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Background/Aims@#The eradication success rate of Helicobacter pylori (H. pylori) infection with a first-line standard triple therapy (STT) has been decreasing in Korea. However, treatment outcomes of H. pylori infection in Yeongdong, Gangwon Province have been scarcely reported. This study aimed to investigate the treatment outcomes of H. pylori infection in a single tertiary care hospital with regional characteristics. @*Materials and Methods@#From July 2018 to June 2019, a total of 592 patients who underwent STT consisting of a proton pump inhibitor, amoxicillin, and clarithromycin for 7 to 14 days as a first-line H. pylori eradication therapy were included. Demographic data and treatment outcomes were retrospectively reviewed using medical records. @*Results@#The median age of 592 patients was 58 years (range 23 to 86) and 329 patients (55.6%) were men. The indication for eradication therapy included chronic atrophic gastritis (57.9%), peptic ulcer disease (19.6%), and gastric neoplasm after endoscopic resection (5.9%). Most patients (92.2%) received a 7-day course of STT. Eradication rate of STT was 64.0% (379/592). Rescue therapy was performed in 146 patients, and the final eradication rate reached 85.6% (507/592). @*Conclusions@#Eradication rate of STT in Yeongdong area of Gangwon Province was unsatisfactory, warranting the consideration of a first-line eradication regimen other than STT.
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Purpose@#This study aimed to compare the outcomes of primary radiotherapy (RT) versus surgery in early-stage human papilloma virus–positive oropharyngeal squamous cell carcinoma (hpv+OPC), and investigate the preoperative clinical factors that can predict the requirement for postoperative adjuvant treatment. @*Materials and Methods@#This multicenter study included 166 patients with American Joint Committee on Cancer 8th edition-Stages I-II hpv+OPC. Sixty (36.1%) and 106 (63.9%) patients underwent primary (concurrent chemo)radiotherapy [(CC)RT] and surgery, respectively. Seventy-eight patients (73.6%) in the surgery group received postoperative (CC)RT. @*Results@#With a median follow-up of 45.6 months for survivors, the 2-year overall survival (OS), progression-free survival (PFS), and locoregional control (LC) for RT/surgery were 97.8%/96.4%, 91.1%/92.0%, and 92.9%/93.3%, respectively. In multivariate analyses, patients with synchronous radiologic extranodal extension and conglomeration (ENEcong) of metastatic lymph nodes (LNs) showed significantly poorer OS (p=0.047), PFS (p=0.001), and LC (p=0.003). In patients undergoing primary surgery, two or more clinically positive LN metastases (odds ratio [OR], 5.15; p=0.004) and LN metastases with ENEcong (OR, 3.75; p=0.009) were predictors of postoperative chemoradiotherapy. No patient in the primary RT group demonstrated late severe toxicity whereas three (2.8%), one (0.9%), and one (0.9%) patient in the surgery group showed grade 3 dysphagia, grade 3 xerostomia, and fatal oral cavity bleeding. @*Conclusion@#We found no differences in OS, PFS, and LC between upfront RT and surgery in stage I-II hpv+OPC which warrants comparison through a prospective trial in the treatment de-escalation era. However, most early-stage hpv+OPC patients undergoing surgery received adjuvant (CC)RT. Pretreatment LN findings were prognostic and predictive for adjuvant treatment.
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Purpose@#The incidence of human papillomavirus (HPV)-related oropharyngeal cancer (OPC) has increased, and staging and optimal therapeutic approaches are challenging. A questionnaire survey was conducted to investigate the controversial treatment policy of stage T2 OPC according to the N category and determine the opinions of multidisciplinary experts in Korea. @*Materials and Methods@#Five OPC scenarios were developed by the Subcommittee on Oropharyngeal Treatment Guidelines of the Korean Society for Head and Neck Oncology and distributed to experts of multidisciplinary treatment hospitals. @*Results@#Sixty-five experts from 45 institutions responded. For the HPV-positive T2N0M0 scenario, 67.7% of respondents selected surgery followed by definitive concurrent chemoradiotherapy (CCRT) or radiotherapy alone. For the T2N1M0 HPV-positive scenario, there was a notable difference in the selection of primary treatment by expert specialty; 53.9% of respondents selected surgery and 39.8% selected definitive CCRT as the primary treatment. For the T2N3M0 advanced HPV-positive scenario, 50.0% of respondents selected CCRT and 33.3% considered induction chemotherapy (IC) as the primary treatment. CCRT and IC were significantly more frequently selected for the HPV-related OPC cases (p=0.010). The interdepartmental variability showed that the head and neck surgeons and medical oncologists favored surgery, whereas the radiation oncologists preferably selected definitive CCRT (p < 0.001). @*Conclusion@#In this study, surgery was preferred for lymph node-negative OPC, and as lymph node metastasis progressed, CCRT tended to be preferred, and IC was administered. Clinical practice patterns by stage and HPV status showed differences according to expert specialty. Multidisciplinary consensus guidelines will be essential in the future.
