망막정맥폐쇄와 당뇨망막병증에서 황반부종 치료를 위한 유리체내 베바시주맙 주입술의 효과 (Long-Term Results of Intravitreal Bevacizumab Injection for Macular Edema : Retinal Vein Obstruction and Diabetic Retinopathy)

서지정보

· 발행기관 : 대한안과학회
· 수록지 정보 : 대한안과학회지 / 50권 / 2호 / 211 ~ 218페이지
· 저자명 : 이승원, 김무상, 김응석, 곽형우, 유승영

초록

목적: 황반부종에 대한 유리체내 베바시주맙 주입술의 치료 효과를 망막정맥폐쇄와 당뇨망막병증으로 나누어 알아보고자 하였다.
대상과 방법: 연속적인 3회의 유리체내 베바시주맙(1.25 mg/0.05 ml) 주입술 후 12개월 이상 지속적인 관찰이 가능하였던 황반부종 34안(망막정맥폐쇄 16안, 당뇨망막병증 18안)을 대상으로 후향적 관찰을 시행하였다. 관찰기간 중 황반부종이 증가하여 시력이 감소한 경우 베바시주맙 주입술을 추가로 시행 받았다. 최대교정시력과 황반부 두께의 변화를 분석하였다.
결과: 망막정맥폐쇄는 황반부 두께 감소와 더불어 유의한 시력 호전이 있었으나(588.5±301.0 µm→191.8±112.0 µm: P＜0.05, 0.75±0.32→0.42±0.25: P＜0.05), 당뇨망막병증은 황반부 두께 감소에도 불구하고 유의한 시력 호전이 없었다(462.0±195.0 µm→282.2±177.3 µm: P＜0.05, 0.63±0.33→0.61±0.37: P＞0.05).
결론: 망막정맥폐쇄나 당뇨망막병증으로 인한 황반부종에서 유리체내 베바시주맙의 반복주입을 시행하고 12개월 간 관찰하였을 때, 황반부종 감소에 효과적이었으며, 망막정맥폐쇄로 인한 황반부종에서는 유의한 시력 호전이 있었다.

영어초록

Purpose: To evaluate the long-term results of intravitreal bevacizumab injection for macular edema (ME) due to retinal vein obstruction (RVO) and diabetic retinopathy (DR).
Methods: The objects of study were patients with decreased visual acuity due to ME with RVO and DR for whom intravitreal injections of 1.25 mg (0.05 ml) bevacizumab were repeated three times with an interval of six weeks and who were available for a follow-up period of more than 12 months. The patients underwent additional bevacizumab injections if ME increased as assessed by optical coherence tomography (OCT). Best-corrected visual acuity (BCVA) and central macular thickness (CMT) were measured at baseline and follow-up visits.
Results: There were 16 patients with RVO and 18 patients with DR. In the RVO group, the mean length of follow-up was 12.4±1.1 months, the mean baseline BCVA was 0.75±0.32 and the final BCVA was 0.42±0.25, a difference that was statistically significant (p＜0.05). The mean CMT at baseline was 588.5±301.0 µm and this decreased to a mean of 191.8±112.0 µm at the end of the follow-up period (p＜0.05). In the DR group, the mean length of follow-up was 15.4±3.2 months, the mean baseline BCVA was 0.63±0.33 and the final BCVA was 0.61±0.37, a difference that was not statistically significant (p＞0.05). The mean CMT at baseline was 462.0±195.0 µm and decreased to a mean of 282.2±177.3 µm at the end of the follow-up period (p＜0.05).
Conclusions: In RVO and DR, three injections of intravitreal bevacizumab with an interval of six weeks and additional injections as indicated were effective in reducing ME and showed especially good results in improvement of visual acuity for ME due to RVO.

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