맥락막신생혈관을 동반한 삼출성 나이관련황반변성 환자에서 광역학치료 후 10년간의 경과관찰
Photodynamic Therapy of Choroidal Neovascularization in Age-Related Macular Degeneration with Verteporfin: An Analysis of 10 Years of Clinical Results
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초록
목적: 맥락막신생혈관을 동반한 삼출성 나이관련황반변성 환자에서 광역학치료 후 10년간 임상양상의 변화 및 예후인자를 알아보고자하였다. 대상과 방법: 본원에서 맥락막신생혈관을 동반한 나이관련황반변성으로 광역학치료를 처음 시행 받은 후 10년 이상 추적관찰하였던 환자들의 의무기록을 후향적으로 조사하여, 나이, 최대교정시력, 맥락막신생혈관의 위치 및 형태, 광역학치료 시행횟수 등을 분석하였다. 결과: 29명 29안을 대상으로 하였으며 환자들의 평균연령은 63.5 ± 7.4세였다. 광역학치료 전 평균시력은 0.78 ± 0.34 (logMAR)이었다. 맥락막신생혈관의 형태는 우세전형적, 소수전형적, 숨은 맥락막신생혈관이 각각 51.7%, 17.2%, 31.1%이었고, 10년의 경과관찰 시한 줄 이상 시력이 호전된 경우는 27.6%, 유지된 경우 20.7%, 저하된 경우 51.7%이었다. 나이와 치료 전 시력은 시력예후와 연관이있는 것으로 나타났다(p＜0.05). 결론: 나이관련황반변성은 광역학치료 후 10년간의 경과를 관찰하였을 때 광역학치료는 안전하고 비교적 효과적인 치료이며 안정적이되었더라도 언제든지 재발 가능함으로 지속적인 경과관찰이 필요하다.
Abstract
Purpose: To analyze the long-term results of photodynamic therapy (PDT) for exudative age-related macular degeneration (AMD). Methods: The clinical data of patients treated with photodynamic therapy for exudative age-related macular degeneration between April 2000 and December 2000 were analyzed. Patients were followed-up for at least 10 years after PDT. Results: Twenty-nine eyes of 29 patients were enrolled. Mean visual acuity on the logarithm of the minimum angle of resolution (log MAR) scale was 0.78 ± 0.34 at baseline, 1.01 ± 0.42 at 60 months, and 1.02 ± 0.41 at 120 months. Predominantly classic, minimally classic, and occult without classic choroidal neovascularization was noted in 51.7%, 17.2%, and 31.1%of patients, respectively. Visual acuity was improved by 1 or more lines in 27.6% of patients and was unchanged in 20.7%of patients, while 51.7% of patients had lost 1 or more lines of visual acuity by 120 months. Baseline visual acuity and age were associated with the final visual prognosis (p < 0.05). Four patients developed neovascular AMD in the contralateral eye. Conclusions: PDT is safe and effective for neovascular AMD. However, AMD can recur at any time and thus patients should be followed-up for a long period of time.
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