South Clin Ist Euras. 2006; 17(1): 1-5

Primer Açýk Açýlý Glokomda Fundus Floresein Anjiyografi

Yasin Yýlmaz, Arif Koytak, Ekrem Kurnaz, Kazým Erol, Yasin Çýnar, Yusuf Özertürk
Dr. Lütfi Kýrdar Kartal Eðitim Ve Araþtýrma Hastanesi 2. Göz Kliniði

AMAÇ: Primer açýk açýlý glokom hastalarýnda fundus fluoresein anjiyografinin (FFA) taný ve prognozdaki yeri araþtýrýldý. Çalýþmamýza Dr. Lütfi Kýrdar Kartal Eðitim ve Araþtýrma Hastanesi glokom biriminde takibi olan, glokomatöz optik disk deðiþiklikleri ve görme alaný defekti olan 28 hastanýn 28 gözü ve glokomatöz deðiþiklikleri olmayan 26 kontrol hastasýnýn 26 gözü dahil edildi. Olgularýn biyomikroskopik muayeneleri, göziçi basýncý ölçümleri, açýlarýnýn ve görme alanlarýnýn deðerlendirilmesi, renkli fundus fotoðraflarý ile optik disk ve peripapiller bölgenin FFA’larý deðerlendirildi. Optik disk ve peripapiller dolum defektlerinin görünümü kontrol grubuyla karþýlaþtýrýldý ve görme alaný deðiþiklikleri ile iliþkileri deðerlendirildi. Glokom grubunda yaþ ortalamasý 57.1±10.9 yýl, kontrol grubunda 42.8±11.9 yýl idi. Glokom grubunun FFA ile incelenmesinde hastalarýn 16’sýnda (%57.1) optik disk üzerinde dolum defekti izlenirken, kontrol grubunda optik disk dolum defekti 3 hastada (%11.4) izlendi. Ýki grup arasýndaki fark klinik olarak anlamlý idi (p<0.05). Peripapiller koroidal yapýlar incelendiðinde glokom grubunda 13 hastada (%46.4) peripapiller koroidal perfüzyon defektleri izlenirken, kontrol grubunda 1 hastada (%3.8) izlendi. Peripapiller atrofi glokom grubunda 12 hastada (%42.8) izlenirken kontrol grubunda 5 hastada (%19.2) izlendi. Ýki grup arasýndaki fark istatistiksel olarak anlamlý idi (p<0.05). Baþlangýç görme alaný defekti olan hastalarda optik disk dolum defekti üst ve alt kutuplar, nazal kenar ve merkezde yoðunlaþýrken, ileri derece glokomatöz deðiþiklikleri olan hastalarda dolum defektinin daha çok tüm diskte yaygýn olarak yerleþim gösterdiði saptandý. Peripapiller koroid dolma defekti, optik disk absolü dolma defekti, peripapiller atrofi ve glokom çukurluðu gibi deðiþikliklerin o bölgelerde kan akýmýnýn azalmasýnýn birer göstergesi olduðu kabul edilebilir. FFA’da glokomun aðýrlýðýna paralel olarak arka kutup ve peripapiller koroidde dolma defektlerinde artýþ saptanmýþtýr.
YÖNTEMLER:
BULGULAR:
SONUÇ:

Anahtar Kelimeler: Anahtar Sözcükler: Glokom, dolum defekti; fundus fluoresein anjiyografi; optik disk.

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Fundus Fluoresceýn Angýography In Prýmary Open-Angle Glaucoma

Yasin Yýlmaz, Arif Koytak, Ekrem Kurnaz, Kazým Erol, Yasin Çýnar, Yusuf Özertürk
Dr. Lütfi Kýrdar Kartal Eðitim Ve Araþtýrma Hastanesi 2. Göz Kliniði

OBJECTIVE: The purpose of this study is to evaluate the effectiveness of fundus fluorescein angiography (FFA) in diagnosis and prognosis of primary open-angle glaucoma (POAG). Twenty-eight eyes of 28 patients with glaucomatous optic nerve damages and visual field defects and 26 eyes of 26 control patients with no glaucomatous changes were included in this study. Slit lamp examination, intraocular pressure (IOP) measurements, visual field analyses and fluorescein angiographies of the optic nerve and peripapillary area were performed and the relation between the fluorescein filling defects and glaucomatous changes were investigated. The mean age was 57.1±10.9 in glaucoma group and 42.8±11.9 in control group. Fluorescein filling defects of optic disc was observed in 16 (57.1%) patients in glaucoma group and in 3 (11.4%) patients in control group. The difference between two groups was statistically significant (p<0.05). When the peripapillary choroideal areas were investigated, peripapillary choroideal perfusion defects were observed in 13 (46.4%) patients in glaucoma group and 1 (3.8%) patient in control group. Peripapillary atrophy was observed in 12 (42.8%) patients in glaucoma group and 5 (19.2%) patients in control group. The difference between two groups was statistically significant (p<0.05). In patients with mild glaucomatous changes, filling defect was mostly seen at superior and inferior poles of optic disc, nasal neuroretinal rim area and central area. However, in patients with severe glaucomatous changes, filling defect was observed generally in whole disc area. Peripapillary choroideal perfusion defects, absolute filling defects of optic disc, peripapillary atrophy and glaucomatous cupping may indicate insufficiency of blood flow supplementation of these regions. An increase was determined at the posterior poles of optic disc and peripapillary choroideal filling defects in FFA in parallel with the severity of the glaucoma.
METHODS:
RESULTS:
CONCLUSION:

Keywords: Glaucoma, filling defects; fundus fluorescein angiography; optic

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ATIF KOPYALA