유리체강 내 베바시주맙이 각막내피세포에 미치는 영향
Corneal Endothelial Change After Intravitreal Bevacizumab Injection
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목적: 유리체강 내 bevacizumab 주입술 후 각막내피세포의 변화를 알아보고자 하였다. 대상과 방법: 본원 안과에서 유리체강 내 bevacizumab 주입술을 시행 받은 환자 28명 30안을 대상으로 술 후 1개월과 3개월에 각막내 피세포의 변화를 경면현미경을 이용하여 전향적으로 비교하였으며, 1회 주입안(1군)과 2회 이상 주입안(2군)으로 나누어 주입 횟수에 따른 차이를 분석하였다. 결과: 전체 환자군에서 각막내피세포수는 술 전 2497.4 ± 427.8에서 술 후 1개월에 2421.2 ± 430.5, 3개월에 2362.7 ± 366.2로 통계 적으로 유의한 변화를 보이지 않았다(p = 0.719). 1군과 2군 각각에서도 각막내피세포수는 감소하는 경향을 보이긴 하였으나 유의하지 는 않았다(p = 0.987, p = 0.332). 또한 1군에 비해 2군에서 각막내피세포수의 감소가 더 컸으나 두 군간에 유의한 차이를 보이지는 않았다. 세포변이계수나 육각세포비율은 술 전과 비교 시 유의한 변화가 없었다. 결론: 유리체강 내 bevacizumab 주입술은 각막내피세포에 유의한 변화를 가져오지 않았으며, 주입횟수에 따른 차이 역시 유의하지 않았다.
Abstract
Purpose: To evaluate the in vivo corneal endothelial changes after intravitreal bevacizumab (Avastin®; Genentech Inc., San Francisco, California, USA) injection. Methods: A total of 30 eyes of 28 patients who received intravitreal bevacizumab injections were included in the present study. Before injection and one and three months after injection, specular microscopy was performed to analyze the corneal endothelial cell changes. In order to compare the differences in the changes of corneal endothelial cells, the eyes were divided into two groups, a single injection group and a multiple injection group. Results: The mean endothelial cell count decreased from 2,497.4 ± 427.8 at baseline to 2,421.2 ± 430.5 at one month and to 2,362.7 ± 366.2 at three months after the injection in all patients. However, the change in endothelial cell count was not statistically significant. In addition, the postoperative change in endothelial cell count was more prominent in the multiple injection group than in the single injection group, although the difference was again not significant. No significant changes in preoperative or postoperative coefficients of variation for cell area or hexagonalities were observed in either patient group or within each group. Conclusions: There was no significant change in corneal endothelial cells after intravitreal bevacizumab injection. In addition, there was no significant difference in the changes in corneal endothelial cells according to the number of bevacizumab injections.
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