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망막분지정맥폐쇄에 동반된 황반부종에서 베바시주맙치료 결과

Treatment Results of Bevacizumab for Macular Edema Secondary to Branch Retinal Vein Occlusion

정인영|최영제|조용운|유웅선|최유진
대한안과학회 (The Korean Ophthalmological Society)|2021.09|대한안과학회지 (Journal of The Korean Ophthalmological Society)|제62권 제9호|pp. 1207-1217

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키워드

Macular edemaBevacizumabBranch retinal vein occlusionThree-monthly regimen
주제분류안과학

초록

목적: 망막분지정맥폐쇄에 동반된 황반부종에서 유리체내 베바시주맙주입술 방법에 따른 치료 결과를 알아보고자 한다. 대상과 방법: 망막분지정맥폐쇄에서 첫 치료로 유리체내 베바시주맙을 주입한 62명 62안에 관하여 후향적으로 분석하였다. 초기 한 달 간격으로 3회 로딩 치료에 성공한 21안과 그렇지 않은 그룹 41안을 대상으로 주사 전과 주사 후 시기별 최대교정시력 및 빛간섭단층촬영의 소견 변화와 예후 관련인자를 분석하였다. 결과: 최대교정시력은 초기 3회 주입군에서 3회 로딩으로 치료하지 않은 군보다 3개월, 6개월, 12개월째 더 큰 호전을 보였다(p=0.025, p=0.019, p=0.008). 중심황반두께는 6개월째 초기 3회 주입군에서 3회 로딩으로 치료하지 않은 군보다 더 큰 호전을 보였다(p=0.034). 다변량 회귀분석 결과 증상 발현 기간, 3회 로딩, 최대교정시력, 망막내층손상, 맥락막두께가 시력호전 정도와 관련된 예측인자였으며(p=0.044, p=0.047, p=0.004, p=0.045, p=0.034), 연령, 3회 로딩, 최대교정시력, 망막내층손상이 최종 시력과 관련된 예측인자로 나타났다(p=0.045, p=0.046, p=0.002, p=0.034). 증상 발현 기간, 중심황반두께, 맥락막두께가 중심황반두께 호전에 관련된 예측인자로 나타났다(p=0.042, p=0.009, p=0.015). 결론: 망막분지정맥폐쇄의 황반부종에서 유리체내 베바시주맙 초기 3회 주입은 3회 로딩으로 치료하지 않은 방법에 비하여 단기적인 기능적 및 해부학적 호전과 장기적인 기능적 호전에 치료 우위적 효과를 보였다.

Abstract

Purpose: To evaluate the results of treatment according to the method of intravitreal injection of bevacizumab for macular edema due to branch retinal vein occlusion (BRVO). Methods: The clinical records of macular edema patients were analyzed retrospectively for a total of 62 eyes of 62 patients who were injected with bevacizumab into the vitreous as the first treatment for BRVO. Best-corrected visual acuity (BCVA), the findings of spectral-domain optical coherence tomography before and after injection, and prognosis-related factors were evaluated for 21 eyes that received the initial three monthly loading treatments and the 41 eyes that did not. Results: Significant improvement in BCVA was observed in the group having received the initial three injections compared with the group who did not receive the injections at 3, 6, and 12 months (p = 0.025, p = 0.019, and p = 0.008, respectively). The central macular thickness (CMT) showed greater improvement in the initial three injections group than the group without at 6 months (p = 0.034). Multivariate regression showed that the duration from the onset, the three loadings, BCVA, disorganization of the retinal inner layer (DRIL), and choroidal thickness were predictors related to visual gain (p = 0.044, p = 0.047, p = 0.004, p = 0.045, and p = 0.034, respectively). Age, three loadings, BCVA, and DRIL were predictors related to final visual acuity (p = 0.045, p = 0.046, p = 0.002, and p = 0.034, respectively). Duration from the onset, CMT, and choroidal thickness were predictors related to CMT improvement (p = 0.042, p = 0.009, and p = 0.015, respectively). Conclusions: In macular edema of BRVO, the initial three monthly intravitreal injections of bevacizumab provided superior treatment outcomes regarding short-term functional and anatomical improvements and long-term functional improvement, compared with methods that did not treat with the initial three monthly injections.