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Objectives@#. Head and neck squamous cell carcinomas (HNSCs) are frequently diagnosed at the locoregional advanced stage (stage IVa), but controversy remains regarding whether stage IVa HSNCs should be treated with upfront surgery or definitive chemoradiation therapy (CRT). The purpose of this study was to compare overall survival (OS) and disease-free survival (DFS) in patients with stage IVa HNSC treated primarily by surgery with curative intent with/without (neo)adjuvant treatment (surgery group) versus those treated primarily with CRT (CRT group). @*Methods@#. We reviewed data of 1,033 patients with stage IVa HNSC treated with curative intent at 17 cancer centers between 2010 and 2016. @*Results@#. Among 1,033 patients, 765 (74.1%) received upfront surgery and 268 (25.9%) received CRT. The 5-year OS and DFS rates were 64.4% and 62.0% in the surgery group and 49.5% and 45.4% in the CRT group, respectively. In multivariate analyses, OS and DFS were better in the surgery group than in the CRT group (odds ratio [OR] for death, 0.762; 95% confidence interval [CI], 0.592–0.981; OR for recurrence, 0.628; 95% CI, 0.492–0.802). In subgroup analyses, the OS and DFS of patients with oropharyngeal cancer were better in the surgery group (OR for death, 0.548; 95% CI, 0.341–0.879; OR for recurrence, 0.598; 95% CI, 0.377–0.948). In the surgery group, patients with laryngeal cancer showed better OS (OR for death, 0.432; 95% CI, 0.211–0.882), while those with hypopharyngeal cancer DFS was improved (OR for recurrence, 0.506; 95% CI, 0.328–0.780). @*Conclusion@#. A survival benefit from surgery may be achieved even in patients with stage IVa HNSC, particularly those with oropharyngeal and laryngeal cancer. Surgery led to a reduction in the recurrence rate in patients with hypopharyngeal cancer.
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Objectives@#. The transcutaneous approach is a good option for office-based vocal fold injection (VFI). However, precise localization requires extensive experience because the needle tip is invisible in small and complex laryngeal spaces. Recently, real-time light-guided VFI (RL-VFI) was proposed as a new technique that allows simultaneous injection under precise needle localization by light guidance. Herein, we aimed to verify the feasibility of RL-VFI in an in vivo canine model and explored its clinical usefulness. @*Methods@#. The device for RL-VFI comprised a light source (light-emitting diode modules [10 W] of red color [650 nm]) and injectors (1.5 inches, 23 gauge). An adult male beagle was used for the experiment. After tracheostomy, a rigid laryngoscope was inserted and suspended to expose the larynx. A flexible naso-laryngoscopy system was used to visualize the vocal folds. @*Results@#. RL-VFI was performed using various transcutaneous approaches, including the cricothyroid, transthyroid, and transhyoid approaches. Light guidance helped identify the path of the needle and prevent inadvertent penetration. The location of the needle tip was accurately indicated by the light. The illuminated needle could be easily placed at the intended points in the vocal fold with real-time visual-motor feedback. Hyaluronic acid could be simultaneously injected lateral to the vocal process under light guidance without manipulation of the device. @*Conclusion@#. RL-VFI was found to be safe and feasible in an in vivo canine model, providing precise localization and visualmotor feedback. The clinical application of RL-VFI is expected to improve the safety and precision of VFI.
