절반망막정맥폐쇄 황반부종에서의 유리체강내 베바시주맙의 효과와 전방수내 사이토카인 농도
Intravitreal Bevacizumab for Treatment of Macular Edema Secondary to Hemicentral Retinal Venous Occlusion and Concentrations of Cytokine in Aqueous Humor
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목적: 절반망막정맥폐쇄에 의한 황반부종에서 유리체강내 Bevacizumab 주입술의 효과와 전방수내 사이토카인 농도에 대해 알아보고자 하였다. 대상과 방법: 절반망막정맥폐쇄로 인한 황반부종으로 유리체강내 Bevacizumab 주입술을 시행 받은 15명, 15안을 대상으로 12개월 이상 경과관찰을 시행하였다. 유리체강내 주입술 시 전방수를 채취해 multiplex bead assay를 시행하여 대조군과 전방수내 사이토카인 농도를 비교하였다. 결과: 12개월의 경과관찰 기간 동안 평균 4.5회의 유리체강내 주입술이 시행되었으며 12개월후 시력과 중심황반두께 모두 유의하게 호전되었다(p=0.028, p=0.000). 전방수에서 대조군에 비하여 Interleukin-6, vascular endothelial growth factor, monocyte chemoattractant protein-1이 유의하게 높게 측정되었다(p=0.010, p=0.045, p＜0.001). 결론: 절반망막정맥폐쇄에서 전방수내 증가된 사이토카인 농도를 확인할 수 있었으며 유리체강내 Bevacizumab 주입술은 황반부종의 감소 및 유의한 시력호전을 이룰 수 있었다.
Abstract
Purpose: To evaluate the effects of intravitreal bevacizumab and to investigate the concentrations of cytokine in the aqueous humors of patients with macular edema secondary to hemicentral retinal venous occlusion. Methods: Fifteen eyes of 15 patients with macular edema secondary to hemicentral retinal venous occlusion received intravitreal bevacizumab injections and completed 12 months of follow-up. Cytokine levels were measured in the aqueous humors of these patients using a multiplex bead assay and the levels were compared with those of the controls. Results: During 12 months of follow-up, a mean of 4.5 intravitreal bevacizumab injections were performed. The visual acuity and the central macular thickness improved significantly (p = 0.028, p = 0.000) after treatment. The levels of interleukin- 6, vascular endothelial growth factor, and monocyte chemoattractant protein-1 were increased in the aqueous humor compared with the levels in the control group (p = 0.010, p = 0.045, p < 0.001). Conclusions: Elevated cytokine levels were identified in the aqueous humor after hemicentral retinal venous occlusion. Intravitreal bevacizumab injections were effective for improvements in visual acuity and macular edema due to hemicentral retinal venous occlusion.
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