acuity in patients with proliferative diabetic retinopathy at 52 weeks (CLARITY): a multicentre, single-blinded, randomised, controlled, phase 2b, non-inferiority trial. Lancet. 2017;389(10085):2193–2203. doi:10.1016/S0140-6736(17)31193-5
Ip MS, Domalpally A, Hopkins JJ, Wong P, Ehrlich JS. Long-term effects of ranibizumab on diabetic retinopathy severity and progression. Arch Ophthalmol. 2012;130(9):1145–1152. doi:10.1001/archophthalmol.2012.1043
irgili G, Parravano M, Evans JR, Gordon I, Lucenteforte E. Anti-vascular endothelial growth factor for diabetic macular oedema: a network meta-analysis. Cochrane Database of Systematic Reviews 2018, Issue 10. Art. No.: CD007419.
Wu, L., Martinez-Castellanos, M.A., Quiroz- Mercado, H., Arevalo, J.F., Berrocal, M.H., Farah, M.E., et al. 2008. Twelve-month Safety of Intravitreal Injections of Bevacizumab (Avastin®): Results of the Pan-American Collaboration Retina Study Group (PACORES). Graefes Arch Clin Exp Ophthalmol 2008, 246:81-87.
Seethala A, Steven N, Manju S. Current treatments in diabetic macular edema. J of endocrinology and diabetes. 2015;23(4):1-6
Massin. Targeting the pathophysiology of diabetic macular edema. J of diabetes care. 2010; 11 (11): 2484-5.
Bafaraj AG, Njoud SA. Hadeah SA. Visual and anatomical outcomes after signle injection of intravitreal bevacizumab (avastin) in patients with diabetic macular edema. Annals of international medical and dental research. 2017;3(5):7-10
Joshi L, Asaf B, Oren TN. Intravitreal bevacizumab injections for diabetic macular edema – predictors of response: a retrospective study. J Clin Ophthalmol. 2016:10(10):2093-8.
Kuo BL, Singh RP. Brolucizumab for the treatment of diabetic macular edema. Curr Opin Ophthalmol. 2022 May 1;33(3):167-173. doi: 10.1097/ICU.0000000000000849. Epub 2022 Mar 9. PMID: 35266896
U. Schmidt-Erfurth, J. Garcia-Arumi, F. Bandello et al., “Guidelines for the management of diabetic macular edema by the European society of retina Specialists (EURETINA),” Ophthalmologica, vol. 237, no. 4, pp. 185–222, 2017.
D. J. Browning, M. W. Stewart, and C. Lee, “Diabetic macular edema: evidence-based management,” Indian Journal of Ophthalmology, vol. 66, no. 12, pp. 1736–1750, 2018.
E. A. Urias, G. A. Urias, F. Monickaraj, P. McGuire, and A. Das, “Novel therapeutic targets in diabetic macular edema: beyond VEGF,” Vision Research, vol. 139, pp. 221– 227, 2017.
Diabetic Retinopathy Clinical Research Network, U. Scott, I. U. Scott, and A. R. Edwards, “A phase II randomized clinical trial of intravitreal bevacizumab for diabetic macular edema,” Ophthalmology, vol. 114, no. 10, pp. 1860–1867, 2007
L. M. Jampol, A. R. Glassman, D. Liu et al., “Diabetic retinopathy clinical Research Network. Plasma vascular endothelial growth factor concentrations after intravitreous anti-vascular endothelial growth factor therapy for diabetic macular edema,” Ophthalmology, vol. 125, no. 7, pp. 1054–1063, 2018.
S.R Fransisco, B. Emmerson, F. Paulo, k. Michael, F.E. Michel, M. Mauricio. Anti-VEGF for the Management of Diabetic Macular Edema. Areview Article. Hindawi Publishing Corporation Journal of Immunology Research. 2014. Volume 2014, Article ID 632307
Diabetic Retinopathy Clinical Research Network, Wells JA, Glassman AR, et al. Aflibercept, bevacizumab, or ranibizumab for diabetic macular edema. N Engl J Med 2015;372:1193– 203.
Wells JA, Glassman AR, Ayala AR, et al. Aflibercept, bevacizumab, or ranibizumab for diabetic macular edema: two-year results from a comparative effectiveness randomized clinical trial. Ophthalmology 2016;123:1351–9.
D. F. Martin, M. G. Maguire, G.-S. Ying, J. E. Grunwald, S. L. Fine, and G. J. Jaffe, “Ranibizumab and bevacizumab for neovascular age-related macular degeneration,” The New England Journal of Medicine, vol. 364, no. 20, pp. 1897–1908, 2011.
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