유리체강내 덱사메타존 임플란트 삽입술 후 안압 상승: 1년 경과 관찰
Intraocular Pressure Elevation after 0.7 mg Intravitreal Dexamethasone (Ozurdex®) Implantation: A One Year Follow-Up
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목적: 유리체강내 덱사메타존 임플란트 삽입술 후 안압 증가 환자의 비율, 시기 및 안압 증가에 영향을 미치는 요인, 치료방법에 대해알아보고자 한다. 대상과 방법: 2012년 7월부터 2013년 12월까지 본원에서 유리체강내 덱사메타존 임플란트 삽입술을 받은 환자 중 술 후 1년 이상 경과관찰이 가능했던 30명(33안)을 대상으로 1년간 경과 관찰하였다. 대상 환자는 골드만 안압검사를 시행하여 안압의 변화를 확인하였다. 안압 증가는 안압이 21 mmHg 이상이거나 초기 안압에 비해 6 mmHg 이상 증가한 경우로 정의하였다. 결과: 유리체강내 덱사메타존 임플란트 삽입술 후 안압은 16안(48.5%)에서 증가하였고 안압이 처음 증가한 시기는 평균 2.0 ± 0.7개월이었다. 유리체강내 덱사메타존 임플란트 삽입술을 2회 이상 시행한 21안에서 시술을 시행한 간격은 평균 4.5개월이었다. 스테로이드 반응 환자와 스테로이드 미반응 환자에서 안압은 시술 후 1개월, 2개월, 3개월, 6개월, 7개월에 의미 있는 차이를 보였고, 치료를한 눈과 치료를 하지 않은 눈에서 안압은 시술 1개월, 2개월, 3개월, 5개월, 7개월 후에 의미 있는 차이를 보였다. 결론: 유리체강내 덱사메타존 임플란트 삽입술 후 2개월째 가장 높은 안압을 보였으며 전체 대상자의 약 반수(48.5%)에서 안압 상승을 보였다. 유리체강내 덱사메타존 임플란트 삽입술이 황반부종을 보이는 여러 질환에서 효과가 있지만 장기적인 치료를 위해서 안압증가 환자에 대한 선별과 적절한 치료가 필요할 것으로 생각된다.
Abstract
Purpose: To investigate the percentage and time of intraocular pressure (IOP) elevation and the factors influencing IOP elevation and treatment. Methods: Thirty patients (33 eyes) who received intravitreal dexamethasone implantation from July 2012 to December 2013 and followed up more than 1 year were evaluated by measuring Goldmann IOP and confirming changes in IOP. The definition of IOP elevation was IOP above 20 mm Hg or IOP increase greater than 6 mm Hg. Results: In 16 eyes (48.5%), IOP was elevated after intravitreal dexamethasone implantation. The first IOP elevation was mean 2.0 ± 0.7 months. In 21 eyes which received intravitreal dexamethasone implantation more than twice, the mean intervals of implantation were 4.5 months. In steroid responders, IOP after dexamethasone implantation was significantly increased at 1, 2, 3, 6, and 7 months. IOP increase in the treated eye was significant at 1, 2, 3, 5, and 7 months after dexamethasone implantation. Conclusions: After intravitreal dexamethasone implantation, IOP was highest at 2 months. Additionally, IOP was elevated in approximately half of the patients (48.5%). Although the intravitreal dexamethasone implantation is effective against various diseases which occur due to macular edema, thorough identification of suitable patients and frequent IOP control is necessary for long-term treatment.
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