습성 나이관련황반변성에서 안축장이 초기 항혈관내피성장인자 치료 후 재발에 미치는 영향
Influence of Axial Length on Recurrence of Wet Age-related Macular Degeneration after Initial Treatment
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목적: 안축장이 습성 나이관련황반변성에서 항혈관내피성장인자 치료 후 재발에 미치는 영향에 대해 알아보고자 한다. 대상과 방법: 습성 나이관련황반변성으로 진단된 후 1개월 간격 ranibizumab 3회 주입술을 시행받은 45안을 대상으로 후향적 의무기록 분석을 시행하였다. 12개월의 경과 관찰기간 동안 재발을 보인 군을 ‘재발한 군’, 재발하지 않은 경우를 ‘재발하지 않은 군’으로 나누어 양 군 간에 안축장을 비교하였다. 재발한 군의 경우 안축장과 첫 재발까지의 기간 사이의 연관관계를 추가로 분석하였다. 결과: 습성 나이관련황반변성 진단 후 평균 20.6 ± 10.1개월에 안축장을 측정하였으며, 평균 안축장은 23.33 ± 0.90 mm였다. 재발한 군(n=30)과 재발하지 않은 군(n=15)을 비교하였을 때, 평균 안축장은 재발한 군에서의 23.29 ± 0.96 mm, 재발하지 않은 군에서 23.40 ± 0.79 mm로 양 군 사이에 유의한 차이는 없었다(p=0.709). 재발한 군에서 3회 주사로부터 첫 재발까지의 기간은 평균 6.3 ± 2.3개월이었으며, 상기 기간과 안축장 사이의 연관관계는 유의하지 않았다(p=0.582). 결론: 본 연구의 결과 습성 나이관련황반변성에 대한 초기 치료 후 재발한 군과 그렇지 않은 군 사이에 안축장의 유의한 차이는 없었으며, 재발까지의 기간 역시 안축장과 연관관계가 나타나지 않았다. 그러나 본 연구가 소수의 안을 대상으로 한 후향적 연구라는 점을 고려하였을 때, 향후 보다 잘 설계된 전향적 연구를 통해 안축장의 영향을 보다 더 정확하게 평가하고자 하는 시도가 필요할 것이다.
Abstract
Purpose: To evaluate the influence of axial length on the recurrence of wet age-related macular degeneration (AMD) after anti- vascular endothelial growth factor therapy. Methods: A retrospective review of the medical records for 45 eyes of 45 patients, who were diagnosed with neovascular AMD and treated with three ranibizumab injections per month, was performed. Axial length was compared between eyes with (recurrence group) and without (no recurrence group) recurrence of fluid during a 12-month follow-up period. In eyes with recurrence, the association between axial length and the time between the third injection and the first recurrence was also evaluated. Results: The axial length was measured at a mean of 20.6 ± 10.1 months after the diagnosis of neovascular AMD. The mean axial length at that time was 23.33 ± 0.90 mm. The mean axial length was 23.29 ± 0.96 mm in the recurrence group (n = 30) and 23.40 ± 0.79 mm in the no-recurrence group (n = 15). There was no difference in the axial length between the two groups (p = 0.709). In the recurrence group, the period between the third injection and the first recurrence was not associated with axial length (p =0.582). Conclusions: There was no significant difference in axial length between eyes with and without recurrence after initial treatment for wet AMD. In addition, the time to first recurrence was not significantly associated with axial length. Because the present study was retrospective and the sample size was small, further prospective studies with a better design are needed to more accurately assess the influence of axial length.
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