처음 진단된 습성 나이관련황반변성에서 라니비주맙 치료 및 연장 방법의 1년 결과: 후향적 연구
One-year Outcomes of a Treat-and-extend of Ranibizumab for Naive Exudative Age-related Macular Degeneration: Retrospective Analysis
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목적: 습성 나이관련황반변성에서 라니비주맙 치료 및 연장 방법의 1년 결과와 같은 기간 내 약제를 변경하여 치료한 경우 임상결과를 알아보고자 하였다. 대상과 방법: 습성 나이관련황반변성으로 처음 진단되고 라니비주맙 치료 및 연장 방법으로 1년 이상 치료한 32안과 같은 기간 내에 약제를 변경하여 치료한 24안을 대상으로 주사 횟수, 중심망막두께 변화, 최대교정시력 변화를 후향적으로 분석하였다. 결과: 라니비주맙 치료 및 연장 방법으로 치료한 32안은 초기 최대교정시력은 평균 59.46 ± 15.13글자에서 12개월에 68.00 ± 12.48글자로 향상되었다. 초기 중심망막두께는 평균 409 ± 141 μm였고, 12개월에 273 ± 89 μm로 감소하였다. 1년간 평균 주사 회수는 7.2 ± 0.85회였다. 12개월간 주사와 관련된 합병증은 망막색소상피 찢겨짐이 1건 관찰되었으며, 전신적인 합병증은 관찰되지 않았다. 약제를 변경한 24안 중 애플리버셉트 3회 주사를 시행한 12안에서 초기 시력이 호전되거나 보존할 수 있었던 비율은 83% (10안)였으며, 중심망막두께는 초기 371.58 ± 109.96에서 290.33 ± 58.66으로 호전을 보였다. 결론: 1년간의 관찰에서 습성 나이관련황반변성에서 라니비주맙 치료 및 연장 방법은 효과적이고, 애플리버셉트로 변경한 경우 단기간의 결과 시력을 유지하는 경우가 많고, 해부학적 호전을 보일 수 있음을 알 수 있었다.
Abstract
Purpose: This study investigated the 1-year outcomes of a treat-and-extend regimen of ranibizumab for exudative age-related macular degeneration and examined the clinical results when drug treatment was changed within the same period. Methods: This retrospective analysis included 32 eyes first diagnosed with wet age-related macular degeneration and treated for more than 1 year with a treat-and-extend regimen of ranibizumab, as well as 24 eyes treated by changing from ranibizumab to aflibercept within the same period. The injection number, maximum injection interval, change in central retinal thickness, and best-corrected visual acuity were assessed in all eyes. Results: In 32 eyes that received a treat-and-extend regimen of ranibizumab, the mean best-corrected visual acuity improved from 59.46 ± 15.13 to 68.00 ± 12.48 at 12 months (p < 0.0001). The mean central retinal thickness decreased from 409 ± 141 μm to 273 ± 89 μm at 12 months (p < 0.0001). The average number of injections per year was 7.2 ± 0.85. One complication related to the 12 months of injections was a tear in the retinal pigment epithelium; no systemic complications were observed. Of 24 eyes that underwent a change in medication, the rate of maintenance or improvement in initial visual acuity was 83% (10 eyes). The central retinal thickness was initially 371.58 ± 109.96 μm, but improved to 290.33 ± 58.66 μm in 12 eyes that received three injections of aflibercept. Conclusions: At 1 year, good outcomes were obtained using treat-and-extend ranibizumab for exudative age-related macular degeneration. When the treatment was changed to aflibercept within the same period, vision was often maintained and short-term anatomical improvement was evident.
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