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Retinal nerve fiber layer thickness change in patients with wet AMD treated with ranibizumab,

Retinal nerve fiber layer thickness change in patients with wet AMD treated with ranibizumab, short term results. Özen Osmanbaşoğlu, MD 1 Zeynep Alkın, MD 2 Ahmet Taylan Yazıcı , Ass. Prof. 2 Hülya Güngel, Prof. Dr 1 1.Istanbul Education and Research Hospital

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Retinal nerve fiber layer thickness change in patients with wet AMD treated with ranibizumab,

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  1. Retinal nerve fiber layer thickness change in patients with wet AMD treated with ranibizumab, short term results Özen Osmanbaşoğlu, MD 1 Zeynep Alkın, MD 2 Ahmet Taylan Yazıcı , Ass. Prof.2 Hülya Güngel, Prof. Dr1 1.Istanbul Education and Research Hospital 2.Beyoglu Eye Training and research Hospital Advantages: Todeterminetheeffect of ranibizumabinjections on intraocularpressure (IOP) andretinalnerve fiber layer (RNFL) thickness in patientswithage-relatedmaculardegeneration (AMD) Methods: Fourteen eyes of 11 treatment naive patients with neovascular age related macular degeneration treated with ranibizumab were included in thisprospectivestudy. Patientswho had opticnervediseaseincludingglaucoma, elevated IOP, narrowangles, pigment dispersionorpseudoexfoliationandanyoculardiseasesordisordersthatmightaffect RNFL thickness andmeasurementswereexcludedfromthestudy. Patients were followed up by monthly examinationsincludingvisualacuity assessmentwithSnellenchart, biomicroscopicandfundoscopicexaminations. Intraocular pressure was measuredwith applanationtonometerat baselineandbefore and 1 hour after eachintravitreal injection. RNFL thickness was measured by time domainoptical coherence tomography (Startus OCT, Carl ZeissMeditecInc, Dublin,CA)at baselineexaminationandbefore injections.Intravitrealranibizumab injections were done as on needed basis. Central-superior-temporal-nasal-inferior RNFL thicknesses and IOP changewithranibizumabinjections were analysed. Effectiveness and safety: The mean age of patients were 76.5±10.5 years. The mean follow up time was 5.3±1.1 months and mean number of injections were 3.3±0.9. Mean IOP was 16.2±2.05 mmHg and during the follow up IOP change was insignificant, none of the patients experienced an IOP spike of 5 mmHg or more and none of them required antiglaucomatous medication. Baseline RNFL thicknesses were 96.8±8.5µm in the central, 117.2±16.2µm in the superior, , 71.2±14.4µm in the temporal,76.5±16.9µm in the nasal and 119.7±23.8µm in the inferior quadrant. The decrease in average and superior quadrant RNFLthickness after the first injection was statistically significant ( p: 0.01,p:0.04) From second to third injection average RNFL thickness did not change according to baseline, but significant decrease was observed in superior quadrant measurements according to baseline (p:0.04,0.02,0.04 respectively). During the follow up there were not a significant change in RNFL thickness in the other quadrants. . Take a homemessage: As theearlyspikes of IOP afterinjectionusuallyreturnstobaselinewithin 30-60 minutes, andthe IOP wasmeasured 1 houraftertheinjection in ourstudy, may be wecould not observesuchspikes in ourpatients. But none of the patientsexperiencedan increaseof 5 mmHgormoreonehouraftertreatment. Sosignificantthinning of RNFL may be attributed to the direct toxic effect of the drug.

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