망막분지정맥폐쇄에 의한 황반부종에서 망막전막이 덱사메타손 삽입물 치료 효과에 미치는 영향
The Effect of Epiretinal Membrane on Dexamethasone Implant for Branch Retinal Vein Occlusion Macular Edema
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목적: 망막분지정맥폐쇄에 의한 황반부종의 덱사메타손 삽입물 치료에서 망막전막이 미치는 영향을 알아보고자 한다. 대상과 방법: 망막분지정맥폐쇄로 인한 황반부종에 대해 덱사메타손 삽입물 치료를 시행받고 6개월 이상 경과 관찰한 30명 30안을후향적으로 분석하였다. 초진 당시 망막전막을 동반한 군과 동반하지 않은 군으로 분류하여, 덱사메타손 삽입물 치료 시행 전, 시행후 1, 3, 6개월에 각각 최대교정시력 및 중심와 두께, 황반부종의 재발 유무, 재치료 여부를 비교 분석하였다. 결과: 총 30안 중 10안(33%)에서 망막전막이 동반되었다. 두 군 모두에서 덱사메타손 삽입물 치료 시행 후 1개월째 유의한 중심와두께의 감소를 보였고, 3, 6개월째 서서히 다시 증가하는 경향을 보였다. 치료 후 1개월(p=0.022)과 6개월(p=0.001)째에 망막전막을동반한 군이 그렇지 않은 군에 비해 유의하게 더 높은 평균 중심와 두께를 보였다. 하지만 최대교정시력은 모든 시점에서 두 군 간에유의한 차이를 보이지 않았다. 황반부종이 관찰된 환자의 비율은 치료 후 6개월째 망막전막을 동반한 군(90%)에서 그렇지 않은 군(35%)에 비해 유의하게 더 높았다(p=0.009). 재치료가 시행된 환자의 비율, 재치료의 시점 및 사용된 주사제의 종류는 두 군 간에유의한 차이를 보이지 않았다. 결론: 망막분지정맥폐쇄에 의한 황반부종에서 망막전막이 동반된 경우 덱사메타손 삽입물 치료의 효과가 낮았고, 지속 기간 또한 짧았다. 하지만 망막전막의 유무가 덱사메타손 삽입물 치료 효과에 있어 시력에는 유의한 영향을 미치지 않았다.
Abstract
Purpose: To evaluate the effect of epiretinal membrane (ERM) on the outcomes of intravitreal dexamethasone implant (Ozurdex®, Allergan, Irvine, CA, USA) treatment for macular edema (ME) secondary to branch retinal vein occlusion (BRVO). Methods: Thirty eyes of 30 patients who received Ozurdex treatment for ME secondary to BRVO, and were followed-up for at least 6 months were retrospectively reviewed. Patients were divided into two groups based on the presence (ERM [+] or absence ERM [-]) of ERM at baseline. The best-corrected visual acuity (BCVA), central foveal thickness (CFT), recurrence of ME, and retreatment rate were evaluated at baseline, 1, 3, and 6 months after Ozurdex injection. Results: Ten eyes of 30 eyes (33%) showed ERM at baseline. While the mean CFT was significantly reduced at 1 month after Ozurdex injection, it began to increase gradually thereafter in both groups. The ERM (+) group showed a significantly higher mean CFT than the corresponding values of the ERM (-) group at 1 (p = 0.022) and 6 months (p = 0.001) after Ozurdex injection. However, no significant difference was found in the BCVA between the two groups at every visit. The proportion of eyes with ME was significantly higher in the ERM (+) group (90%) than that in the ERM (-) group (35%) at 6 months after Ozurdex injection (p = 0.009). There were no significant differences between the two groups in the percentage of retreatment, time to retreatment, and type of materials used for retreatment. Conclusions: In patients with ME secondary to BRVO, the treatment effect of Ozurdex was low and the duration of treatment was short when ERM was concurrently present. However, the presence of ERM did not significantly affect visual outcomes after treatment with Ozurdex.
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