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Objectives@#. Head and neck squamous cell carcinomas (HNSCs) are frequently diagnosed at the locoregional advanced stage (stage IVa), but controversy remains regarding whether stage IVa HSNCs should be treated with upfront surgery or definitive chemoradiation therapy (CRT). The purpose of this study was to compare overall survival (OS) and disease-free survival (DFS) in patients with stage IVa HNSC treated primarily by surgery with curative intent with/without (neo)adjuvant treatment (surgery group) versus those treated primarily with CRT (CRT group). @*Methods@#. We reviewed data of 1,033 patients with stage IVa HNSC treated with curative intent at 17 cancer centers between 2010 and 2016. @*Results@#. Among 1,033 patients, 765 (74.1%) received upfront surgery and 268 (25.9%) received CRT. The 5-year OS and DFS rates were 64.4% and 62.0% in the surgery group and 49.5% and 45.4% in the CRT group, respectively. In multivariate analyses, OS and DFS were better in the surgery group than in the CRT group (odds ratio [OR] for death, 0.762; 95% confidence interval [CI], 0.592–0.981; OR for recurrence, 0.628; 95% CI, 0.492–0.802). In subgroup analyses, the OS and DFS of patients with oropharyngeal cancer were better in the surgery group (OR for death, 0.548; 95% CI, 0.341–0.879; OR for recurrence, 0.598; 95% CI, 0.377–0.948). In the surgery group, patients with laryngeal cancer showed better OS (OR for death, 0.432; 95% CI, 0.211–0.882), while those with hypopharyngeal cancer DFS was improved (OR for recurrence, 0.506; 95% CI, 0.328–0.780). @*Conclusion@#. A survival benefit from surgery may be achieved even in patients with stage IVa HNSC, particularly those with oropharyngeal and laryngeal cancer. Surgery led to a reduction in the recurrence rate in patients with hypopharyngeal cancer.
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Objectives@#. The transcutaneous approach is a good option for office-based vocal fold injection (VFI). However, precise localization requires extensive experience because the needle tip is invisible in small and complex laryngeal spaces. Recently, real-time light-guided VFI (RL-VFI) was proposed as a new technique that allows simultaneous injection under precise needle localization by light guidance. Herein, we aimed to verify the feasibility of RL-VFI in an in vivo canine model and explored its clinical usefulness. @*Methods@#. The device for RL-VFI comprised a light source (light-emitting diode modules [10 W] of red color [650 nm]) and injectors (1.5 inches, 23 gauge). An adult male beagle was used for the experiment. After tracheostomy, a rigid laryngoscope was inserted and suspended to expose the larynx. A flexible naso-laryngoscopy system was used to visualize the vocal folds. @*Results@#. RL-VFI was performed using various transcutaneous approaches, including the cricothyroid, transthyroid, and transhyoid approaches. Light guidance helped identify the path of the needle and prevent inadvertent penetration. The location of the needle tip was accurately indicated by the light. The illuminated needle could be easily placed at the intended points in the vocal fold with real-time visual-motor feedback. Hyaluronic acid could be simultaneously injected lateral to the vocal process under light guidance without manipulation of the device. @*Conclusion@#. RL-VFI was found to be safe and feasible in an in vivo canine model, providing precise localization and visualmotor feedback. The clinical application of RL-VFI is expected to improve the safety and precision of VFI.
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Background and Objectives@# The ideal flap for head and neck reconstruction should be pliable, have sufficiently long pedicle and minimize donor defects. Anterolateral thigh free flap (ALTFF) and radial forearm free flap (RFFF) have been the workhorse flaps for head and neck reconstruction. However, ALTFF is too bulky and RFFF leaves a conspicuous scar on the donner site. Medial sural artery perforator free flap (MSAPFF) is a possible alternative, which has the benefit of thin RFFF and low donor site morbidity of ALTFF. Here, we evaluated for the first time the usefulness of MSAPF for head and neck reconstruction in Korean patients. Subjects and Method We carried out a retrospective study of patients who underwent MSAPFF for head and neck reconstruction from October 2018 to July 2019 by retrieving their data from electronic medical records. Patient characteristics, flap characteristics, surgical outcomes, and complications of donor sites were analyzed. @*Results@# Eight patients underwent MSAPFF reconstruction after head and neck surgery. The recipient sites were the following: the floor of the mouth, palate, tongue, the base of the tongue and nasolabial fold. The average median flap size was 34.1 cm2 (range 17.5-50 cm2), length 7.1 cm (5.0-10.0 cm), width 4.7 cm (range 3.5-5.0 cm), and pedicle length 9.2 cm (range 8-10 cm). There was one flap failure because of pedicle arterial insufficiency. All donor sites were closed primarily without any complication. @*Conclusion@# Based on the findings of this study, MSAPFF may be a new workhorse flap because it has thin, pliable tissue with low donor-site morbidity for head and neck reconstruction.
