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증식성 당뇨망막병증의 유리체절제술 후 신생혈관녹내장 발생의 예측 인자: 양안 비교 연구

Prognostic Factors for Neovascular Glaucoma after Vitrectomy in Eyes with Proliferative Diabetic Retinopathy

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목적: 증식성 당뇨망막병증 환자에서 유리체절제술 후 신생혈관 녹내장 발생의 예측 인자를 알아보고자 하였다. 대상과 방법: 2008년 3월부터 2014년 5월까지 증식성 당뇨망막병증으로 양안 유리체절제술을 시행 받은 후 단안에만 신생혈관 녹내장이 발생한 14명 28안에 대해 신생혈관이 발생한 안과 발생하지 않은 안의 양안 비교를 통한 후향적 연구를 함으로써 당뇨망막병증의 유리체절제술 후 신생혈관 녹내장 발생에 영향을 줄 수 있는 여러 가지 개인적인 혼란 변수를 배제하여 증식성 당뇨망막병증의유리체절제술 후 신생혈관 녹내장 발생의 예측 인자에 대하여 알아보았다. 대상 환자들의 신생혈관 녹내장 발생안과 발생하지 않은안 간의 임상적 특징 및 술 전, 술 중, 술 후 소견에 대해 Wilcoxon matched-pairs signed-rank test와 Chi-square test를 이용하여비교하였다. 결과: 술 전 시행한 망막 전위도 검사에서 명순응하 추체반응의 b파 진폭은 신생혈관이 발생한 안에서 유의하게 감소하였다(p<0.05). 결론: 술 전 시행한 전체 망막전위도 검사에서 명순응하 추체반응 b파의 진폭이 감소된 경우 유리체절제술 후 신생혈관 녹내장의발생 가능성이 높으므로 면밀한 관찰이 필요하다.

Abstract

Purpose: To investigate the prognostic factors for neovascular glaucoma after vitrectomy in eyes with proliferative diabetic retinopathy. Methods: In the present study we retrospectively reviewed intraindividual and interocular differences in 14 patients (28 eyes) who underwent pars plana vitrectomy for proliferative retinopathy with vitreous hemorrhage and having only 1 eye neovascular glaucoma. The patients underwent vitrectomy between March 2008 and July 2014 at Maryknoll Hospital. The patient clinical data on preoperative, intraoperative and postoperative factors were compared. Statistical analysis was performed using the Wilcoxon matched-pairs signed-rank (Mann-Whitney) test and chi-square test to evaluate the significance of differences within the patient groups. Results: The decrease of photopic b-wave amplitudes on the preoperative electroretinogram significantly correlated with the development of neovascular glaucoma after vitrectomy for proliferative retinopathy with vitreous hemorrhage (p > 0.05). Conclusions: Based on the results from the present study, decreased photopic b-wave amplitudes on preoperative electroretinogram is an effective prognostic factor for the development of neovascular glaucoma after vitrectomy for proliferative retinopathy with vitreous hemorrhage.

참고문헌 (38)