참고문헌 (39)

  1. Cakir M, "Efficacy of intravitreal triamcinolone for the treatment of macular edema secondary to branch retinal vein occlusion in eyes with or without grid laser photocoagulation", Retina, 28, pp.465~472 (2008)
  2. Rogers SL, "Natural history of branch retinal vein occlusion : an evidence-based systematic review", Ophthalmology, 117, pp.1094~1101 (2010)
  3. Noma H, "Cytokine kinetics after monthly intravitreal bevacizumab for retinal vein occlusion associated with macular oedema", Ophthalmic Res, 56, pp.207~214 (2016)
  4. Shchuko AG, "Intraocular cytokines imbalance in retinal vein occlusion and its impact on the efficacy of anti-angiogenic therapy", Vestn Oftalmol, 131, pp.50~58 (2015)
  5. Noma H, "Aqueous soluble vascular endothelial growth factor receptor-2 in macular edema with branch retinal vein occlusion", Curr Eye Res, 38, pp.1288~1290 (2013)
  6. The Branch Vein Occlusion Study Group, "Argon laser photocoagulation for macular edema in branch vein occlusion", Am J Ophthalmol, 98, pp.271~282 (1984)
  7. Scott IU, "A randomized trial comparing the efficacy and safety of intravitreal triamcinolone with standard care to treat vision loss associated with macular edema secondary to branch retinal vein occlusion: the Standard Care vs Corticosteroid for Retinal Vein Occlusion (SCORE) study report 6", Arch Ophthalmol, 127, pp.1115~1128 (2009)
  8. Higashiyama T, "Prospective comparisons of intravitreal injections of triamcinolone acetonide and bevacizumab for macular oedema due to branch retinal vein occlusion", Acta Ophthalmol, 91, pp.318~324 (2013)
  9. Jonas JB, "Branch retinal vein occlusion treated by intravitreal triamcinolone acetonide", Eye(Lond), 19, pp.65~71 (2005)
  10. Yepremyan M, "Early treatment of cystoid macular edema secondary to branch retinal vein occlusion with intravitreal triamcinolone acetonide", Ophthalmic Surg Lasers Imaging, 36, pp.30~36 (2005)
  11. Campochiaro PA, "Ranibizumab for macular edema following branch retinal vein occlusion : six-month primary end point results of a phase III study", Ophthalmology, 117, pp.1102~1112 (2010)
  12. Campochiaro PA, "Intravitreal aflibercept for macular edema following branch retinal vein occlusion : the 24-week results of the VIBRANT study", Ophthalmology, 122, pp.538~544 (2015)
  13. Yunoki T, "Treatment of macular edema due to branch retinal vein occlusion with single or multiple intravitreal injections of bevacizumab", Jpn J Ophthalmol, 56, pp.159~164 (2012)
  14. Moradian S, "Intravitreal bevacizumab vs. sham treatment in acute branch retinal vein occlusion with macular edema: results at 3 months (report 1)", Graefes Arch Clin Exp Ophthalmol, 249, pp.193~200 (2011)
  15. Rabena MD, "Intravitreal bevacizumab(Avastin)in the treatment of macular edema secondary to branch retinal vein occlusion", Retina, 27, pp.419~425 (2007)
  16. Figueroa MS, "Results of bevacizumab as the primary treatment for retinal vein occlusions", Br J Ophthalmol, 94, pp.1052~1056 (2010)
  17. Osaka R, "Retinal oximetry in branch retinal vein occlusion", Acta Ophthalmol, 97, pp.e896~e901 (2019)
  18. Babiuch AS, "Association of disorganization of retinal inner layers with visual acuity response to anti-vascular endothelial growth factor therapy for macular edema secondary to retinal vein occlusion", JAMA Ophthalmol, 137, pp.38~46 (2019)
  19. Coban-Karatas M, "Choroidal thickness measurements with optical coherence tomography in branch retinal vein occlusion", Int J Ophthalmol, 9, pp.725~729 (2016)
