중기 나이관련황반변성 환자에서 항산화영양제 복용 후 장기 관찰 결과
Long-term Results of Taking Anti-oxidant Nutritional Supplement in Intermediate Age-related Macular Degeneration
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목적: 중기 나이관련황반변성 환자에서 항산화영양제 복용 후 3년간의 경과 변화를 전향적으로 분석하였다. 대상과 방법: 전향적, 다기관 연구로서 중기 나이관련황반변성으로 진단받은 55명 79안을 대상으로 루테인과 지아잔틴을 복용하게 한 후 전향적으로 관찰하였다. 첫 방문 후 12개월 간격으로 총 36개월간 대비감도검사를 시행하였고, 교정시력 및 중심와 망막두께, 드루젠 부피를 측정하였다. 중심와 망막두께 및 드루젠 부피는 스펙트럼영역 빛간섭단층촬영기를 이용해 측정하였다. 결과: 대상 환자의 임상 양상을 분석한 결과, 환자들의 평균 연령은 72.46 ± 7.16세였다. 대비감도 검사 결과는 종료 시점에서 최초 시점과 비교하여 호전된 양상을 보였고, 특히 3, 6 cycles per degree에서 통계적으로 유의한 차이를 보였다. 최초 환자들의 교정시력은 0.13 ± 0.14 logMAR로, 이후 36개월간 유의한 차이가 없었다. 관찰 기간 동안 중심와 망막두께, 드루젠 부피 또한 통계적으로 의미 있는 변화가 없었다. 결론: 중기 나이관련황반변성 환자에서 항산화영양제 복용 후 장기간의 추적관찰 기간 동안 대비감도가 호전되어 시기능 향상에 도움이 되었으며, 교정시력과 중심와 망막두께, 드루젠 부피에는 의미 있는 변화는 없었다. 따라서 항산화영양제의 섭취를 통해 황반 변성의 진행을 감소시키고 시기능의 질적 향상을 기대해 볼 수 있다.
Abstract
Purpose: We prospectively investigated clinical changes and long-term outcomes after administration of the drugs recommended by the Age-Related Eye Disease Study-2 to patients with intermediate age-related macular degeneration (AMD). Methods: This prospective multicenter study enrolled 79 eyes of 55 patients taking lutein and zeaxanthin. The primary endpoint was contrast sensitivity; this was checked every 12 months for a total of 36 months after treatment commenced. The secondary endpoints were visual acuity, central macular thickness, and drusen volume; the latter two parameters were assessed using spectral domain optical coherence tomography. Results: The mean patient age was 72.46 ± 7.16 years. Contrast sensitivity gradually improved at both three and six cycles per degree. The corrected visual acuity was 0.13 ± 0.14 logMAR and did not change significantly over the 36 months. Neither the central macular thickness nor drusen volume changed significantly. Conclusions: Contrast sensitivity markedly improved after treatment, improving vision and patient satisfaction. Visual acuity, central retinal thickness, and drusen volume did not deteriorate. Therefore, progression of AMD and visual function deterioration were halted.
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