만성중심장액맥락망막병증에서 광역학치료와 국소레이저광응고술의 치료 효과 비교
Photodynamic Therapy and Focal Laser Photocoagulation in Chronic Central Serous Chorioretinopathy
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목적: 만성중심장액맥락망막병증에서 광역학치료와 국소레이저광응고술의 치료 효과를 비교하고자 하였다. 대상과 방법: 만성중심장액맥락망막병증으로 진단 받아 광역학치료 또는 국소레이저광응고술을 시행한 40명 40안을 대상으로 치료 전후의 시력, 망막하액과 망막색소상피박리의 호전 여부 및 합병증 발생 여부를 비교 분석하였다. 결과: 광역학치료군이 23안, 국소레이저광응고술 치료군이 17안이었다. 두 군 모두에서 치료 1개월과 6개월 후 시력이 유의하게 호전되었고, 두 군 간의 치료 전후 시력 및 시력호전의 정도는 차이가 없었다. 망막하액 및 망막색소박리는 모든 군에서 완전소실 또는 부분호전되었고, 치료 1개월 후 광역학치료군에서 망막하액에 대한 치료 효과가 더 좋았으나 완전소실까지의 기간은 두 군 간에 차이가 없었다. 광역학 치료군에서는 합병증이 없었지만 2안에서 재발하여 1안에서 재치료를 시행하였고, 국소레이저광응고술 치료군 1명에서 맥락막신생혈관이 발생하였다. 결론: 만성중심장액맥락망막병증에서 광역학치료와 국소레이저광응고술은 모두 치료에 효과적이었지만, 비용 및 편의성 측면에서 본다면 국소레이저광응고술을 광역학치료 전에 먼저 고려해 볼 수 있겠다.
Abstract
Purpose: The aim of this study was to compare the treatment efficacy of photodynamic therapy (PDT) and focal laser photocoagulation in chronic central serous chorio retinopathy (CSC). Methods: A retrospective study in a clinical practice setting including 40 eyes of 40 patients with chronic CSC which were treated with PDT or focal laser photocoagulation were recruited in this study from March 2011 to December 2013. Mean change in best corrected visual acuity (BCVA), presence or absence of resolution of subretinal fluid (SRF) and pigment epithelial detachment (PED), recurrence rate, and complications were analyzed. Results: PDT was performed in 23 eyes of 23 patients and focal laser photocoagulation was performed in 17 eyes of 17 patients, and all patients were followed up for more than six months. Location of leakage point and appearance of leakage showed no statistically significant difference between the two groups. Both groups showed significant improvement in BCVA at one month and six months after the treatment; however, there was no statistically significant difference in BCVA improvement between the two groups. In both groups, SRF and PED were partially or completely resolved. Resolution of SRF was better in the PDT group at one month after the treatment; however, no statistically significant difference in the resolution period was observed between the two groups. None of the patients experienced adverse events in the PDT group, but one patient developed choroidal neovascularization after treatment in the focal laser photocoagulation group. Two patients showed recurrence in the PDT group and needed retreatment. Conclusions: Both treatments are beneficial in patients with chronic CSC. Focal laser photocoagulation can be a good treatment option in terms of cost-effectiveness and convenience.
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