Stage 3 플러스 징후를 동반한 미숙아 망막병증에서 일차유리체강내 베바시주맙 주입술의 효과
Effect of Primary Intravitreal Bevacizumab Injection on Stage 3 Retinopathy of Prematurity with Plus Signs
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목적: Plus 징후를 동반한 Stage 3 미숙아 망막병증에서 레이저광응고술 대신 일차적으로 유리체강내 베바시주맙 주입술을 시행하고그 치료효과 및 안정성에 대해 알아보고자 하였다. 대상과 방법: 2011년 3월부터 2013년 2월까지 본원에서 plus 징후가 동반된 stage 3 미숙아 망막병증을 진단받고 유리체강내 베바시주맙 주입술을 시행 받은 환자 중 9개월 이상 경과 관찰이 가능하였던 16명 30안을 대상으로 의무기록을 후향적으로 분석하였다. 결과: 평균 재태기간은 26+4주 ± 11일, 평균 출생체중은 822 ± 251.4 g이었다. 치료 당시 범위는 zone II가 24안, zone III가 6안이었다. Plus 징후가 관찰된 후 평균 1.3 ± 1일 후에 치료를 시행하였으며, 치료 시 평균 수태 후 주령은 38+2주 ± 16일이었다. 평균추적관찰 기간은 16.6 ± 6.9개월로 주사 후 평균 4.6 ± 2.3일 이후에 plus 징후가 호전되기 시작하였으며, 평균 24.3 ± 12.4일 후에plus 징후가 소실되었다. 9개월 이상의 경과관찰 기간 중 1안은 유리체강내 주입술로 인한 외상과는 관련이 없는 것으로 생각되는백내장이 발생하여 백내장 적출술을 시행하였으나 치료 실패로 분류하였으며, 국소적, 전신적 합병증은 관찰되지 않았다. 결론: Plus 징후를 동반한 stage 3 미숙아 망막병증에서 일차적 유리체강내 베바시주맙 주입술은 단기적으로 효과적이며 안전한 치료방법이다.
Abstract
Purpose: To evaluate the efficacy and safety of primary intravitreal bevacizumab injection in stage 3 retinopathy of prematuritywith plus signs. Methods: We reviewed retrospectively the medical records of 30 eyes of 16 patients diagnosed with stage 3 retinopathy of prematuritywith plus signs treated with primary intravitreal bevacizumab injection between March 1, 2011 and February 28, 2013and followed up for at least 9 months. Results: Mean gestational age was 26 + 4 weeks ± 11 days and mean birth weight was 822 ± 251.4 g. The locations of diseasewere zone II in 24 eyes and zone III in 6 eyes. Intravitreal bevacizumab injection was performed after the mean 1.3 ± 1 day afterplus signs were detected. Mean postconceptional age at treatment was 38 + 2 weeks ± 16 days. Mean follow-up period was 16.6± 6.9 months. Plus signs started to regress after the mean 4.6 ± 2.3 days after injection and completely regressed after the mean24.3 ± 12.4 days. Cataract extraction was performed in 1 eye due to a cataract that appeared not associated with the injectionprocedure, but was regarded as a treatment failure. There were no local or systemic complications. Conclusions: Primary intravitreal bevacizumab injection in stage 3 retinopathy of prematurity with plus signs demonstrated excellentshort-term efficacy and safety.
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