중심망막정맥폐쇄에서 베바시주맙군과 저용량 베바시주맙-트리암시놀론 혼합군의 단기 효과 비교
Comparison of Bevacizumab and Combined Low-dose Bevacizumab and Triamcinolone in Central Retinal Vein Occlusion
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목적: 비허헐성 중심망막정맥폐쇄에 동반된 황반부종 환자에서 유리체강 내에 베바시주맙을 단독 주입한 군과 저용량의 베바시주맙- 트리암시놀론을 혼합하여 유리체강 내로 주입한 군의 단기간 치료 효과 및 안압 변동의 차이를 비교하고자 하였다. 대상과 방법: 비허혈성 중심망막정맥폐쇄 환자 총 40명 40안 중 유리체강 내 베바시주맙 1.25 mg/0.05 mL를 단독 주입한 20안과 유리체강 내 저용량의 베바시주맙 0.625 mg/0.025 mL와 트리암시놀론 1 mg/0.025 mL를 혼합하여 주입한 20안을 대상으로 시술 전, 1개월, 2개월, 3개월의 중심망막 두께, 최대 교정시력, 안압을 비교하였다. 결과: 비허혈성 중심망막정맥폐쇄 환자에서 베바시주맙을 단독으로 주입한 군과 저용량의 베바시주맙-트리암시놀론을 혼합하여 주입한 군 모두에서 시술 후 1개월, 2개월, 3개월의 중심망막 두께는 유의한 감소 소견을 보였고(p＜0.05), 최대 교정시력은 유의한 증가 소견을 보여 주었으며(p＜0.05), 3개월간 의미 있는 안압의 증가는 없었다. 두 군의 효과를 서로 비교하였을 때 주입술 1개월, 2개월, 3개월 후의 황반의 두께, 최대 교정시력, 안압변동을 비교한 결과 의미 있는 차이는 나타나지 않았다(p＞0.05). 결론: 비허혈성 중심망막정맥폐쇄 환자에서 베바시주맙을 단독으로 유리체강 내로 주입한 군과 저용량의 베바시주맙-트리암시놀론을 혼합하여 주입한 군에서 경과관찰을 시행한 3개월 내 모두 황반의 부종감소, 시력호전 효과가 있었고, 안압의 의미 있는 증가는 없었다. 중심망막정맥폐쇄 환자에서 유리체강 내 단독 베바시주맙 주입뿐만 아니라 유리체강 내 저용량의 베바시주맙-트리암시놀론 혼합 주입을 고려해 볼 수 있다.
Abstract
Purpose: To report the effects and intraocular pressure (IOP) results of intravitreal injection of bevacizumab alone compared with intravitreal low-dose bevacizumab combined with low-dose triamcinolone injection in patients with central retinal vein occlusion. Methods: In total, 40 eyes of 40 patients diagnosed with central retinal vein occlusion were evaluated. Of these, 20 eyes of 20 patients were injected with intravitreal bevacizumab (1.25 mg/0.05 mL), and 20 eyes of 20 patients were injected with low-dose bevacizumab (0.625 mg/0.025 mL) combined with low-dose triamcinolone (1 mg/0.025 mL). The best corrected visual acuity (BCVA), central macular thickness (CMT), and IOP of treated eyes were measured before injection and at 1 month, 2 months, and 3 months after injection. Results: In both the intravitreal bevacizumab and the low-dose bevacizumab combined with low-dose triamcinolone groups, CMT decreased significantly at 1 month, 2 months, and 3 months after injection (p < 0.05). In addition, in both groups, neither IOP nor BCVA decreased significantly at 1 month, 2 months, or 3 months after injection (p > 0.05). The BCVA, IOP, and CMT at 1 month, 2 months, and 3 months after injection showed no significant differences between the intravitreal bevacizumab group and the low-dose bevacizumab combined with low-dose triamcinolone group (p > 0.05). Conclusions: The CMT of both groups decreased significantly, and BCVA of both groups increased significantly in patients with central retinal vein occlusion. Injection of low-dose intravitreal bevacizumab combined with low-dose intravitreal triamcinolone may be useful for the treatment of central retinal vein occlusion.
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