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Purpose@#To investigate the efficacy and safety of intensity-modulated radiotherapy (IMRT)-based re-irradiation (reRT) for recurrent or second primary head and neck cancer (HNC). @*Materials and Methods@#Patients who underwent IMRT-based reRT for recurrent or second primary HNC between 2007 and 2019 at two institutions were included. Medical records and dosimetric data were retrospectively reviewed. Overall survival (OS), progression-free survival (PFS), severe late toxicities, and clinicopathological prognostic factors were analyzed. @*Results@#A total of 42 patients were analyzed. With a median follow-up of 15.1 months (range, 3.7 to 85.8 months), the median OS was 28.9 months with a 2-year OS rate of 54.6%. The median PFS and 2-year PFS rates were 10.0 months and 30.9%, respectively. Multivariate analysis showed that good performance (Eastern Cooperative Oncology Group [ECOG] 0 or 1), a longer time interval (≥24 months) between radiotherapy courses, and higher reRT dose (>60 Gy) were significantly favorable factors for OS (all p < 0.05). Higher reRT dose and salvage surgery were significantly associated with improved PFS (all p < 0.05). Regarding the Multi‐Institution Reirradiation (MIRI) Collaborative RPA classification, the 2-year OS rates of each class were 87.5% in class I, 51.8% in class II, and 0% in class III (p = 0.008). Grade ≥3 late toxicity was reported in 10 (23.8%) patients. There was no significant factor associated with increased late toxicities. @*Conclusion@#IMRT-based reRT should be considered as a treatment option for patients with recurrent or second primary HNC. Further trials are needed to establish a subset of patients who may benefit from reRT without severe late toxicity.
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The transformation of papillary thyroid carcinoma (PTC) to anaplastic thyroid carcinoma (ATC) is well documented in the literature but is an exceptionally rare occurrence in metastatic foci outside the primary thyroid lesion. Even rarer is the simultaneous occurrence of PTC and ATC in the cervical lymph nodes. We report the case of an 85–year–old man who presented with a rapidly growing neck mass diagnosed as PTC. Following surgery, multiple ATC foci in the metastatic cervical lymph node were found coexisting with PTC, whereas in the thyroid, only PTC was found. This case is of high clinical significance because transformation of PTC to ATC outside the thyroid gland per se is very rare and because it suggests rapidly growing tumors in an elderly patient. The use of core needle biopsies in cases with suspected rapid tumor growth can aid in proper diagnosis, surgical decision making, and patient counselling.
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The Korean Bronchoesophagological Society appointed a task force to develop a clinical practice guideline for tracheostomy. The task force conducted a systematic search of the Embase, Medline, Cochrane Library, and KoreaMed databases to identify relevant articles, using search terms selected according to key questions. Evidence-based recommendations for practice were ranked according to the American College of Physicians grading system. An external expert review and a Delphi questionnaire were conducted to reach a consensus regarding the recommendations. Accordingly, the committee developed 18 evidence-based recommendations, which are grouped into seven categories. These recommendations are intended to assist clinicians in performing tracheostomy and in the management of tracheostomized patients.
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Objectives@#. To evaluate the feasibility of brachial plexus schwannoma enucleation under intraoperative neuromonitoring. @*Methods@#. Five patients who were treated for brachial plexus schwannoma under intraoperative neuromonitoring from 2008 to 2018 were included in this retrospective review. Neuromonitoring was performed with a 100-μV event threshold of the neuromonitoring system (NIM-2 or 3) at the deltoid, biceps brachii, triceps brachii, and brachioradialis muscles. Patient characteristics, tumor size and location, intraoperative neuromonitoring findings, and postoperative function were evaluated. @*Results@#. The intraoperative neuromonitoring findings were in accordance with the preoperative assessment of the included nerve root. Three patients had no postoperative morbidity, one patient had temporary paresthesia of the forearm for 2 months, and one patient mild loss of grip strength for 1 month. @*Conclusion@#. Intraoperative neuromonitoring of the arm and forearm muscles during enucleation of brachial plexus schwannoma promoted confident and successful surgery with minimal postoperative morbidity.
