양안 동시 유리체강 내 베바시주맙주입술의 단기간 안전성 고찰
Safety Evaluation of Bilateral Same-day Intravitreal Injections of Bevacizumab
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목적: 양안 동시 유리체강내 베바시주맙주입술의 단기간 안과적 부작용 빈도를 확인하여 안정성을 평가하고자 하였다. 대상과 방법: 후향적으로 차트 리뷰를 통하여 2015년 1월부터 2019년 6월까지 양안 동시 유리체강내 베바시주맙주입술을 시행한 환자들을 모두 분석하였다. 환자들은 주사 후 1일 뒤, 1주일 뒤, 1달 뒤 내원하였다. 결과: 총 281명, 562안, 950회의 양안 동시 유리체강내 베바시주맙주입술이 시행되었다. 이들의 평균 연령은 58.87 ± 13.44세였으며 남성 153명, 여성 128명이었다. 주사 치료의 원인 질환으로 가장 많았던 것은 당뇨망막병증에 의한 합병증이며(66.3%), 나이관련황반변성이 22.2%, 망막정맥폐쇄가 5.1%, 중심성장액성맥락망막병증이 2.1%를 차지하였다. 총 950회의 주입술 이후 발생한 안내염은 없었으며, 결막하출혈이 발생한 경우는 13안, 일시적으로 안압이 상승한 환자는 17명이 있었다. 11안에서 급성 안내염증 소견이 나타났으나 주사 후 최대 2주 이내 모든 환자들이 완전한 호전 소견을 보였다. 주사 전과 1달 뒤 비교 시 시력은 호전되는 양상을 보였다(p<0.001). 결론: 단기간의 안과적 부작용 빈도를 평가하였을 때, 양안 동시 유리체강내 베바시주맙주입술은 높지 않은 부작용 빈도를 보였으며, 시행하여도 안전할 것으로 생각된다.
Abstract
Purpose: To evaluate the short-term ophthalmic side effects of bilateral same-day intravitreal bevacizumab injections. Methods: We retrospectively analyzed patients who underwent intravitreal bevacizumab injection in both eyes on the same day from January 2015 to June 2019. The patients were followed up at 1 day, 1 week, and 1 month after the injection. Results: A total of 281 patients (153 males and 128 females) and 562 eyes were included in the study, and 950 bilateral same-day intravitreal bevacizumab injections were performed. The mean age of patients was 58.87 ± 13.44 years. The most common cause of bilateral injection was that of complications due to diabetic retinopathy, which accounted for 66.3%, followed by age-related macular degeneration at 22.2%, retinal vein occlusion at 5.1%, and central serious chorioretinopathy at 2.1%. There were 0 cases of endophthalmitis after 950 injections, 13 cases of subconjunctival hemorrhage, and 17 patients with a temporary elevation of intraocular pressure. There were 11 patients with acute intraocular inflammation after bilateral injection, but none in both eyes. Patients with acute intraocular inflammation were followed up at short-term intervals until they improved. All patients showed complete improvement within 2 weeks after injection. Comparing the patients’ condition before and after injection, visual acuity improved (p < 0.001). Conclusions: In terms of the frequency of short-term ophthalmic adverse events, bilateral same-day intravitreal bevacizumab injection is a safe procedure with fewer side effects and is more convenient for both the patient and the doctor.
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