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Tuvaan, Bulgan

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Товч нэр
Tuvaan, Bulgan
Бүтэн нэр
Tuvaan Bulgan
Латин нэр
Tuvaan Bulgan
Албан тушаал
Судлаач
Харьяалал
ORCID

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    Bevacizumab Monotherapy or Combined with Laser versus Laser Monotherapy in Mongolian Patients with Diabetic Macular Edema
    (Mongolian National University of Medical Sciences, 2016-06-25)
    Anaraa Toishubai
    ;
    Uranchimeg Davaatseren
    ;
    Baasankhuu Jamyanjav
    ;
    Sun Taek Lim
    ;
    Bulgan Tuvaan
    Objectives: To evaluate the efficacy and safety of bevacizumab monotherapy and bevacizumab therapy combined with laser therapy versus laser monotherapy in Mongolian patients with visual impairment due to diabetic macular edema (DME). Methods: One hundred twelve eligible patients, aged ^18 years, with type 1 or 2 diabetes mellitus and best corrected visual acuity (BCVA) in the study eye of 35 to 69 Early Treatment Diabetic Retinopathy Study letters at 4 m (Snellen equivalent: >6/60 or <6/12), and with visual impairment due to center-involved DME were included in the study. Patients were randomized into three treatment groups: (1) intravitreal bevacizumab monotherapy (n = 42), (2) intravitreal bevacizumab combined with laser therapy (n = 35), and (3) laser monotherapy (n = 35). Bevacizumab injections were given for three initial monthly doses and then pro re nata thereafter based on BCVA stability and DME progression. The primary efficacy endpoints were the mean change in BCVA and central retinal subfield thickness from baseline to month 12. Results: Bevacizumab monotherapy and bevacizumab + laser were superior to laser monotherapy in improving the mean change in BCVA letter score from baseline to month 12 (+8.3 and +11.3 vs +1.1 letters; both p ><0.0001). At month 12, a greater proportion of patients gained >10 and >15 letters and had a BCVA letter score >73 (Snellen equivalent: >6/12) with bevacizumab monotherapy (23.8% and 7.1% and 4.8%, respectively) and bevacizumab + laser (57.1% and 28.6% and 14.3%, respectively) versus laser monotherapy (0% and 0% and 0%, respectively). The mean central retinal subfield thickness was significantly reduced from baseline to month 12 with bevacizumab (-124.4 pm) and bevacizumab + laser (-129.0 pm) versus laser (-62.0 pm; both p = 0.002). Conjunctival hemorrhage was the most common ocular event. No endophthalmitis cases occurred. Conclusion: Bevacizumab monotherapy or bevacizumab + laser showed superior BCVA improvements over macular laser treatment alone in Mongolian patients with visual impairment due to DME.
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    Anatomy of lacrimal sac fossa affecting success rate in endoscopic and external dacryocystorhinostomy surgery in Mongolians
    (Korean Association of Anatomists, 2021-12)
    Purevdorj, Bayasgalan
    ;
    Dugarsuren, Uranchimeg
    ;
    Tuvaan, Bulgan
    ;
    Jamiyanjav, Baasankhuu
    To study the affect of anatomical variance of lacrimal sac fossa on dacryocystorhinostomies (DCR) performed by the traditional external (EX-DCR) approach or an endoscopic (EN-DCR) endonasal approach. A total of 292 consecutive cases with primary nasolacrimal obstruction underwent DCR surgery. Orbital computed tomography scan was used to measure lacrimal sac fossa and other related structures and Lac-Q questionnaire was used to compare surgery result. Maxillary portion of lacrimal sac fossa is thicker in failed surgery group than successful surgery group (P<0.05). Lateral nasal structures (uncinate process, operculum of the middle turbinate, agger nasi) are dominantly adjusting to lacrimal sac fossa in failed surgery group (P<0.05). Patients who underwent EX-DCR has a 6.0-point and EN-DCR group 11.0-point improvement (P<0.016) in Lac-Q questionnaire. Patients who have a thick frontal process of the maxilla and uncinate process, operculum of the middle turbinate, ethmoid cells adjusting to lacrimal fossa are prone to have recurrence of nasolacrimal duct obstruction after DCR surgery. The EN-DCR and the EX-DCR approach have an equivalent surgical success rate but improvement in quality of life by using the Lac-Q questionnaire is greater in the endoscopic group when compared with the external.
    Scopus© Citations 9