망막중심정맥폐쇄에 동반된 황반부종에서 라니비주맙 주입술의 단기 임상 효과
The Short-Term Efficacy of Intravitreal Ranibizumab for Macular Edema in Central Retinal Vein Occlusion
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목적: 망막중심정맥폐쇄에 동반된 황반부종에서 유리체강내 라니비주맙 주입술의 단기 효과를 알아보고자 하였다. 대상과 방법: 망막중심정맥폐쇄에 동반된 황반부종으로 라니비주맙 주입술을 시행받은 17명, 17안(비허혈성 11안, 허혈성 6안)을 후향적으로 조사하여, 시술 전 후 최대교정시력, 중심황반두께의 변화를 분석하였다. 결과: 전체 환자에서 평균시력(logMAR)은 시술 후 4주째 0.78 ± 0.49, 12주째 0.81 ± 0.52로 각각 시술 전 1.25 ± 0.47보다 유의한향상이 있었다(p＜0.05). 중심황반두께는 시술 후 4주째 224.4 ± 129.9 μm, 12주째 271.6 ± 174.1 μm로, 시술 전 679.4 ± 230.5 μm보다 유의한 감소를 보였다(p＜0.001). 비허혈성군과 허혈성군 모두에서 시술 후 12주째 유의한 중심황반두께의 감소를 보였으나,허혈성군에서는 시술 후 12주째 시력향상이 유의하지 않았다(p=0.138). 10명(58.8%)의 환자는 1번의 주입술로 황반부종이 호전되어12주간 유지되었다. 결론: 라니비주맙 유리체강내 주입술은 망막중심정맥폐쇄에서 황반부종의 감소와 시력회복을 기대할 수 있는 유용한 치료로 사료된다.
Abstract
Purpose: To evaluate the short-term efficacy of intravitreal ranibizumab injection in eyes with macular edema secondary to central retinal vein occlusion (CRVO). Methods: The records of 17 patients (17 eyes, 11 ischemic, six ischemic) who received an intravitreal ranibizumab injection for macular edema secondary to CRVO were retrospectively analyzed. The ophthalmic examination included best corrected visual acuity (BCVA) and central macular thickness (CMT) at baseline and follow-up visits. Results: After intravitreal ranibizumab injection, the mean BCVA improved from log MAR 1.25 ± 0.47 at baseline to log MAR 0.78 ± 0.49 at 4 weeks and to log MAR 0.81 ± 0.52 at 12 weeks (p < 0.05). Additionally, the mean CMT decreased from 679.4 ± 230.5 μm at baseline to 224.4 ± 129.9 μm at 4 weeks and to 271.6 ± 174.1 μm at 12 weeks (p < 0.001). In subgroup analysis, the decreases in CMT at 4 weeks and 12 weeks were similar in ischemic CRVO and non-ischemic CRVO, but no significant changes in visual acuity were found at 12 weeks in the ischemic CRVO group (p = 0.138). Ten eyes (58.8%) did not require re-injections for macular edema for up to 12 weeks. Conclusions: Intravitreal ranibizumab injection appeared to be an effective option for the treatment of macular edema secondary to central retinal vein occlusion.
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