급성후유리체박리 이후 망막전막의 발생률 및 위험인자
Incidence and Risk Factors of Epiretinal Membrane Following Acute Posterior Vitreous Detachment
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목적: 급성후유리체박리 이후 망막전막의 발생률을 알아보고, 위험인자를 분석하고자 하였다. 대상과 방법: 2013년 2월부터 2019년 2월까지 비문증 또는 광시증으로 내원하여 후유리체박리를 진단받은 환자의 의무기록을 조사하였다. 증상 발현 이후 1달 이내 진단받은 환자를 연구에 포함하였다. 망막전막은 안저사진을 이용하여 진단하였다. 증상 발현 후 1-3개월, 3-6개월, 6-12개월 사이로 기간을 나누어 발생률을 조사하였으며, 또한 Kaplan-Meier 분석을 통해 망막전막의 누적발생률을 구하였다. 망막전막 발생과 각 변수들과의 관련성을 로지스틱 회귀분석을 이용하여 분석하였다. 결과: 154안이 연구에 포함되었다. 평균 연령은 56.6 ± 8.0세였다. 1-3개월 사이에는 144안 중 3안(2.1%), 3-6개월 사이에는 56안 중 11안(19.6%), 6-12개월 사이에는 63안 중 15안(23.8%)에서 망막전막이 진단되었다. 후유리체박리 증상 발현 후 12개월 동안에 망막전막의 누적발생률은 35.3%였다. 다변량 로지스틱 회귀분석에서 반대안에서 망막전막이 관찰된 경우(교차비 11.9, 95% 신뢰구간1.4-100.1)가 망막전막 발생과 유의하게 관련되었다. 결론: 후유리체박리 이후 망막전막의 발생은 비교적 흔하였다. 후유리체박리 환자는 증상 발현 이후 6개월 이상 장기적인 추적 관찰이 필요하다.
Abstract
Purpose: To investigate the incidence and risk factors of epiretinal membrane (ERM) after acute posterior vitreous detachment (PVD). Methods: We reviewed the medical records of patients diagnosed with PVD between February 2013 and February 2019. Patients with symptom onset (new floaters or photopsia) within 1 month at the time of diagnosis were included in the study. The ERM was diagnosed using fundus photographs. The incidence rate was investigated in each of the three periods: 1-3, 3-6, and 6-12 months after symptom onset. The cumulative incidence rate of ERM was calculated using Kaplan-Meier analysis. Data were analyzed using logistic regression to determine the association between ERM development and various factors. Results: The study included 154 eyes. The mean age was 56.6 ± 8.0 years. ERM was observed in three of 144 eyes (2.1%) between 1 month and 3 months, in 11 of 56 eyes (19.6%) between 3 and 6 months, and in 15 of 63 eyes (23.8%) between 6 and 12 months from symptom onset. The cumulative incidence rate of ERM was 35.3% over the 12 months following the onset of PVD symptoms. In a multivariate logistic regression analysis, the fellow eye with ERM (odds ratio 11.9, 95% confidence interval 1.4-100.1) was significantly associated with ERM development. Conclusions: ERM development was relatively common after PVD. Long-term follow-up of 6 months or more should be required after the onset of symptoms.
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