중심장액맥락망막병증 환자에서 유리체강내 베바시주맙 주입술의 치료 효과에 영향을 주는 요인
Factors Influencing the Effect of the Intravitreal Bevacizumab Injection in Patients with Central Serous Chorioretinopathy
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목적: 중심장액맥락망막병증 환자에서 유리체강내 베바시주맙 주입술의 치료 효과에 영향을 주는 요인에 대해 알아보고자 하였다. 대상과 방법: 중심장액맥락망막병증으로 증상이 3개월 이상 지속된 환자 중 유리체강내 베바시주맙 주입술을 시행하고 6개월 이상 경과관찰이 가능했던 환자 54명 56안을 대상으로 의무기록을 후향적으로 조사하였다. 결과: 치료 반응군은 32명 34안(60.7%)이었으며, 비반응군은 치료 효과가 없었던 12명 12안과 호전을 보인 뒤 일정 기간 후 다시 재발한 10명 10안으로 총 22명 22안(39.3%)이었다. 비반응군은 형광안저촬영에서 반응군에 비해 누출점의 개수가 많았고(1.26 ± 0.35vs 1.90 ± 0.42, p=0.01), 누출점이 황반부에 가까이 위치함을 알 수 있었다(p=0.044). 또한 빛간섭단층촬영에서는 낭포성 황반부종이 비반응군에서 많이 관찰되었다(p=0.042). 결론: 중심장액맥락망막병증 환자에서 누출점이 여러 개 또는 황반부 중심부에 위치하거나, 빛간섭단층촬영에서 낭포성 황반부종이관찰되면 치료효과가 없거나 재발이 흔하다.
Abstract
Purpose: To evaluate the factors influencing the effect of the intravitreal bevacizumab injection in patients with central serouschorioretinopathy. Methods: We performed a retrospective review of the medical records of 54 patients (56 eyes) who had been symptomaticfor more than 3 months with central serous chorioretinopathy (CSC), who had undergone intravitreal bevacizumab injectionand been on regular follow-up for at least 6 months. Results: Responders were 34 eyes (60.7%) and non-responders were 22 eyes (39.3%). The leaking points of the non-respondergroup were multiple and located more centrally than that of the responder group on fluorescein angiography (FA)(p = 0.01, p = 0.044). In addition, non-responder group showed cystoid macular edema on optical coherence tomography(OCT) as compared with responder group (p = 0.042). Conclusions: CSC with multiple, centrally located leaks on FA or cystoid macular edema on OCT was ineffective or recurrentwith intravitreal bevacizumab injection.
참고문헌 (29)
- Gass JD, "Pathogenesis of disciform detachment of the neuroepithelium. Π. Idiopathic central serous chorioretinopathy", Am J Ophthalmol, 63, pp.587~615 (1967)
- Yannuzzi LA, "The macula: a comprehensive text and atlas", pp.145~165 (1982), William & Wilkins
- Gilbert CM, "Long-term follow-up of central serous chorioretinopathy", Br J Ophthalmol, 68, pp.815~820 (1984)
- Wang MS, "Retinal atrophy in idiopathic central serous chorioretinopathy", Am J Ophthalmol, 133, pp.787~793 (2002)
- Iida T, "Cystoid macular degeneration in chronic central serous chorioretinopathy", Retina, 23, pp.1~7 (2003)
- Burumcek E, "Laser photocoagulation for persistent central serous retinopathy: results of long-term follow-up", Ophthalmology, 104, pp.616~622 (1997)
- Battaglia Parodi M, "Photodynamic therapy in chronic central serous chorioretinopathy", Retina, 23, pp.235~237 (2003)
- Cardillo Piccolino F, "Photodynamic therapy for chronic central serous chorioretinopathy", Retina, 23, pp.752~763 (2003)
- Chan WM, "Choroidal vascular remodelling in central serous chorioretinopathy after indocyanine green guided photodynamic therapy with verteporfin: a novel treatment at the primary disease level", Br J Ophthalmol, 87, pp.1453~1458 (2003)
- Yannuzzi LA, "Indocyanine green angiography-guided photodynamic therapy for treatment of chronic central serous chorioretinopathy: a pilot study", Retina, 23, pp.288~298 (2003)
- Canakis C, "Ocular photodynamic therapy for serous macular detachment in the diffuse retinal pigment epitheliopathy variant of idiopathic central serous chorioretinopathy", Am J Ophthalmol, 136, pp.750~752 (2003)
- Taban M, "Chronic central serous chorioretinopathy: photodynamic therapy", Am J Ophthalmol, 137, pp.1073~1080 (2004)
- 정송이, "만성중심장액맥락망막병증에 대한 광역학치료의 효과", 대한안과학회지, 48(2), pp.279~284 (2007), 대한안과학회
- 장문희, "만성 중심장액맥락망막병증에서 절반 에너지를 적용한 광역학치료의 효과", 대한안과학회지, 50(9), pp.1326~1333 (2009), 대한안과학회
- 김마르다, "만성중심장액맥락망막병증에 대한 광역학치료 결과", 대한안과학회지, 50(7), pp.1035~1043 (2009), 대한안과학회
- Torres-Soriano ME, "A pilot study of intravitreal bevacizumab for the treatment of central serous chorioretinopathy (case reports)", Graefes Arch Clin Exp Ophthalmol, 246, pp.1235~1239 (2008)
- Huang WC, "Intravitreal bevacizumab for treatment of chronic central serous chorioretinopathy", Eye (Lond), 23, pp.488~489 (2009)
- Seong HK, "Intravitreal bevacizumab to treat acute central serous chorioretinopathy: short-term effect", Ophthalmologica, 223, pp.343~347 (2009)
- 김형석, "중심장액맥락망막병증 환자에서 유리체내 베바시주맙 주입술의 단기효과", 대한안과학회지, 51(6), pp.860~864 (2010), 대한안과학회
- Costa RA, "Indocyanine green-mediated photothrombosis as a new technique of treatment for persistent central serous chorioretinopathy", Curr Eye Res, 25, pp.287~297 (2002)
- Costa RA, "Choriocapillaris photodynamic therapy using indocyanine green", Am J Ophthalmol, 132, pp.557~565 (2001)
- Guyer DR, "Digital indocyanine green videoangiography of central serous chorioretinopathy", Arch Ophthalmol, 112, pp.1057~1062 (1994)
- Prünte C, "Choroidal capillary and venous congestion in central serous chorioretinopathy", Am J Ophthalmol, 121, pp.26~34 (1996)
- Spaide RF, "Indocyanine green videoangiography of older patients with central serous chorioretinopathy", Retina, 16, pp.203~213 (1996)
- Lai TY, "Transient reduction in retinal function revealed by multifocal electroretinogram after photodynamic therapy", Am J Ophthalmol, 137, pp.826~833 (2004)
- Tzekov R, "Ocular changes after photodynamic therapy", Invest Ophthalmol Vis Sci, 47, pp.377~385 (2006)
- Lee JY, "Intravitreal bevacizumab versus the conventional protocol of photodynamic therapy for treatment of chronic central serous chorioretinopathy", Acta Ophthalmol, 89, pp.e293~e294 (2011)
- Semeraro F, "Intravitreal bevacizumab versus low-fluence photodynamic therapy for treatment of chronic central serous chorioretinopathy", Jpn J Ophthalmol, 56, pp.608~612 (2012)
- Lim JW, "Aqueous humor and plasma levels of vascular endothelial growth factor and interleukin-8 in patients with central serous chorioretinopathy", Retina, 30, pp.1465~1471 (2010)