  20. Yang HN, "Clinical evaluation for branch retinal vein occlusion", J Korean Ophthalmol Soc, 33, pp.599~604 (1992)
  21. Campochiaro PA, "Vascular endothelial growth factor promotes progressive retinal nonperfusion in patients with retinal vein occlusion", Ophthalmology, 120, pp.795~802 (2013)
  22. Ota M, "Visual acuity following intravitreal bevacizumab for macular edema associated with retinal vein occlusion", Jpn J Ophthalmol, 54, pp.555~564 (2010)
  23. Noma H, "Cytokines and recurrence of macular edema after intravitreal ranibizumab in patients with branch retinal vein occlusion", Ophthalmologica, 236, pp.228~234 (2016)
  24. Noma H, "Intravitreal ranibizumab and aqueous humor factors", cytokines in major and macular branch retinal vein occlusion, 2016, pp.235, 203~207
  25. Ozdek S, "Posterior subtenon triamcinolone, intravitreal triamcinolone and grid laser photocoagulation for the treatment of macular edema in branch retinal vein occlusion", Ophthalmic Res, 40, pp.26~31 (2008)
  26. Miwa Y, "Ranibizumab for macular edema after branch retinal vein occlusion : one initial injection versus three monthly injections", Retina, 37, pp.702~709 (2017)
  27. Ito Y, "Comparison of single injection and three monthly injections of intravitreal bevacizumab for macular edema associated with branch retinal vein occlusion", Clin Ophthalmol, 9, pp.175~180 (2015)
  28. Ahn SJ, "Initial dose of three monthly intravitreal injections versus PRN intravitreal injections of bevacizumab for macular edema secondary to branch retinal vein occlusion", Biomed Res Int, 2013, pp.209735~ (2013)
  29. Lloyd Clark W, "Baseline characteristics associated with early visual acuity gains after ranibizumab treatment for retinal vein occlusion", BMC Ophthalmol, 19, pp.11~ (2019)
  30. Shin HJ, "Association between integrity of foveal photoreceptor layer and visual outcome in retinal vein occlusion", Acta Ophthalmol, 89, pp.e35~e40 (2011)
  31. Středová M, "Ranibizumab in macular oedema secondary to branch retinal vein occlusion-24 months of treatment", Cesk Slov Oftalmol, 75, pp.190~198 (2019)
  32. Nicholson L, "Diagnostic accuracy of disorganization of the retinal inner layers in detecting macular capillary non-perfusion in diabetic retinopathy", Clin Exp Ophthalmol, 43, pp.735~741 (2015)
  33. Suzuki M, "Predicting recurrences of macular edema due to branch retinal vein occlusion during anti-vascular endothelial growth factor therapy", Graefes Arch Clin Exp Ophthalmol, 258, pp.49~56 (2020)
  34. Arifoglu HB, "Short-term effects of intravitreal dexamethasone implant(OZURDEX®)on choroidal thickness in patients with naive branch retinal vein occlusion", Arq Bras Oftalmol, 79, pp.243~246 (2016)
  35. Rayess N, "Baseline choroidal thickness as a predictor for treatment outcomes in central retinal vein occlusion", Am J Ophthalmol, 171, pp.47~52 (2016)
  36. Kim KH, "Regional choroidal thickness changes in branch retinal vein occlusion with macular edema", Ophthalmologica, 234, pp.109~118 (2015)
  37. 송미령, "망막분지정맥폐쇄 환자에서 맥락막 두께의 변화", 대한안과학회지, 57(8), pp.1222~1227 (2016), 대한안과학회
  38. Rayess N, "Baseline choroidal thickness as a short-term predictor of visual acuity improvement following antivascular endothelial growth factor therapy in branch retinal vein occlusion", Br J Ophthalmol, 103, pp.55~59 (2019)
  39. An Y, "Aqueous humor inflammatory cytokine levels and choroidal thickness in patients with macular edema associated with branch retinal vein occlusion", Int Ophthalmol, 41, pp.2433~2444 (2021)

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