망막분지정맥폐쇄에 합병된 황반부종에서 유리체강내 베바시주맙 주입술이 삶의 질에 미치는 영향
Impact of Intravitreal Bevacizumab Injection on Life Quality in Patients with Branch Retinal Vein Occlusion
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목적: 망막분지정맥폐쇄로 인한 황반부종 환자에서 bevacizumab을 이용한 치료가 시력과 관련된 삶의 질에 미치는 효과를 알아보고자 하였다. 대상과 방법: 망막분지정맥폐쇄로 인한 황반부종으로 bevacizumab 안내주입술을 받은 32명을 대상으로 시술 전과 시술 3개월 후,최대교정시력, 빛간섭단층촬영, 한국어판 미국 국립안연구센터 시각기능 설문지 25를 이용한 설문조사를 시행하여 그 변화를 관찰하였다. 결과: Bevacizumab 주입 후 3개월째 최대교정시력과 중심황반두께, 황반부용적은 치료 전과 비교하여 유의하게 호전되었다. 설문조사에서는 총점이 유의하게 증가하였으며, 세부항목별로는 전반적 시력, 근거리 시력, 원거리 시력, 사회적 기능, 정신 건강, 역할의제한, 의존성, 주변부 시력은 유의하게 호전되었고, 전반적인 건강, 눈 통증, 운전과 색각 면에서는 유의한 차이를 보이지 않았다. 결론: 망막분지정맥폐쇄에 합병된 황반부종에서 bevacizumab 주입술은 황반부종을 감소시켜 시력뿐만 아니라 시력과 관련된 삶의질도 효과적으로 향상시켰다. 그러나 다른 세부항목에 비해 운전과 색각에 관련된 삶의 질은 상대적으로 회복 속도가 느린 것을 알수 있다.
Abstract
Purpose: To evaluate the impact of intravitreal bevacizumab injection on visual function and vision-related quality of life (VR-QOL) in patients with branch retinal vein occlusion (BRVO) using the Korean version of the National Eye Institute Visual Function Questionnaire 25 (K-NEI-VFQ-25). Methods: This study included 32 normal control subjects and 32 patients with BRVO. The Korean version of NEI-VFQ-25was answered by the patients with BRVO before and 3 months after intravitreal bevacizumab injection, as well as by normal control subjects. Clinical data were collected, including central macular thickness (CMT), total macular volume (TMV)(using time-domain optical coherence tomography [OCT]), and best corrected visual acuity (BCVA). Results: Visual acuity, CMT, and TMV significantly improved 3 months after intravitreal bevacizumab injections. No bevacizumab-related systemic or ocular adverse effects following intravitreal drug injections were observed. Significant improvement in the VFQ-25 composite score was observed in patients with BRVO. Subscale scores, including general vision, near activities, distance activities, social functioning, mental health, role difficulties, dependency, and peripheral vision, improved after injection. However, subscale scores regarding general health, ocular pain, driving, and color vision did not improve significantly. Conclusions: Intravitreal bevacizumab injection appears to be an effective treatment for visual function, as well as VR-QOL in macular edema secondary to BRVO. However, improvement of driving function and color vision appears to require a longer recovery time than visual function.
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