  1. Machemer R., "Vitrectomy : a pars plana approach", Trans Am Acad Ophthalmol Otolaryngol, 75, pp.813~820 (1971)
  2. "Early vitrectomy for severe proliferative diabetic retinopathy in eyes with useful vision. Clinical application of results of a randomized trial-Diabetic Retinopathy Vitrectomy Study Report 4. The Diabetic Retinopathy Vitrectomy Study Research Group", Ophthalomology, 95, pp.1321~1334 (1988)
  3. "Early vitrectomy for severe proliferative diabetic retinopathy in eyes with useful vision. Results of a randomized trial-Diabetic Retinopathy Vitrectomy Study Report 3. The Diabetic Retinopathy Vitrectomy Study Research Group", Ophthalomology, 95, pp.1307~1320 (1988)
  4. Aaberg TM., "Late complication of pars plana vitreous surgery", Ophthalmology, 85, pp.126~140 (1978)
  5. John T., "The myofibroblastic component of rubeosis iridis", Ophthalmology, 90, pp.721~728 (1983)
  6. Gartner S., "The association of rubeosis iridis with endothelialization of the anterior chamber : report of a clinical case with histopathological review of 16 additional cases", Br J Ophthalmol, 61, pp.267~271 (1977)
  7. Sivak-Callcott JA., "Evidence-based recommendations for the diagnosis and treatment of neovascular glaucoma", Ophthalmology, 108, pp.1767~1776 (2001)
  8. Helbig H., "Rubeosis iridis after vitrectomy for diabetic retinopathy", Graefes Arch Clin Exp Ophthalmol, 236, pp.730~733 (1998)
  9. Wand M., "Effects of panretinal photocoagulation on rubeosis iridis, angle neovascularization, and neovascular glaucoma", Am J Ophthalmol, 86, pp.332~339 (1978)
  10. Horsley MB., "Anti-VEGF therapy for glaucoma", Cur Opin Ophthalmol, 21, pp.112~117 (2010)
  11. Weiss DI., "Neovascular glaucoma complicating carotid-cavernous fistula", Arch Ophthalmol, 69, pp.304~307 (1963)
  12. The Diabetes Control and Complications Trial Research Group., "The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus", N Engl J Med, 329, pp.977~986 (1993)
  13. Blankenship GW., "Management of vitreous cavity hemorrhage following pars plana vitrectomy for diabetic retinopathy", Ophthalmology, 93, pp.39~44 (1986)
  14. Blankenship G., "Preoperative iris rubeosis and diabetic vitrectomy results", Ophthalmology, 87, pp.176~182 (1980)
  15. Aiello LM., "Neovascular glaucoma and vitreous hemorrhage after cataract surgery in patients with diabetes mellitus", Ophthalmology, 90, pp.814~820 (1983)
  16. Weinreb RN., "Neovascular glaucoma following neodymium-YAG laser posterior capsulotomy", Arch Ophthalmol, 104, pp.730~731 (1986)
  17. Tanaka S., "Neovascularization of the iris in rhegmatogeneous retinal detachment", Am J Ophthalmol, 112, pp.632~634 (1991)
  18. Michels RG., "Vitrectomy for complication of diabetic traction retinal detachment", Arch Ophthalmol, 88, pp.237~246 (1978)
  19. Kim YH., "Serum factors associated with neovascular glaucoma following vitrectomy for proliferative diabetic retinopathy", Korean J Ophthalmol, 15, pp.81~86 (2001)
  20. Hu DN., "Vascular endothelial growth factor is increased in aqueous humor of glaucomatous eyes", J Glaucoma, 11, pp.406~410 (2002)
  21. Tripathi RC., "Increased level of vascular endothelial growth factor in aqueous humor of patients with neovascular glaucoma", Ophthalmology, 105, pp.232~237 (1998)
  22. Sawada O., "Negative correlation between aqueous vascular endothelial growth factor levels and axial length", Jpn J Ophthalmol, 55, pp.401~404 (2011)
  23. Man RE., "Axial length, retinal function, and oxygen consumption : a potential mechanism for a lower risk of diabetic retinopathy in longer eyes", Invest Ophthalmol Vis Sci, 54, pp.7691~7698 (2013)
  24. Yonemura D., "Clinical importance of the oscillatory potential in the human ERG. Acta Ophthamol Suppl", Acta Ophthamol Suppl, 70(Suppl), pp.115~123 (1962)
  25. Li X., "Electroretinographic oscillatory potentials in diabetic retinopathy. An analysis in the domains of time and frequency", Doc Ophthalmol, 81, pp.173~179 (1992)
  26. Satoh S., "Photopic electroretinogram implicit time in diabetic retinopathy", Jpn J Ophthalmol, 38, pp.178~184 (1994)
  27. Algvere P., "The diagnostic value of the oscillatory potentials of the ERG and fluorescein angiography in diabetic proliferative retinopathy", Ophthalmologica, 168, pp.97~108 (1974)
  28. Tzekov R., "The electroretinogram in diabetic retinopathy", Surv Ophthalmol, 44, pp.53~60 (1999)
  29. Bresnick GH., "Predicting progression to severe proliferative diabetic retinopathy", Arch Ophthalmol, 105, pp.810~814 (1987)
  30. Ramsay WJ., "Involutional diabetic retinopathy", Am J Ophthalmol, 84, pp.851~858 (1977)
  31. Tahara K., "Diagnostic evaluation of diabetic retinopathy by 30-Hz flicker electroretinography", Jpn J Ophthamol, 37, pp.204~210 (1993)
  32. Bresnick GH., "Temporal aspects of the electroretinogram in diabetic retinopathy", Arch Ophthalomol, 105, pp.660~664 (1987)
  33. Hirose T., "Vitreous surgery and advances in fundus diagnosis and treatment", pp.79~97 (1977), Appleton-Centry -Crofts
  34. Hiraiwa T., "Preoperative electroretinogram and postoperative visual outcome in patients with diabetic vitreous hemorrhage", Jpn J Ophthalmol, 47, pp.307~311 (2003)
  35. Summanen P., "Vitrectomy for diabetic eye disease. The prognositic value of pro-operative electroretinography and visual evoked cortical potentials", Ophthalmologica, 199, pp.60~71 (1989)
  36. Galloway NR., "Electrophysiological testing of eyes with opaque media", Eye(Lond), 2, pp.615~624 (1988)
  37. Fuller DG., "Bright-flash electroretinography for the evaluation of eyes with opaque vitreous", Am J ophthalmol, 80, pp.214~223 (1975)
  38. Algvere P., "Preoperative electroretinograms and visual evoked cortical potentials for predicting outcome of vitrectomy in diabetics", Retina, 5, pp.179~183 (1985)

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