유리체강내 덱사메타손 삽입물 주입술 후 발생하는 안압상승에 대한 예방적 안압하강제의 효과
The Effect of Prophylactic IOP-Lowering Medication after Intravitreal Dexamethasone Implantation
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목적: 유리체강내 덱사메타손 삽입물 주입술 후 안압변화 양상을 관찰하고 예방적 안압하강제를 사용하였을 때 안압상승예방효과에대해 알아보고자 한다. 대상과 방법: 황반부종으로 유리체강내 덱사메타손 삽입물 주입술을 시행 받은 39안을 대상으로 예방적 안압하강제를 사용한 군과사용하지 않은 군으로 나누어 시술 전, 시술 1주 후, 시술 6개월 후까지 한 달 간격으로 안압변화 양상을 관찰하였다. 결과: 예방적 안압하강제를 사용하지 않은 군과 사용한 군에서 안압은 각각 시술 전 13.95 ± 3.32 mmHg, 13.56 ± 3.71 mmHg,첫 시술 2개월 후 15.81 ± 3.75 mmHg, 12.56 ± 5.02 mmHg, 6개월 후 12.90 ± 2.95 mmHg, 11.44 ± 3.59 mmHg를 보였으며예방적 안압하강제를 사용한 군에서 시술 1주, 1개월, 2개월, 3개월 후 안압이 유의하게 낮았다(p=0.001, 0.002, 0.011, 0.035,respectively). 그리고 예방적 안압하강제를 사용하지 않은 군과 사용한 군 각각 4안(19.05%), 1안(5.56%)에서 안압이 22 mmHg 이상측정되었고(p=0.209) 8안(38.10%), 1안(5.56%)에서 안압이 시술 전보다 5 mmHg 이상 상승하며 유의한 차이를 보였다(p=0.016). 결론: 유리체강내 덱사메타손 삽입물 주입술을 시행할 때 발생하는 안압상승은 예방적 안압하강제를 사용하여 유의하게 억제할 수있으며 추가적인 치료를 필요로 하는 빈도를 낮추어 잠재적인 망막과 시신경의 손상을 예방할 수 있을 것이다.
Abstract
Purpose: To investigate the effect of prophylactic intraocular pressure (IOP)-lowering medication after intravitreal dexamethasoneimplantation. Methods: This is a retrospective analysis of 39 eyes undergoing intravitreal dexamethasone implantation for macular edema. Eyes were divided into two groups, those which had used prophylactic IOP-lowering medication and those which had not. IOPwas measured preoperatively, at one week, and monthly until six months post-injection in each group. Results: The mean pre-injection IOP for the group that had not used prophylactic IOP-lowering medication and the group thathad was 13.95 ± 3.32 mm Hg and 13.56 ± 3.71 mm Hg, the mean post-injection IOP at two months was 15.81 ± 3.75 mm Hg and12.56 ± 5.02 mm Hg, and that at six months was 12.90 ± 2.95 mm Hg and 11.44 ± 3.59 mm Hg, respectively. The difference betweenthe two groups was statistically significant at one week, one month, two months, and three months (p = 0.001, 0.002,0.011, 0.035, respectively). A greater than 22 mm Hg increase in IOP was seen in four eyes (19.05%) in the group that had notused IOP-lowering medication and in one eye (5.56%) in the group that had. A greater than 5 mm Hg increase in IOP from baselinewas seen in eight eyes (38.10%) in the group that had not used IOP-lowering medication and in one eye (5.56%) in the groupthat had. Conclusions: After intravitreal dexamethasone implantation, prophylactic IOP-lowering medication will significantly prevent IOPincrease and decrease the number of patients requiring additional treatment that could cause potential damage to the retina andoptic nerve.
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