만성 B형 간염에서의 페그인터페론 치료 시 망막병증의 임상양상
Clinical Features of Retinopathy in Chronic Hepatitis B Patients With Treated With Peginterferon
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
목적: 만성 B형 간염 환자에서 페그인터페론(Peginterferon) 치료 시 발생하는 망막병증의 임상양상을 알아보고자 하였다. 대상과 방법: 본원에서 만성 B형 간염으로 페그인터페론 치료를 시행받은 환자를 대상으로 치료 전과 치료 시작 후 1년까지 안저검사를 비롯한 정기적인 안과검진을 시행하였으며 검사를 완료한 총 88명의 환자를 대상으로 분석하였다. 결과: 11명(12.5%)에서 치료 시작 후 평균 7주에 망막병증을 관찰하였다. 면화반, 망막출혈, 미세혈관류를 비롯한 망막이상은 페그인터 페론 치료 유지에도 시력저하 없이 모두 저절로 호전되었다. 고혈압의 빈도만이 망막증을 보인 군과 안 보인 군 사이에 유의한 차이를 보였다(p=0.020). 결론: 만성 B형 간염환자에서 페그인터페론 치료 시 발생하는 망막병증의 빈도는 낮으며 경과는 양호하므로 일괄적인 안과검진은 필요 하지 않다.
Abstract
Purpose: To evaluate the clinical features of retinopathy in chronic hepatitis B patients treated with peginterferon. Methods: Chronic hepatitis B patients treated with peginterferon were evaluated during regular routine ophthalmic examinations including fundus examination before and during the 1-year follow-up after treatment. A total of 88 patients were included in the study. Results: Retinopathy developed in 11 (12.5 %) out of 88 patients at a mean of 7 weeks after initiation of treatment. Peginterferon treatment was continued in all patients and retinal abnormalities including cotton wool spot, retinal hemorrhage and microaneurysm resolved without visual impairment. The incidence of hypertension between the retinopathy group and the group without retinopathy was significantly different (P = 0.020). Conclusions: The incidence of retinopathy with peginterferon in chronic hepatitis B patients was low and the prognosis was benign. Thus, routine screening for peginterferon retinopathy is not necessary.
참고문헌 (26)
- Chae HB, "status of liver diseases in Korea", Korean J Hepatol, 15, pp.13~24 (2009)
- 신정우, "만성 B형 간염 치료", 대한내과학회지, 77(3), pp.265~274 (2009), 대한내과학회
- Okuno H, "Interferon associated retinopathy", Nippon Rinsho, 52, pp.1919~1923 (1994)
- Kawano T, "Retinal complications during interferon therapy for chronic hepatitis C", Am J Gastroenterol, 91, pp.309~313 (1996)
- Wilkins T, "diagnosis and treatment", Am Fam Physician, 81, pp.965~972 (2010)
- Lim JW, "Pegylated-Interferon-Associated Retinopathy in Chronic Hepatitis Patients", OPHTHALMOLOGICA, 224(4), pp.224~229 (2010), KARGER
- d'Alteroche L, "Ophthalmologic side effects during alpha interferon therapy for viral hepatitis", Hepatology, 44, pp.56~61 (2006)
- 강희영, "만성 간염환자에서의 페기레이티드 인터페론 망막증", 대한안과학회지, 50(3), pp.383~389 (2009), 대한안과학회
- Hayasaka S, "Interferon associated retinopathy", Br J Ophthalmol, 82, pp.323~325 (1998)
- Bedossa P, "An algorithm for the grading of activity inchronic hepatitis C", Hepatology, 24, pp.289~293 (1996), The METAVIR Cooerative Study Group
- Malik NN, "A prospective study of change in visual function in patients treated with pegylated interferon alpha for hepatitis C in the UK", Br J Ophthalmol, 92, pp.256~258 (2008)
- Ogata H, "Pegylated interferon associated retinopathy in chronic hepatitis C patients", Jpn J Ophthalmol, 50, pp.293~295 (2006)
- "Retinal vein thrombosis associated with pegylated-interferon and ribavirin combination therapy for chronic hepatitis C", World J Gastroenterol, 12, pp.4908~4910 (2006)
- Goncalves LL, "Branch retinal vein thrombosis and visual loss probably associated with pegylated interferon therapy of chronic hepatitis C", World J Gastroenterol, 12, pp.4602~4603 (2006)
- Wei YH, "Anterior ischemic optic neuropathy associated with pegylated interferon therapy for chronic hepatitis C", Ocul Immunol Inflamm, 17, pp.191~194 (2009)
- Cuthbertson FM, "Is screening for interferon retinopathy in hepatitis C justified", Br J Ophthalmol, 88, pp.1518~1520 (2004)
- Nadir A, "Retinal vein thrombosis associated with chronic hepatitis C", J Viral Hepat, 7, pp.466~470 (2000)
- Chisholm JA, "Retinal toxicity during pegylated alpha-interferon therapy for chronic hepatitis C:", Aliment Pharmacol Ther, 21, pp.723~732 (2005)
- Guyer DR, "Interferon associated retinopathy", Arch Ophthalmol, 111, pp.350~356 (1993)
- Andrade RJ, "Vascular ophthalmological side effects associated with antiviral therapy for chronic hepatitis C are related to vascular endothelial growth factor levels", Antivir Ther, 11, pp.491~498 (2006)
- Pawlotsky JM, "Immunological disorders in C virus chronic active hepatitis", Hepatology, 19, pp.841~848 (1994)
- Nagaoka T, "Retinal circulatory changes associated with interferon induced retinopathy in patients with hepatitis C", Invest Ophthalmol Vis Sci, 48, pp.368~375 (2007)
- Fried MW, "Side effects of therapy of hepatitis C and their management", Hepatology, 36, pp.237~244 (2002)
- Kim ET, "Retinopathy in hepatitis C patients due to combination therapy with pegylated interferon and ribavirin", JAPANESE JOURNAL OF OPHTHALMOLOGY, 53(6), pp.598~602 (2009), ELSEVIER SCIENCE INC
- Jain K, "Retinopathy in chronic hepatitis C patients during interferon treatment with ribavirin", Br J Ophthalmol, 85, pp.1171~1173 (2001)
- Tu KL, "Severe interferon associated retinopathy", Br J Ophthalmol, 87, pp.247~248 (2003)