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We describe here diagnosis treatment of a case that rose from the sternocleidomastoid muscle and was treated without surgical excision. A 56-year-old man presented with a rapidly growing, painless and not well-circumscribed mass at the right side of the neck. We diagnosed this tumor as proliferative myositis (PM) based on the typical findings from ultrasonography, computed tomography, and core-needle biopsy, and treated it without surgical excision. Herein we report a successful diagnosis and treatment process of a case of PM, which was followed-up with ultrasonography.
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Parotid tumor resection, parotidectomy, is a surgical procedure that requires considerable experience from surgeons in most of the cases because of the risk of facial nerve damage. In addition, it is often times difficult to identify and preserve the facial nerve during the procedure, because it requires removal of a considerable amount of normal parotid tissue even when it is not related to the location of the tumor itself. Post-operative cosmetic problems and complications associated with inevitable removal of the normal parotid gland tissue cannot be ignored. For these reasons, parotidectomy has been evolved over the years to ensure the oncological safety, avoid complications, and improve functional and cosmetic results. Recently, the use and importance of extracapsular dissection (ECD) has become more recognized because it is a more conservative surgical method than partial superficial parotidectomy with preservation of facial nerve function, minimization of functional and cosmetic complications, and limited removal of unnecessary normal parotid gland tissue. Herein, we review the literatures related to ECD for benign parotid tumors and explain the efficacy of this emerging procedure based on the previous study results reported by the authors.
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PURPOSE: To evaluate the efficacy of oral rehabilitation therapy (ORT) in terms of prematurity-associated morbidities in preterm infants born before a gestational age of 33 weeks. METHODS: This was a single-institution retrospective case-control study including 78 high-risk preterm infants born between January 2015 and December 2016, who were administered with ORT for at least 15 minutes, 2 to 5 times/week by an occupational therapist. Various factors associated with feeding progression and neonatal morbidities were compared between the two groups. RESULTS: Seventy-eight subjects, of whom 39 were cases and 39 controls, were included in this study. Infants in the case group achieved a greater total feeding volume (122.9±85.3 mL vs. 48.9±25.7 mL, P<0.001), i.e., 8 times/day with oral feeding only, and showed significantly higher body weight (1,852.1±303.3 g vs. 1,592.3±444.1 g, P=0.003) than those in the control group with complete oral feeding day. The duration from the first day of oral feeding to full enteral feeding, i.e., 150 mL/day, was significantly shorter in the cases than that in the controls (15.4±1.4 days vs. 23.1±1.8 days, P=0.004). The body weight at discharge was higher in the cases than that in the controls (3,102.6± 619.3 g vs. 2,744.6± 436.8 g, P=0.008). Moreover, the incidence of late-onset sepsis was lower in the cases than that in the controls (12.8% vs. 25.6%, P=0.033). Other prematurity-associated morbidities were not different between the two groups. CONCLUSION: ORT in preterm infants facilitated the transition process from tube feeding to full oral feeding and reduced the incidence of late-onset sepsis.
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Humans , Infant , Infant, Newborn , Body Weight , Bottle Feeding , Case-Control Studies , Enteral Nutrition , Gestational Age , Incidence , Infant, Premature , Rehabilitation , Retrospective Studies , Sepsis , Treatment OutcomeABSTRACT
A subepithelial tumor-like esophageal carcinoma is rare. We report a case of an esophageal squamous cell carcinoma with lymph node metastasis presenting as a small subepithelial tumor. A 68-year-old man presented to our hospital complaining of hoarseness since last three months. Endoscopic examination revealed a 1 cm hard and fixed subepithelial tumor with surface erosion in the lower esophagus. A biopsy specimen was obtained using conventional forceps, and histopathological evaluation revealed few atypical squamous epithelial cells. Subsequent EUS demonstrated a homogeneous hypoechoic lesion in the deep mucosal layer. A CT scan of the chest showed a 3 cm mass in the right upper paratracheal area. EUS-guided fine needle biopsy of the lesion led to the diagnosis of squamous cell carcinoma with lymph node metastasis.
