나이관련황반변성에 동반된 맥락막신생혈관에서 유리체내 라니비주맙 주사의 2년 장기 효과
Long-Term Effect of Intravitreal Ranibizumab Injection on Choroidal Neovascularization in Age-Related Macular Degeneration
1
조회
0
다운로드
6
인용
0
참고문헌
키워드
초록
목적: 한국인을 대상으로 나이관련황반변성에 동반된 맥락막신생혈관에서 유리체내 라니비주맙 주사의 2년 이상 장기 효과에 대해알아보고자 하였다. 대상과 방법: 나이관련황반변성에 동반된 맥락막신생혈관 환자에서 라니비주맙 주사 후 2년 이상 경과 관찰한 환자 23명 23안을 대상으로 술 전과 6, 12, 18, 24개월 후 최대교정시력, 중심황반두께를 후향적으로 조사하여 비교하였다. 결과: 시력은 시술전(logMAR 0.58 ± 0.36)에 비해 6, 12, 18, 24개월에 0.54, 0.59, 0.64, 0.61으로 감소하는 경향이 있었으나 유의성은없었다. 중심황반두께는 시술 전(283.75 ± 61.41 μm)에 비해 6, 12, 18, 24개월에 239.93, 244.89, 246.36, 244.70 μm로 유의하게감소한 것으로 나타났다(p＜0.05). 환자들의 24개월 평균 주사횟수는 5.96 ± 2.93회로 나타났다. 결론: 나이관련황반변성에 동반된 맥락막신생혈관 환자에서 유리체내 라니비주맙 주사로 장기적인 해부학적 호전과 기능적 안정을얻을 수 있으나 시력의 개선은 적었다는 점에서, 장기간의 시력 호전을 위한 다각적 치료 방법들이 필요하다.
Abstract
Purpose: To evaluate long-term efficacy and safety of intravitreal ranibizumab on choroidal neovascularization (CNV) in age-related macular degeneration (AMD) in Korean patients over a 2-year period. Methods: Twenty-three eyes of 23 patients who underwent intravitreal ranibizumab injection for secondary CNV in AMD were followed up more than 2 years, and their records were retrospectively investigated. The best corrected visual acuity (BCVA), central macular thickness (CRT) were compared at baseline and at 6, 12, 18 and 24 months after injection. Results: The mean BCVA (log MAR) was 0.58 ± 0.36, 0.54 ± 0.49, 0.59 ± 0.49, 0.64 ± 0.51, and 0.61 ± 0.51 at baseline, 6,12, 18 and 24 months, respectively (p = 0.332, p = 1.000, p = 0.670, p = 0.697). The mean CRT was 283.75 ± 61.41 μm,239.93 ± 53.12 μm, 244.89 ± 47.44 μm, 246.36 ± 55.78, and 244.70 ± 54.86 at baseline, 6, 12, 18 and 24 months, respectively (p = 0.009, p = 0.036, p = 0.01, p = 0.015). The mean number of injection was 5.96 ± 2.93 over a 2-year period. Conclusions: In Korean patients who underwent intravitreal ranibizumab injection for secondary CNV in AMD, long-term efficacy in diminishing CRT was evident. However, long-term efficacy in increasing visual acuity was not observed.
참고문헌 (18)
- Friedman DS, "Prevalence of age-related macular degeneration in the United States", Arch Ophthalmol, 122, pp.564~572 (2004)
- Augood C, "Methods for a population- based study of the prevalence of and risk factors for age-related maculopathy and macular degeneration in elderly European populations: the EUREYE study", Ophthalmic Epidemiol, 11, pp.117~129 (2004)
- Resnikoff S, "Global data on visual impairment in the year 2002", Bull World Health Organ, 82, pp.844~851 (2004)
- Au Eong KG, "Age-related macular degeneration: an emerging challenge for eye care and public health professionals in the Asia Pacific region", Ann Acad Med Singapore, 35, pp.133~135 (2006)
- Kliffen M, "Increased expression of angiogenic growth factors in age-related maculopathy", Br J Ophthalmol, 81, pp.154~162 (1997)
- Otani A, "Vascular endothelial growth factor family and receptor expression in human choroidal neovascular membranes", Microvasc Res, 64, pp.162~169 (2002)
- Rakic JM, "Placental growth factor, a member of the VEGF family, contributes to the development of choroidal neovascularization", Invest Ophthalmol Vis Sci, 44, pp.3186~3193 (2003)
- Rosenfeld PJ, "Ranibizumab for neovascular age-related macular degeneration", N Engl J Med, 355, pp.1419~1431 (2006)
- Brown DM, "Ranibizumab versus verteporfin for neovascular age-related macular degeneration", N Engl J Med, 355, pp.1432~1444 (2006)
- Kwon OW, "EXTEND III: Efficacy and safety of ranibizumab in South Korean and Taiwanese patients with subfoveal CNV secondary to AMD", Graefes Arch Clin Exp Ophthalmol, 250, pp.1467~1476 (2012)
- Fung AE, "An optical coherence tomography-guided, variable dosing regimen with intravitreal ranibizumab (Lucentis) for neovascular age-related macular degeneration", Am J Ophthalmol, 143, pp.566~583 (2007)
- 강승범, "연령관련황반변성에 동반된 맥락막신생혈관의 유리체강내 라니비주맙 주입술 임상결과", 대한안과학회지, 50(5), pp.725~730 (2009), 대한안과학회
- Ferrara N, "Development of ranibizumab, an anti-vascular endothelial growth factor antigen binding fragment, as therapy for neovascular age-related macular degeneration", Retina, 26, pp.859~870 (2006)
- Gaudreault J, "Preclinical pharmacokinetics of Ranibizumab (rhuFabV2) after a single intravitreal administration", Invest Ophthalmol Vis Sci, 46, pp.726~733 (2005)
- Tano Y, "EXTEND-I Study Group. Long-term efficacy and safety of ranibizumab administered pro re nata in Japanese patients with neovascular age-related macular degeneration in the EXTEND-I study", Acta Ophthalmol, 89, pp.208~217 (2011)
- Holz FG, "Safety and efficacy of a flexible dosing regimen of ranibizumab in neovascular age-related macular degeneration: the SUSTAIN study", Ophthalmology, 118, pp.663~671 (2011)
- Rosa RH Jr, "Clinicopathologic reports, case reports, and small case series: clinicopathologic correlation of idiopathic polypoidal choroidal vasculopathy", Arch Ophthalmol, 120, pp.502~508 (2002)
- Gomi F, "Efficacy of intravitreal bevacizumab for polypoidal choroidal vasculopathy", Br J Ophthalmol, 92, pp.70~73 (2008)