황반부종이 합병된 망막분지정맥폐쇄에서 자연경과와 유리체강내 트리암시놀론 주입술의 결과 비교
Comparison of the Natural Course and Intravitreal Triamcinolone Treatment for Macular Edema with Branch Retinal Vein Occlusion
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목적: 황반부종이 합병된 망막분지정맥폐쇄의 자연경과를 살펴보고 유리체강내 트리암시놀론 주입술을 시행한 환자군과 시력 및 황반두께 변화를 비교분석하였다. 대상과 방법: 황반부종이 합병된 망막분지정맥폐쇄 환자들 중 1년 이상 추적관찰이 가능하였던 환자의 의무기록을 후향분석하였다. 자연경과군의 시력 및 황반두께의 경과를 살펴보고 유리체강내 트리암시놀론 주입술(치료군)과 비교하였다. 결과: 자연경과군 29안, 치료군 27안으로 자연경과군은 서서히 시력이 호전되어 12개월째부터 유의한 시력호전이 관찰되었으나 치료군은 관찰기간 내내 유의한 시력호전을 보이지 않아 6개월 이후부터는 자연경과군이 치료군에 비해 유의하게 시력이 좋았다. 황반두께는자연경과군에서 3개월, 치료군에서는 주사 후 1개월째부터 유의한 감소를 보였다. 주사 후 1개월째는 치료군이 유의하게 황반두께의감소를 보였으나 6개월 이후부터는 자연경과군이 치료군에 비해 유의한 황반두께의 감소를 보였다. 결론: 황반부종이 합병된 망막분지정맥폐쇄의 자연경과는 유리체강내 트리암시놀론 주입술을 시행한 경우에 비해 황반두께의 감소의시작은 늦지만, 지속적인 황반두께의 감소와 시력호전으로 6개월 이후부터는 치료군에 비해 더 좋은 결과를 보였다.
Abstract
Purpose: To evaluate the natural course of eyes with decreased visual acuity associated with macular edema secondary to branch retinal vein occlusion (BRVO) and to compare the visual outcome and macular thickness with those of eyes treated with intravitreal triamcinolone acetonide injection (IVTA). Methods: We reviewed the medical records of patients with macular edema secondary to BRVO who were followed-up for 12 months. We evaluated the best corrected visual acuity (BCVA) and macular thickness of the patients who had no treatment for macular edema (natural course group) and compared them with those of patients who had been treated with IVTA (treatment group). Results: A total of 29 eyes (29 patients) in the natural course group and 27 eyes (27 patients) in the treatment group were enrolled. The BCVA of the natural course group improved in a slow but steady manner and showed a statistically significant difference at 12 months. The treatment group did not show any improvement in BCVA throughout the follow-up period. Therefore, BCVA significantly improved in the natural course group after six months compared to that in the treatment group. Macular thickness showed a statistically significant reduction in three months in the natural course group and in one month in the treatment group. Conclusions: Although IVTA was effective in reducing macular edema in branch retinal vein occlusion at one month after administration, the natural course group had a superior outcome and more improved macular thickness after six months.
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