망막분지정맥폐쇄에서 황반부종 형태에 따른 유리체강내 베바시주맙 주입술 효과와 주입횟수 비교
Effects of Intravitreal Bevacizumab Injection in 3 Types of Macular Edema Secondary to Branch Retinal Vein Occlusion
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목적: 빛간섭단층촬영 소견으로 망막분지정맥폐쇄에 병발한 황반부종을 분류하여 유리체강내 주입술의 효과를 비교하고자 한다. 대상과 방법: 2007년 8월부터 2009년 3월까지 망막분지정맥폐쇄에 병발한 황반부종으로 진단받고 유리체강내 베바시주맙 주입술을시행 받은 후 1년 이상 추적관찰이 가능했던 환자를 후향적으로 조사하여 황반부종을 전반적인 황반부종(1형), 낭포성 황반부종(2형),장액성 망막박리(3형) 등 3가지 형태로 분류하고 시술 후 1개월, 3개월, 6개월, 1년의 최대교정시력과, 황반두께, 안정화까지 시행된주입횟수를 비교하였다. 결과: 총 41명 41안 중 1형 11안, 2형 16안 3형 14안이 대상에 포함되었다. 안정화되기까지 필요했던 주입횟수는 2형과 3형 간에 유의한주입횟수의 차이를 보였고(p=0.02), 2형과 3형 간에 술후 1년째 유의한 황반두께 변화량의 차이를 나타냈다(p=0.03). 모든 형태에서술 후 1년 유의한 황반두께의 감소를 보였다. 고찰: 망막분지정맥폐쇄에 의한 황반부종에서 3형보다 2형에서 많은 주입술이 필요하며, 주입술의 효과를 예측하는 데 황반부종의 형태학적 분류가 도움이 될 것으로 생각한다.
Abstract
Purpose: To compare the effects of intravitreal bevacizumab injection (IVB) in 3 types of macular edema secondary to branch retinal vein occlusion (BRVO). Methods: Patients with macular edema secondary to BRVO with at least 1-year follow-up after IVB were included in the present retrospective study. The authors classified the macular edema into 3 types according to OCT findings: diffuse macular edema (type 1), cystoid macular edema (type 2), and serous retinal detachment (type 3). The clinical outcome indicators were best corrected visual acuity, central macular thickness (CMT), and total number of injections. Results: The total injection number was significantly higher in type 2 than type 3 (p = 0.02). Changes in CMT were significantly different between type 2 and type 3 (p = 0.03). CMT decreased significantly after IVB in all types of macular edema. Conclusions: Morphologic classification of macular edema with OCT is useful for predicting efficacy of IVB in macular edema secondary to BRVO.
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