중심장액맥락망막병증 환자에서 선택적 망막치료술의 효과와 안전성
Selective Retina Therapy in Patients with Central Serous Chorioretinopathy
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목적: 중심장액맥락망막병증 환자들을 대상으로 선택적 망막치료술 전후 시력과 중심망막두께의 변화 양상을 알아보고자 한다. 대상과 방법: 중심장액맥락망막병증으로 진단받고 선택적 망막치료술을 시행받은 후 경과관찰한 환자들을 대상으로 하였다. 형광안저혈관조영술을 치료 전 시행하여 중심장액맥락망막병증으로 진단하고 레이저 시행 위치를 결정하였다. 총 16명(17안)을 대상으로 후향적 의무기록을 검토하여 나이, 성별, 시력, 안압, 세극등현미경검사, 유병 기간, 레이저 시기, 레이저 조사 위치, 부작용을 조사하였다. 시력의 측정은 최대교정시력을 측정하여 선택적 망막치료술 치료 전과 1달째를 비교하였다. 빛간섭단층촬영술을 선택적 망막치료술치료 전과 치료 후 1달째에 시행하여 중심망막두께를 측정하고 두께의 변화를 비교하였다. 결과: 중심장액맥락망막병증 진단 초기 평균 시력은 0.20 (대수시력표)이고 치료 1달 후 평균시력은 0.12 (대수시력표)로 치료 전에 비해서 0.08 (대수시력표)의 시력 개선을 보였다. 17안의 초기 중심망막두께는 326.53 ± 59 μm, 레이저 치료 1달 후 추적관찰이 가능했던 16안의 중심망막두께는 151.75 ± 15 μm로 평균 174.78 μm 감소하였다. 결론: 선택적 망막치료술 후 중심장액맥락망막병증 환자들은 망막의 해부학적 개선과 시력 개선을 보였고 합병증을 보이지 않았다.
Abstract
Purpose: We evaluated the visual outcomes and changes in central macular thickness in patients with central serous chorioretinopathy who underwent selective retina therapy. Methods: Patients diagnosed with central serous chorioretinopathy were included in the study. Fundus fluorescein angiography was performed before laser treatment. We reviewed the charts of 16 patients (17 eyes) in terms of age, sex, best-corrected visual acuity, intraocular pressure, slit lamp examination, the time from diagnosis to laser treatment, the site of laser treatment and side-effects. Optical coherence tomography was performed before laser treatment and 1 month later; the central macular thicknesses were compared. Results: The average best-corrected visual acuity at diagnosis and 1 month after laser treatment were 0.20 and 0.12 (logMAR) respectively. The improvement was thus 0.08 (logMAR). The average central macular thickness decreased by 174.78 μm from 326.53 ± 59 μm at baseline to 151.75 ± 15 μm 1 month after selective retina therapy. Conclusions: Selective laser therapy afforded favorable visual and structural outcomes and was not associated with a risk of scotoma or other untreatable side-effects.
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