습성 나이관련황반변성으로 진단된 90세 이상 초고령 환자의 특성
Characteristics of Patients Older than 90 Years Diagnosed with Neovascular Age-related Macular Degeneration
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목적: 90세 이상 초고령 습성 나이관련황반변성 환자들의 특성을 알아보고자 한다. 대상과 방법: 습성 나이관련황반변성으로 진단된 환자들 중 진단 당시 90세 이상이었던 44명의 환자들을 대상으로 후향적 의무기록 분석을 시행하였다. 진단 당시 뇌혈관계 혹은 심혈관계 질환의 병력 및 시력을 확인하였다. 반대안 시력을 추가로 확인하였으며, 반대안 시력이 0.5 미만으로 측정된 경우 시력 저하의 주된 원인을 확인하였다. 결과: 환자의 평균 연령은 91.5 ± 1.5세(90-95세)였으며, 10명(22.7%)에서 뇌혈관계 혹은 심혈관계 질환의 병력이 있었다. 진단 당시 평균 logarithm of minimal angle of resolution (logMAR) 시력은 1.11 ± 0.51이었으며, 20안(45.5%)에서 시력이 0.1 미만으로 측정되었다. 반대안의 경우 26안(59.1%)에서 시력이 0.5 미만으로 측정되었으며, 그중 23안(88.5%)에서 습성 혹은 위축성 나이관련황반변성이 동반되었다. 결론: 90세 이상의 초고령에 습성 나이관련황반변성으로 진단받은 환자들은 뇌혈관계 혹은 심혈관계 질환의 빈도가 높았고, 진단 당시 시력의 손상이 상당히 진행된 경우가 많았으며, 반대안 역시 이미 시력 손상이 발생한 경우가 높은 빈도로 나타났다. 이같은 결과는 초고령 환자를 치료할 때 전신적 문제를 고려해야 한다는 점과 평소 증상이 없는 경우라도 질환을 빨리 발견할 수 있도록 정기적인 안과 검진이 필요하다는 점을 시사한다.
Abstract
Purpose: To evaluate the characteristics of patients aged ≥ 90 years who were diagnosed with neovascular age-related macular degeneration (AMD). Methods: A retrospective review of medical records was performed for 44 patients aged ≥ 90 years diagnosed with neovascular AMD. History of cerebrovascular or cardiovascular disorder and visual acuity at diagnosis were assessed. Fellow eye visual acuity data were also collected. When the fellow eye visual acuity was worse than 0.5, the primary reason for the visual deterioration was identified. Results: The mean patient age was 91.5 ± 1.5 years (range: 90–95 years). Ten (22.7%) patients had histories of cerebrovascular or cardiovascular disorders. The mean logarithm of the minimal angle of resolution (logMAR) of visual acuity was 1.11 ± 0.51 and the visual acuity was worse than 0.1 in 20 eyes (45.5%). The fellow eye visual acuity was worse than 0.5 in 26 eyes (59.1%). The primary reason was neovascular or atrophic AMD in 23 eyes (88.5%). Conclusions: The incidence of cerebrovascular or cardiovascular disorders was relatively high in patients aged ≥ 90 years. Patients also had poor visual acuity at diagnosis and a high incidence of fellow eye visual deterioration. These systemic conditions should be considered when treating these patients. Additionally, a regular ophthalmic examination is recommended for the early detection of these disorders.
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