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GİRİŞ ve AMAÇ: Glokom, optik sinirin progresif dejenerasyonu ve retinal ganglion hücrelerinin kaybı ile karakterize bir grup hastalıktır. Glokomda humor aköz ve vitreus içerisinde protein natüründe birçok biyomarkerın artışı tanımlanmaktadır. Ancak “proteomik” olarak adlandırılan bu proteinlerin biyokimyasal analizi oldukça güçtür. Diğer yandan manyetik rezonans görüntüleme (MRG) tetkikinde, protein içerik, sinyal değişikliğine neden olmaktadır. Çalışmamızın amacı vitreus içerisinde bulunan protein natürlü moleküllerin MR sinyal değişikliğine neden olabileceği hipotezinden yola çıkarak glokom tanısının orbita MR ile konulmasının etkinliğini araştırmaktır. YÖNTEM ve GEREÇLER: Hastanemizin Göz Hastalıkları AD. Glokom birimine Nisan - Kasım 2018 ve Ağustos - Ekim 2019 tarihleri arasında başvuran hastalardan glokom tanısı olan ve orbita MR incelemesi bulunanlar retrospektif olarak saptanarak çalışmamıza dahil edilmiştir. Çocuk hastalar, göz travması ya da hasarı bulunan hastalar dışlanmıştır. Kontrol grubu olarak glokom hastalığı bulunmayan, diğer sebeplerle orbita MR tetkiki elde olunan ve orbita MR incelemesi normal olan hastalar seçilmiştir. Hasta ve kontrol grubunun orbita MR tetkiklerinde T1 ve T2 ağırlıklı aksiyel kesitlerde, bilateral bulbus okuli vitreus düzeyine “region of interest” (ROI) yerleştirilerek intensite değerleri ölçülmüştür. Aynı ROI, incelemeye dahil olan beyin omurilik sıvısı (BOS) alanına da yerleştirilerek ölçüm yapılmıştır. Vitreus ve BOS ölçümleri birbirine oranlanarak normalizasyonu sağlanmıştır. İstatistiksel farklılık Mann Whitney U testi uygulanarak araştırılmıştır. BULGULAR: Hasta grubunda 16 hastanın 31 gözü, kontrol grubunda ise 16 olgunun 32 gözü değerlendirilmiştir. İki grubun, T1 ağırlıklı görüntülerden gerçekleştirilen ölçümleri arasında istatistiksel olarak anlamlı fark saptanmıştır (p=0.045). Bununla birlikte T2 ağırlıklı görüntülerde ölçümler arasında anlamlı fark saptanmamıştır (p=0.729). TARTIŞMA ve SONUÇ: Bu çalışma sonucunda glokom hastalarında izlenen vitreal proteinoz değişikliklerin radyolojik olarak da saptanabileceği gösterilmiştir.
Glucoma is a group of disease characterized by progressive degeneration of the optical nerve and loss of the retinal ganglion cells. Glokomda humor acoustic and vitreus in the protein nature identify the increase of many biomarker. But the biochemical analysis of these proteins, called "proteomic", is quite difficult. On the other hand, in magnetic resonance imaging (MRG) inspection, protein content causes signals to change. The purpose of our study is to investigate the effectiveness of placing the glucoma diagnosis in the orbit with the MR, based on the hypothesis that the natural protein molecules in the vitreus may cause the MR signal change. Method and Requirements: Our Hospital Eye Diseases AD. Patients who have been diagnosed with glucoma from April-November 2018 and August-October 2019 and who have had an orbit MR examination were included in our study by retrospective detection. Children patients, patients with eye trauma or injury are excluded. The control group has selected patients who have not been diagnosed with glucoma disease, who have obtained orbit MR examination for other reasons and orbit MR examination is normal. In the patient and control group's orbit MR inspections, the intensity values were measured by placing "region of interest" (ROI) at the bilateral bulb school vitreus level in T1 and T2 major action cuts. The same ROI was measured by placing in the area of the brain spinal fluid (BOS) involved in the study. Vitreus and BOS measurements are normalized by comparison. The statistical difference was studied by the application of Mann Whitney U test. In the patient group, 31 eyes of 16 patients were assessed, and 32 eyes of 16 incidents were assessed. A statistically significant difference has been found between the two groups of measurements from T1 weighted images (p=0.045). However, there is no significant difference between the measurements in T2 weighted images (p=0.729). CONTRIBUTION and RESULTS: This study has shown that changes in vitreal proteinose observed in glucoma patients can also be radiologically detected.
NTRODUCTION: Glaucoma is a progressive disease causes to optic nerve and retinal ganglion cell damage. In glaucoma, increase of some protein nature biomarkers (proteomics) in vitreous were defined. Chemical analyze of proteomics is very difficult. On the other hand, it is known that protein content causes intensity changes in magnetic resonance imaging (MRI). Aim of this study, is to evaluate the role of orbital MRI measurements on detecting the presence of proteomics in vitreous. METHODS: Glaucoma patients with orbital MRI investigations in our eye clinic between April to November 2018 and August to October 2019 were collected retrospectively. Patients under 18 years old or with eye trauma clinic or history were excluded. Patients with normal orbital MRI which is taken due to other reasons except glaucoma were selected for control group. Vitreous measurements were performed by placing “region of interest” (ROI) on T1 and T2 weighted axial images. Cerebrospinal fluid (CSF) measurements were also performed by using same ROI on the same sequence. Vitreous measurements were divided by CSF measurements for normalization. Mann Whitney U test were performed to evaluate the statistically significant difference. RESULTS: In glaucoma group 31 eyes of 16 patients and in control group 32 eyes of 16 patients were evaluated. Measurements performed on T1 weighted images showed statistically significant difference between two groups (p=0.045). On the other hand, no statistically significant difference was found between the groups with T2 weighted image measurements (p=0.729). DISCUSSION AND CONCLUSION: Our study showed that it is possible to detect vitreous changes with orbital MRI measurements.
Field : Sağlık Bilimleri
Journal Type : Ulusal
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