안와가성종양의 임상양상과 스테로이드 반응성에 대한 분석
Clinical Features and Results of Steroid Therapy for Orbital Inflammatory Pseudotumor
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목적: 안와가성종양의 임상양상과 스테로이드 치료효과에 영향을 미치는 인자를 분석하고자 하였다. 대상과 방법: 안와가성종양으로 진단받고 6개월이상 경과관찰이 가능하였던 64명에 대하여 의무기록을 후향적으로 분석하였다. 병변의위치에 따라 외안근형, 눈물샘형, 앞안와형, 미만형, 안와첨형으로 분류하였다. 스테로이드 치료를 일차로 시행하여 효과를 관찰하였으며 반응에 따라 관찰기간 동안 증상호전이 지속적으로 유지되었던 군과 치료에 반응이 없거나 재발하였던 군으로 나누어 치료효과에영향을 미치는 인자를 분석하였다. 결과: 병변의 위치에 따른 분류에서 외안근형이 가장 많았고(34.4%) 안와주위 부종이 가장 흔한 증상이었다(53.1%). 스테로이드 치료후 59.4%에서 관찰기간 동안 재발 없이 증상호전이 유지되었다. 연령, 성별, 병변의 양측성, 경과관찰 기간은 치료결과에 유의한 영향을 미치지 않았으나, 증상발생부터 치료시작까지의 기간이 짧거나 안와첨형의 경우 치료 성공률이 높은 것으로 분석되었다(p＜0.05). 결론: 안와가성종양은 외안근형이 가장 흔하였으며, 증상발생부터 치료시작까지의 기간이 짧고 병변이 안와첨부에 위치한 경우 스테로이드에 좋은 반응을 보였다.
Abstract
Purpose: To evaluate the clinical features and treatment outcomes of steroid therapy for orbital inflammatory pseudotumor. Methods: Sixty-four patients diagnosed with orbital inflammatory pseudotumor were reviewed retrospectively. Patients with a follow-up period of less than 6 months were excluded from the study. The pseudotumor was classified into myositic,lacrimal, anterior, diffuse, or apical type according to orbital computed tomography findings. All patients were initially treated with systemic corticosteroids and evaluated for response to the treatment. Treatment outcome was considered a “success” if the patient had complete relief of symptoms with no recurrence, and a “failure” if the patient had no or only partial relief of symptoms or showed relapse. Factors affecting the treatment outcome were analyzed. Results: The most frequent lesion subtype was myositis. Periorbital edema was the most common symptom and was evident in 53.1% of the patients. Thirty-eight patients (59.4%) showed treatment success. Age, sex, bilaterality, and mean follow-up length did not correlate with the treatment outcome. A short interval from symptom onset to treatment time and apical subtype were significantly associated with good steroid response (p < 0.05). Conclusions: In orbital inflammatory pseudotumor, myositis was the most common subtype. A short interval from symptom onset to treatment time and apical subtype were associated with good steroid response.
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