Prevencija i liječenje dijabetičkog makularnog edema nakon nekomplicirane operacije mrene

professional thesis

• Author: Tomislav Ljubičić
• Mentor: Miro Kalauz (mentor)
• Granter: University of Zagreb; School of Medicine; Zagreb
• Defense date and country: 2024-03-13, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Ophthalmology

Abstract

Predmet istraživanja je pojavnost makularnog edema nakon nekomplicirane operacije mrene u očima s dijabetičkom retinopatijom. Glavnu ulogu u razvoju dijabetičkog makularnog edema (DME) ima kronična upala, tako da se prevencija i liječenje temelje na blokadi proupalnih čimbenika na tri razine u kaskadi; kortikosteroidima, nesteroidnim protuupalnim lijekovima (NSAIL) i antagonistima vaskularnog endotelijalnog faktora rasta (VEGF).
Pregledom stučne literature, pokušali smo dati odgovor na pitanja: kako prevenirati razvoj DME kod dijabetičara bez retinopatije, koliko dugo koristiti NSAIL, kako liječiti aktivni DME, koji su režimi aplikacije antiVEGF i odgađamo li operaciju te treba li i kada kronični DME tretirati depo-kortikosteroidima.
Nova prekretnica može biti PREMED studija 2 koja sugerira da 1,25 mg intravitrealnog bevacizumaba nije imalo utjecaja na ishode operacije, tako da su potrebne nove studije i algoritmi za liječenje i prevenciju DME-a koji će istražiti individualiziranu kombiniranu terapiju.

Abstract (english)

Subject of analysis is incidency of macular edema after uncomplicated cataract surgery in eyes with diabetic retinopathy has been reported. The keystone in the development of diabetic macular edema (DME) is chronic inflammation, so prevention and treatment are based on the blockade of pro-inflammatory factors at three levels; corticosteroids, nonsteroidal antirheumatic drugs and vascular endothelial growth factor (VEGF) antagonists.
By reviewing the literature, we tried to answer these questions: how to prevent DME in diabetics without retinopathy, for how long we need to use NSAIL, how to treat active DME, what regime of anti-VEGF injections and do we need to postpone operation and do we treat chronic DME with depot corticosteroids and when. New landmark can be PREMED Study Report 2 which sugests that 1.25mg of intravitreal bevacizumab had no effect on postoperative outcomes, so new studies and new algorithms are needed to analyse individualized regimen of the combination therapy.

• Keywords: Dijabetička retinopatija; Makularni edem; Hormoni kore nadbubrežne žlijezde; Antireumatski agensi; Upala
• Keywords (english): Diabetic Retinopathy; Macular Edema; Adrenal Cortex Hormones; Antirheumatic Agents; Inflammation
• Language: croatian
• URN:NBN: urn:nbn:hr:105:872007
• Study programme: Title: Ophthalmology and optometry; Study programme type: university; Study level: postgraduate specialist; Academic / professional title: sveučilišni/a magistar/magistra oftalmolgije i optometrije (sveučilišni/a magistar/magistra oftalmolgije i optometrije)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2024-04-24 11:59:38