80세 이상 고령에서 시행한 특발망막앞막제거술의 임상결과
Clinical Outcomes of Idiopathic Epiretinal Membrane Removal in Patients 80 Years or Older
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목적: 80세 이상 초고령 환자에서 특발망막앞막제거술의 임상성적을 보고하고자 한다. 대상과 방법: 특발망막앞막으로 유리체절제술 및 망막앞막제거술을 시행 받은 56명을 대상으로 후향적 연구를 시행하였다. 80세 이상군(n=28)에서 수술 전 측정된 시력과 중심망막두께를 최종 추적 관찰 시의 값과 서로 비교하였다. 80세 이상 군과 80세 미만 군(n=28)에서의 수술 후 시력 변화 정도를 추가적으로 비교하였다. 결과: 80세 이상 군에서 평균 추적 관찰기간은 수술 후 19.1 ± 17.0개월이었다. 수술 전 11안은 위수정체, 17안은 유수정체였으며, 유수정체였던 17안 모두에서 망막앞막제거술 시 백내장수술을 함께 시행하였다. 수술 관련 합병증은 관찰되지 않았다. 수술 전 측정된 평균 logarithm of minimal angle of resolution (logMAR) 시력은 0.75 ± 0.30이었으며, 최종 추적 관찰 시 0.50 ± 0.30으로 호전되었다(p<0.001). 중심망막두께는 수술 전 458.0 ± 79.7 μm였으며, 최종 추적 관찰 시 367.2 ± 83.4 μm로 감소하였다(p<0.001). 80세 이상 군과 80세 미만 군 사이에 수술 후 시력의 변화 정도는 유의한 차이가 없었다(p=0.547). 결론: 80세 이상 고령의 특발망막앞막환자에서 망막앞막제거술 단독 혹은 백내장수술과의 병합수술 결과 해부학적 호전과 함께 시력이 유지 혹은 회복되었다. 이러한 결과는 고령에서도 망막앞막제거술이 유용할 수 있음을 시사한다.
Abstract
Purpose: To evaluate clinical outcomes of idiopathic epiretinal membrane removal in patients ≥ 80 years of age. Methods: A retrospective review of medical records was performed with 56 patients who underwent vitrectomy and removal of idiopathic epiretinal membrane. In the ≥ 80 years of age group (n = 28), the best-corrected visual acuity (BCVA) and central macular thickness (CMT) before surgery were compared with those at the final follow-up. The amount of change in the BCVA after surgery was also compared between the ≥ 80 years of age group and the < 80 years of age group (n = 28). Results: In the ≥ 80 years of age group, the mean follow-up period was 19.1 ± 17.0 months. Before surgery, 11 eyes were pseudophakic and 17 eyes were phakic. Combined cataract surgery was performed with epiretinal membrane removal in all 17 phakic eyes. The mean logarithm of the minimal angle of resolution BCVA was 0.75 ± 0.30 before surgery, which improved to 0.50 ± 0.30 at the final follow-up (p < 0.001). The CMT was 458.0 ± 79.7 μm before surgery, which decreased to 367.2 ± 83.4 μm at the final follow-up (p < 0.001). There was no significant difference in the amount of change in the BCVA after the surgery between the ≥ 80 years of age group and the < 80 years of age group (p = 0.547). Conclusions: In patients with idiopathic epiretinal membrane who were ≥ 80 years of age, the visual acuity was improved or maintained, and was accompanied with anatomical improvement after epiretinal membrane removal with or without cataract surgery. These results suggest the usefulness of epiretinal membrane removal in older patients.
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