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Aged , Humans , Biopsy , Biopsy, Fine-Needle , Carcinoma, Squamous Cell , Diagnosis , Endosonography , Epithelial Cells , Esophageal Neoplasms , Esophagus , Hoarseness , Lymph Nodes , Neoplasm Metastasis , Surgical Instruments , Thorax , Tomography, X-Ray ComputedABSTRACT
BACKGROUND: Nontuberculous mycobacteria (NTM) lymphadenitis is an under-recognized entity, and data of the true burden in children are limited. Without a high index of suspicion, diagnosis may be delayed and microbiological detection is challenging. Here, we report a cluster of NTM lymphadenitis experienced in Korean children. METHODS: Subjects under 19 years of age diagnosed with NTM lymphadenitis during November 2016–April 2017 and April 2018 were included. Electronic medical records were reviewed for clinical, laboratory and pathological findings. Information regarding underlying health conditions and environmental exposure factors was obtained through interview and questionnaires. RESULTS: A total of ten subjects were diagnosed during 18 months. All subjects were 8–15 years of age, previously healthy, male and had unilateral, nontender, cervicofacial lymphadenitis for more than 3 weeks with no significant systemic symptoms and no response to empirical antibiotics. Lymph nodes involved were submandibular (n = 8), preauricular (n = 6) and submental (n = 1). Five patients had two infected nodes and violaceous discoloration was seen in seven subjects. Biopsy specimens revealed chronic granulomatous inflammation and acid-fast bacteria culture identified Mycobacterium haemophilum in two cases and NTM polymerase chain reaction was positive in two cases. Survey revealed various common exposure sources. CONCLUSION: NTM lymphadenitis is rare but increasing in detection and it may occur in children and adolescents. Diagnosis requires high index of suspicion and communication between clinicians and the laboratory is essential for identification of NTM.
Subject(s)
Adolescent , Child , Humans , Male , Anti-Bacterial Agents , Bacteria , Biopsy , Diagnosis , Electronic Health Records , Environmental Exposure , Inflammation , Lymph Nodes , Lymphadenitis , Mycobacterium , Mycobacterium haemophilum , Nontuberculous Mycobacteria , Polymerase Chain Reaction , Tuberculosis, Lymph NodeABSTRACT
Parotid tumor resection, parotidectomy, is a surgical procedure that requires considerable experience from surgeons in most of the cases because of the risk of facial nerve damage. In addition, it is often times difficult to identify and preserve the facial nerve during the procedure, because it requires removal of a considerable amount of normal parotid tissue even when it is not related to the location of the tumor itself. Post-operative cosmetic problems and complications associated with inevitable removal of the normal parotid gland tissue cannot be ignored. For these reasons, parotidectomy has been evolved over the years to ensure the oncological safety, avoid complications, and improve functional and cosmetic results. Recently, the use and importance of extracapsular dissection (ECD) has become more recognized because it is a more conservative surgical method than partial superficial parotidectomy with preservation of facial nerve function, minimization of functional and cosmetic complications, and limited removal of unnecessary normal parotid gland tissue. Herein, we review the literatures related to ECD for benign parotid tumors and explain the efficacy of this emerging procedure based on the previous study results reported by the authors.
Subject(s)
Facial Nerve , Methods , Parotid Gland , SurgeonsABSTRACT
No abstract available.
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PURPOSE: To evaluate microaneurysm (MA) turnover and changes in central retinal thickness after intravitreal dexamethasone implantation or intravitreal bevacizumab injection to treat diabetic macular edema. METHODS: Sixty eyes with diabetic macular edema were evaluated. In all, 30 eyes received intravitreal dexamethasone implants (group A) and 30 received bevacizumab injections (group B). All patients were followed-up at 3 and 6 months. MA formation, disappearance, and turnover (MA formation rate minus disappearance rate) were evaluated. When the disappearance rate was greater than the formation rate (so the turnover was ≤0), the microaneurysms were considered to have resolved. Central retinal thickness (CRT) was measured using optical coherence tomography at all visits. RESULTS: In group A, MA turnover was 86.6% at 3 months and 53.3% at 6 months, and thus decreased slightly over time, but was not eliminated. In group B, MA turnover was 56.6% at 3 months and 13.3% at 6 months; the between-group difference was statistically significant (p = 0.014). CRT decreased in both groups, but significantly less so in group B 3 months after injection. However, no significant between-group difference was apparent 6 months after injection. CONCLUSIONS: There were no significant between-group differences in either CRT or MA turnover 3 months after injection. However, at 6 months, dexamethasone implantation showed slightly better results than intravitreal bevacizumab injection. However, further research on long-term MA turnover is required.