Aggressive 및 1형 미숙아망막병증에서 베바시주맙과 라니비주맙 주사 효과 비교
Comparison of Intravitreal Bevacizumab and Ranibizumab Injections in Aggressive and Type 1 Retinopathy of Prematurity
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목적: 1형 및 aggressive 미숙아망막병증에서 일차 유리체강 내 베바시주맙 주입술과 라니비주맙 주입술 간의 치료 효과 차이를 알아보고자 한다. 대상과 방법: 일차 유리체강 내 항혈관내피성장인자 주사를 시행한 미숙아망막병증 환아 32명 61안의 의무기록을 후향적으로 분석하였다. 1형 또는 aggressive 미숙아망막병증 환아에서 유리체강 내 베바시주맙을 주입한 군과 라니비주맙을 주입한 군으로 구분하였고, 첫 주사 후 plus disease 소실까지의 기간, 재활성화 정도, 추가 치료 여부, 일차 치료 성공률(첫 주사 시술 후 추가 치료 없이망막혈관이 주변부까지 형성된 경우)을 분석하였다. 결과: 1형 미숙아망막병증에서 베바시주맙 주사군 16명(30안)과 라니비주맙 주사군 6명(12안)의 일차 치료 성공률은 각각 100.0%, 91.7%였으며, aggressive 미숙아망막병증에서 베바시주맙 주사군 5명(9안)과 라니비주맙 주사군 5명(10안)의 일차 치료 성공률은 각각 55.6%, 60.0%였다. 1형 및 aggressive 미숙아망막병증 모두에서 주사 약제에 따른 첫 주사 후 plus disease 소실까지의 시간, 재활성화의 정도, 추가 치료의 정도는 유의한 차이를 보이지 않았다. 결론: 1형 및 aggressive 미숙아망막병증에서 베바시주맙과 라니비주맙 주사 간에 비슷한 치료 효과를 보였다. 그러나 aggressive 미숙아망막병증의 경우 치료 부족 및 재활성화로 추가 치료가 필요한 경우가 많으므로, 일차 주사 치료 후 면밀한 추적 관찰이 반드시필요하겠다.
Abstract
Purpose: To investigate the differences in treatment effects between primary intravitreal bevacizumab injections and ranibizumab injections in type 1 retinopathy of prematurity (ROP) and aggressive ROP. Methods: We retrospectively analyzed the medical records of 61 eyes from 32 premature infants who underwent primary intravitreal anti-vascular endothelial growth factor (VEGF) injections for ROP. Patients with type 1 or aggressive ROP were divided into two groups: the intravitreal bevacizumab injection group and the ranibizumab injection group. We analyzed the period until plus disease disappeared after the first injection, reactivation, additional treatment, and the primary treatment success rate (cases in which retinal vessels formed to the periphery without additional treatment after the first injection). Results: In the type 1 ROP group, the primary treatment success rates for 16 patients (30 eyes) in the bevacizumab injection group and 6 patients (12 eyes) in the ranibizumab injection group were 100.0% and 91.7%, respectively. In the aggressive ROP group, the primary treatment success rates for 5 patients (9 eyes) in the bevacizumab injection group and 5 patients (10 eyes) in the ranibizumab injection group were 55.6% and 60.0%, respectively. In both type 1 and aggressive ROP, there were no significant differences in the period until plus disease disappeared after the first injection, reactivation rate, or additional treatment rate depending on the type of anti-VEGF. Conclusions: Bevacizumab and ranibizumab demonstrated similar efficacy in type 1 ROP and aggressive ROP. However, because aggressive ROP required additional treatment more frequently regardless of the type of anti-VEGF used, close follow-up after the primary injection is essential.
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