망막정맥폐쇄 환자에서 황반허혈과 최종시력과의 연관성
Macular Ischemia Correlated with Final Visual Outcome in Retinal Vein Occlusion Patients
0
조회
0
다운로드
3
인용
0
참고문헌
키워드
초록
목적: 망막정맥폐쇄(RVO)환자에서 초진 시 황반허혈과 최종시력 간의 상관관계를 살펴보았다. 대상과 방법: 1998년 1월부터 2012년 7월까지 안저사진과 형광안저촬영을 통해 망막정맥폐쇄로 진단받고 최소 6개월 이상 경과관찰이가능하였던 83명 86안을 대상으로 환자 기록지를 조사하였다. 황반의 허혈 정도와 범위, 황반부종 정도와 범위, 초진시력, 최종시력,동반된 전신질환을 평가하였다. 황반허혈과 부종의 정도는 초진 후 2주 이내에 촬영한 형광안저촬영과 빛간섭단층촬영을 통하여 평가하였고 황반을 4개의 구역(상이측, 상비측, 하이측, 하비측)으로 나누어서 관찰하였다. 결과: 86안 중 원인질환은 중심망막정맥폐쇄 24안, 망막분지정맥폐쇄 62안이었다. 초진시력(logMAR)은 황반허혈이 없는 군이 0.35± 0.31 (36안), 황반허혈 1사분면 0.40 ± 0.21 (11안), 2사분면 0.71 ± 0.32 (26안), 3사분면 이상 0.73 ± 0.36 (13안)으로 나타났다. 최종시력(logMAR)은 각각 0.23 ± 0.23, 0.40 ± 0.30, 0.51 ± 0.32, 0.73 ± 0.31이었다. 결론: 초진 시 황반허혈이 심할수록 초진시력과 6개월 이후의 최종시력이 저하되었으나, 황반부종은 최종시력예후에서 이러한 경향을보이지 않았다.
Abstract
Purpose: To identify the correlation between final visual outcome after at least 6 months of follow-up and the extent of macularischemia on the first visit. Methods: We performed a retrospective clinical analysis of macular ischemia using clinical records, fundus examinations, andfluorescein angiographies in 83 patients (86 eyes) diagnosed with retinal vein occlusion from January 1998 to July 2012 and followedup for over 6 months. We evaluated the extent and the location of macular ischemia, macular edema, initial and final visualacuities and systemic disease based on fluorescein angiography and optical coherence tomography performed within 2 weeksof the first visit. The patients were divided into the following 4 groups based on the extent and location of macular ischemia andedema: superotemporal, superonasal, inferotemporal, and inferonasal. Results: Retinal vein occlusions (RVOs) consisted of 24 central RVOs (CRVOs) and 62 branch RVOs (BRVOs). Mean initialacuity (log MAR) was 0.35 ± 0.31 (36 eyes) in the no macular ischemia group, 0.40 ± 0.21 (11 eyes) in the 1-quadrant macularischemia group, 0.71 ± 0.32 (26 eyes) in the 2-quadrant macular ischemia group and 0.73 ± 0.36 (13 eyes) in the over 3 quadrantsmacular ischemia group. Mean final acuity (log MAR) was 0.23 ± 0.23 in the no macular ischemia group, 0.40 ± 0.30 in the1-quadrant macular ischemia group, 0.51 ± 0.32 in the 2-quadrant macular ischemic group and 0.73 ± 0.31 in the over 3 quadrantsmacular ischemia group. Conclusions: The initial and final visual outcomes were worse when more quadrants were affected by macular ischemia. The extentof macular ischemia was correlated with initial visual acuity and final visual outcome but not with macular edema.
참고문헌 (20)
- Glacet-Bernard A, "Prognostic factors for retinal vein occlusion: prospective study of 175 cases", Ophthalmology, 103, pp.551~560 (1996)
- Kwon OW, "Size of capillary nonperfusion and their prognosis in branch retinal vein occlusion patients", J Korean Ophthalmol Soc, 34, pp.1162~1166 (1993)
- Sohn JH, "Arteriovenous sheathotomy for persistent macular edema in branch retinal vein occlusion", Korean J Ophthalmol, 20, pp.210~214 (2006)
- Chung JH, "The macular circulation state on BRVO according to occlusion site", J Korean Ophthalmol Soc, 41, pp.1556~1562 (2000)
- 강석재, "망막분지정맥폐쇄에서 황반허혈에 동반된 황반부종의 시력 예후", 대한안과학회지, 43(9), pp.9~1628 (2002), 대한안과학회
- Lang GE, "Clinical and fluorescein angiography findings in patients with retinal vein occlusion. A unicenter study of 211 patients", Klin Monbl Augenheilkd, 201, pp.234~239 (1992)
- Park H, "Clinical characteristics and classifications of retinal vein occlusion", J Korean Ophthalmol Soc, 37, pp.1022~1031 (1996)
- Merin S, "Retinal ischemia (capillary nonperfusion)in diabetic retinopathy of patients with and without systemic hypertension", Ophthalmologica, 177, pp.76~81 (1978)
- Roseman RL, "Krypton red laser photocoagulation for branch retinal vein occlusion", Ophthalmology, 94, pp.1120~1125 (1987)
- Sohn JH, "The effect of laser treatment on branch retinal vein occlusion", J Korean Ophthalmol Soc, 34, pp.523~529 (1993)
- Kim HC, "The macular circulatory change in branch retinal vein occlusion", J Korean Ophthalmol Soc, 40, pp.1911~1917 (1999)
- 이주용, "Baseline Characteristics and Risk Factors of Retinal Vein Occlusion: A Study by the Korean RVO Study Group", Journal of Korean Medical Science, 28(1), pp.136~144 (2013), 대한의학회
- Clemett RS, "The visual prognosis in retinal branch vein occlusion", Trans Ophthalmol Soc U K, 93, pp.523~535 (1973)
- Shilling JS, "Retinal branch vein occlusion: a study of argon laser photocoagulation in the treatment of macular oedema", Br J Ophthalmol, 68, pp.196~198 (1984)
- Son MH, "Macular ischemia in temporal branch retinal vein occlusion: fluorescein angiographic classification and visual prognosis", J Korean Ophthalmol Soc, 37, pp.608~613 (1996)
- Finkelstein D, "Ischemic macular edema. Recognition and favorable natural history in branch vein occlusion", Arch Ophthalmol, 110, pp.1427~1434 (1992)
- Chen SD, "Intravitreal triamcinolone for the treatment of ischemic macular edema associated with branch retinal vein occlusion", Am J Ophthalmol, 141, pp.876~883 (2006)
- "Classification of diabetic retinopathy from fluorescein angiograms. ETDRS report number 11. Early Treatment Diabetic Retinopathy Study Research Group", Ophthalmology, 98, pp.807~822 (1991)
- Shukla D, "Macular ischaemia as a marker for nephropathy in diabetic retinopathy", Indian J Ophthalmol, 52, pp.205~210 (2004)
- Min WK, "The natural course and visual prognosis of branch retinal vein occlusion", J Korean Ophthalmol Soc, 35, pp.664~672 (1994)