치료 병력이 없는 85세 이상 습성 나이관련황반변성 환자들의 치료 결과
Treatment Results of Treatment-naïve Neovascular Age-related Macular Degeneration in Patients Over 85 Years of Age
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목적: 85세 이상 치료 병력이 없는 습성 나이관련황반변성 환자들의 특성 및 치료 결과를 보고하고자 한다. 대상과 방법: 습성 나이관련황반변성으로 처음 진단된 환자들 중 진단 당시 85세 이상이었고, 최소 12개월 이상 추적 관찰 가능하였던대상의 의무기록을 후향적으로 분석하였다. 전체 기간 동안 유리체강 내 주사 횟수와 주사 약제의 종류를 조사하였다. 치료 전과 후의최대교정시력과 빛간섭단층촬영 결과를 조사 및 분석하였고, 추가적으로 초진 시 반대안의 시력도 수집하였다. 결과: 총 40명 40안이 연구에 포함되었고, 평균 연령은 87.5 ± 2.4세였다. 초진 시 연구안의 평균 logarithm of minimal angle of resolution (logMAR) 최대교정시력은 0.85 ± 0.57이었고, 반대안의 경우 평균 0.93 ± 0.99였다. 유리체강 내 주사 치료 후 시력은치료 전과 비교하여 유의한 차이를 보이지 않았다. 중심망막두께의 경우 치료 후 모든 시기에서 치료 전에 비해 유의한 호전을 보였다. 결론: 초진 시 나이가 85세 이상의 환자에서도 유리체강 내 주사 치료를 통해 시력의 악화를 막을 수 있었고 성공적인 해부학적 결과를 얻을 수 있었다. 특히 반대안의 시력이 나쁜 경우가 많아 시력의 유지가 의미 있을 것으로 생각되어, 고령에서도 적극적인 치료가필요하다.
Abstract
Purpose: To investigate the characteristics and treatment results of patients aged ≥ 85 years who were diagnosed with treatment- naïve neovascular age-related macular degeneration (nAMD). Methods: The medical records of patients diagnosed with treatment-naïve nAMD who were ≥ 85 years old at the time of diagnosis with at least 12 months follow-up were retrospectively reviewed. The number of intravitreal injections of anti-vascular endothelial growth factor (VEGF) and agents used during the entire period were investigated. Best-corrected visual acuity and optical coherence tomography results before and after treatment were analyzed. Visual acuity of the fellow eye was also collected. Results: A total of 40 eyes of 40 patients with mean age of 87.5 ± 2.4 were included in the study. The mean logarithm of the minimal angle of resolution visual acuity was 0.85 ± 0.57, and the mean of the fellow eye was 0.93 ± 0.99. Compared to before the treatment, there was no significant difference after intravitreal injection in terms of visual acuity. Central retinal thickness showed significant reduction at all time points after treatment. Conclusions: In patients aged ≥ 85 years at the time of diagnosis, intravitreal injections of anti-VEGF prevented deterioration of visual acuity and showed successful anatomical outcomes. Especially, many had poor visual acuity in the fellow eye, suggesting the importance of maintaining visual acuity. Therefore, active treatment is necessary in the elderly.
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