당뇨황반부종에서 안내 베바시주맙 치료 후 빛간섭단층촬영을 이용한 망막 혈관 직경의 변화
Retinal Vascular Caliber Changes on OCT after Intravitreal Bevacizumab Injection in Diabetic Macular Edema
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목적: 빛간섭단층촬영(OCT)을 이용하여 당뇨황반부종 환자에서 안내 베바시주맙(Bevacizumab) 주사 후 망막 혈관 직경의 변화를 알아보았다. 대상과 방법: 당뇨황반부종으로 1.25 mg/0.05 ml 안내 베바시주맙 주사를 받은 환자 29명, 34안을 대상으로 하였으며 주사를 시행한눈의 반대안 24안을 대조군으로 하였다. 주사 전, 주사 후 1개월 및 3개월에 빛간섭단층촬영을 이용하여 중심황반두께 및 망막 혈관의직경을 0.5-1유두직경 떨어진 동일한 지점에서 측정하였다. 결과: 소동맥의 직경은 치료 3개월 후에 유의하게 감소하였다(p=0.024). 소정맥의 직경은 치료 1개월 후(p=0.001), 치료 3개월 후 모두의미 있게 감소된 값을 보였다(p=0.000). 치료 3개월 후 소정맥 직경의 감소치는 중심황반두께의 감소치와 유의한 상관관계를 보였다(R=0.487, p=0.003). 결론: 안내 베바시주맙 주사 후 소동맥, 소정맥 모두에서 직경이 감소하였으며, 치료 3개월 후 소정맥 직경의 감소된 정도는 중심황반두께의 감소치와 유의한 상관관계를 보였다.
Abstract
Purpose: To investigate retinal vascular caliber changes with Spectral Domain OCT after intravitreal bevacizumab injection in diabetic macular edema patients Methods: Thirty-four eyes of 29 diabetic macular edema patients who were intravitreously injected with bevacizumab (1.25g/0.05 ml) were studied. Twenty-four fellow eyes of 24 patients with bevacizumab injection were also recruited as a control group. We measured retinal vascular caliber a distance of 0.5-1 disc sizes from the disc margin with Spectral Domain OCT at baseline and 1-month and 3-month follow-up visits. Central macular thicknesses were also measured. Results: Over the 3 months of study, there was a significant reduction of arteriolar caliber compared to baseline (p = 0.024),There was significant reduction of venular caliber at 1 month (p = 0.001) and 3 months (p = 0.000) compared to baseline. Venular caliber reduction at the 3-month follow-up was significantly correlated with central macular thickness (R = 0.487,p = 0.003). Conclusions: Retinal venular caliber reduction was significant at 1- and 3-month follow-up, and arteriolar caliber reduction was significant at 3-month follow-up compared to baseline. After 3 months of treatment, venular caliber reduction was correlated with reduction of central macular thickness.
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