당뇨망막병증에서 나비라스 레이저 시스템과 기존 범망막광응고술의 소요시간과 통증 비교
Comparison of the Time Required for Panretinal Photocoagulation and Associated Pain between Navilas® and Conventional Laser Therapy in Diabetic Retinopathy
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목적: 당뇨망막병증에서 NavilasⓇ (OD-OS, Teltow, Germany)와 기존의 레이저를 이용하여 범망막광응고술 시 통증 정도와 소요시간을 비교하고자 한다. 대상과 방법: 범망막광응고술이 필요한 증식성 당뇨망막병증 환자 15명 15안을 대상으로 하였다. 먼저 NavilasⓇ로 망막의 상측, 비측,하측에 패턴 방식(5×5)을 이용하여 광응고술을 시행하였고 1주 뒤 기존의 광응고술을 이측에 시행하였다. 각각의 레이저에서 처음광응고반을 만들기 시작한 순간부터 마지막 광응고반을 만들기까지 소요시간과 총 레이저 횟수를 구하여 100회당 소요시간을 구하였다. 또, 각 레이저 시술이 끝난 직후 통증이 없는 상태를 0, 가장 심할 때를 10으로 하는 시각화 통증 척도(Visual analog pain scale)를 이용하여 환자에게 통증의 정도를 답하도록 하였다. 결과: NavilasⓇ를 이용한 범망막광응고술은 기존의 광응고술에 비해 광응고반 100회당 소요시간이 유의하게 짧았고(27.7초 vs 102.0초, p＜0.001) 통증의 정도도 적었다(3.3 vs 6.9, p＜0.001). 결론: NavilasⓇ를 이용한 범망막광응고술은 기존의 광응고술에 비해 빠르고 환자의 통증이 적어 환자와 시술자의 편리함을 높일 수있는 효과적인 방법으로 생각한다.
Abstract
Purpose: To compare the pain scale and time necessary for panretinal photocoagulation (PRP) between Navilas® (OD-OS,Teltow, Germany) and conventional laser in diabetic retinopathy. Methods: Fifteen patients who required PRP for diabetic retinopathy were enrolled in the present study. PRP was performed usingNavilas® (5 x 5 array patterned system) in the superior, nasal and inferior areas, and using conventional laser at the temporalarea 1 week later. Total time of laser application and number of laser shots were counted for calculating required time per 100spots of each laser system. Immediately after the laser photocoagulation, patients were asked to quantify their pain on a visualanalog pain scale (0 = no pain; 10 = worst pain). Results: PRP using Navilas® required shorter time per 100 laser spots (27.7 sec vs. 102.0 sec, p < 0.001) and subjects had lowertreatment-related pain than with the conventional laser system (3.3 vs. 6.9, p < 0.001). Conclusions: PRP using Navilas® can be considered as an efficient method for improving patient and operator’s comfort withfaster laser application and lower treatment-related pain.
참고문헌 (17)
- Kernt M, "Pain and accuracy of focal laser treatment for diabetic macular edema using a retinal navigated laser (Navilas)", Clin Ophthalmol, 6, pp.289~296 (2012)
- Nakamura Y, "Functional and morphological changes of macula after subthreshold micropulse diode laser photocoagulation for diabetic macular oedema", Eye(Lond), 24, pp.784~788 (2010)
- Bolz M, "In vivo retinal morphology after grid laser treatment in diabetic macular edema", Ophthalmology, 117, pp.538~544 (2010)
- Chhablani J, "A novel navigated laser system brings new efficacy to the treatment of retinovascular disorders", Oman J Ophthalmol, 6, pp.18~22 (2013)
- Chalam KV, "Evaluation of a novel, non contact, automated focal laser with integrated (NAVILAS) fluorescein angiography for diabetic macular edema", Middle East Afr J Ophthalmol, 19, pp.158~162 (2012)
- Kozak I, "Clinical evaluation and treatment accuracy in diabetic macular edema using navigated laser photocoagulator NAVILAS", Ophthalmology, 118, pp.1119~1124 (2011)
- Neubauer AS, "Navigated macular laser decreases retreatment rate for diabetic macular edema: a comparison with conventional macular laser", Clin Ophthalmol, 7, pp.121~128 (2013)
- Ober MD, "Time required for navigated macular laser photocoagulation treatment with the Navilas", Graefes Arch Clin Exp Ophthalmol, 251, pp.1049~1053 (2013)
- MeyerSchwickerath G., "Light coagulation; a method for treatment and prevention of the retinal detachment", Albrecht Von Graefes Arch Ophthalmol, 156, pp.234~ (1954)
- "Photocoagulation treatment of proliferative diabetic retinopathy. Clinical application of Diabetic Retinopathy Study (DRS) findings, DRS Report Number 8. The Diabetic Retinopathy Study Research Group", Ophthalmology, 88, pp.583~600 (1981)
- "Treatment techniques and clinical guidelines for photocoagulation of diabetic macular edema. Early Treatment Diabetic Retinopathy Study Report Number 2. Early Treatment Diabetic Retinopathy Study Research Group", Ophthalmology, 94, pp.761~774 (1987)
- Pahor D, "Visual field loss after argon laser panretinal photocoagulation in diabetic retinopathy: full- versus mild-scatter coagulation", Int Ophthalmol, 22, pp.313~319 (1998)
- Lewis H, "Choroidal neovascularization after laser photocoagulation for diabetic macular edema", Ophthalmology, 97, pp.503~510 (1990)
- Yuki T, "Ciliary body and choroidal detachment after laser photocoagulation for diabetic retinopathy. A high-frequency ultrasound study", Ophthalmology, 104, pp.1259~1264 (1997)
- Kernt M, "Focal and panretinal photocoagulation with a navigated laser (NAVILAS®)", Acta Ophthalmol, 89, pp.e662~e664 (2011)
- Kozak I, "Focal navigated laser photocoagulation in retinovascular disease: clinical results in initial case series", Retina, 32, pp.930~935 (2012)
- 양지욱, "당뇨망막병증에서 패턴 범망막광응고술과 기존 범망막광응고술과의 치료 효과 비교", 대한안과학회지, 51(12), pp.1590~1597 (2010), 대한안과학회