망막분지정맥폐쇄에 동반된 황반부종에서 유리체강 내 베바시주맙 3회 주입 후 비순응 관련 요인
Factors Related to Refractory Macular Edema in Branch Retinal Vein Occlusion
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
목적: 망막분지정맥폐쇄에 동반된 황반부종에서 유리체강 내 베바시주맙 3회 주입 후 비순응과 관련된 요인을 알아보고자 한다. 대상과 방법: 망막분지정맥폐쇄로 인한 황반부종에 대한 치료로 유리체강 내 베바시주맙(1.25 mg/0.05 mL)을 한 달 간격으로 3회 주입 후 4개월 이상, 즉 유리체강 내 베바시주맙 주입 시작 후 6개월 이상 경과관찰이 가능하였던 90명, 90안에 관하여 후향적으로 분석하였다. 비순응은 베바시주맙 3회 주입 후 1개월 기준으로 빛간섭단층촬영상 평균망막두께가 150 μm 이상 증가한 경우로 정의하였고, 순응군(46명, 46안)과 비순응군(44명, 44안)으로 나누어 비교 분석하였다. 결과: 단변량 로지스틱회귀분석 결과 연령, 당뇨, 고혈압, 시력, 최대혼합반응의 b파 진폭, 최대혼합반응의 b/a 비, 단일광추체반응의 b파 진폭, 중심와아래 맥락막두께, 고반사점의 개수가 비순응에 유의한 영향을 미치는 위험요인(각각 p=0.045, p=0.010, p=0.037, p=0.034, p=0.003, p=0.004, p=0.001, p=0.001, p=0.001)으로, 다변량 로지스틱회귀분석 결과 연령, 최대혼합반응의 b파 진폭, 최대혼합반응의 b/a 비, 중심와아래 맥락막두께, 고반사점의 개수가 비순응에 유의한 영향을 미치는 위험요인으로 밝혀졌다(각각p=0.024, p=0.004, p=0.047, p=0.033, p=0.049). 결론: 주입 전 연령, 최대혼합반응의 b파 진폭, 최대혼합반응의 b/a 비, 중심와아래 맥락막두께, 고반사점의 개수로 비순응을 예측할 수 있다.
Abstract
Purpose: To evaluate the factors associated with refractory macular edema (ME) secondary to branch retinal vein occlusion (BRVO) after three times of intravitreal bevacizumab (IVB) injections. Methods: Ninety eyes of Ninety patients, who were retrospectively reviewed, were treated with IVB of 1.25 mg (0.05 mL) for ME secondary to BRVO, repeated three times at 4-week intervals and then followed-up for at least 4 months after the IVB. The patients were classified as refractory if there was an increase in the mean retinal thickness >150 μm when measured 1 month after the three injections. The patients were divided into two groups: a responsive group (46 eyes) and a refractory group (44 eyes). Results: In univariate logistic regression analyses, age, diabetes mellitus, hypertension, visual acuity, maximal combined response b wave amplitude (Max B amp), maximal combined response B/A ratio (Max B/A), cone response b wave amplitude, subfoveal choroidal thickness (SFCT), and the number of hyperreflective foci (HF) were risk factors for refractory ME of BRVO (p = 0.045, p = 0.010, p = 0.037, p = 0.034, p = 0.003, p = 0.004, p = 0.001, p = 0.001 and p = 0.001, respectively). In backward multivariate logistic regression analyses, age, Max B amp, Max B/A, SFCT and number of HF were risk factors for refractory ME of BRVO (p = 0.024, p = 0.004, p = 0.047, p = 0.033 and p = 0.049, respectively). Conclusions: Baseline age, Max B amp, Max B/A, SFCT and number of HF predicted the probability of refractory ME secondary to BRVO after IVB.
참고문헌 (21)
- Ehlers JP, "Intravitreal bevacizumab for macular edema secondary to branch retinal vein occlusion", Retina, 31, pp.1856~1862 (2011)
- Rabena MD, "Intravitreal bevacizumab (Avastin) in the treatment of macular edema secondary to branch retinal vein occlusion", Retina, 27, pp.419~425 (2007)
- Prager F, "Intravitreal bevacizumab (Avastin) for macular oedema secondary to retinal vein occlusion:12-month results of prospective clinical trial", Br J Ophthalmology, 93, pp.452~456 (2009)
- Kohner EM, "Do medical conditions have an influence on central retinal vein occlusions?", Proc R Soc Med, 67, pp.1052~1054 (1974)
- Dodson PM, "Retinal vein occlusion and prevalence of lipoprotein abnormalities", Br J Ophthalmol, 66, pp.161~164 (1982)
- 이영섭, "망막정맥폐쇄 환자에서 유리체내 베바시주맙 주입술의 2년 임상 결과", 대한안과학회지, 52(9), pp.1039~1047 (2011), 대한안과학회
- Karpe G, "The basis of clinical electroretinography", Acta Ophthalmol Suppl, 24, pp.1~118 (1945)
- Matsui Y, "Correlation of electroretinogrphic and fluoresein angiographic findings in unilateral central retinal vein obstruction", Graefes Arch Clin Exp Ophthalmol, 232, pp.449~457 (1994)
- 강경태, "망막분지정맥폐쇄에 동반된 황반부종에서 유리체강내 베바시주맙주입술의 반복성에 관련된 인자", 대한안과학회지, 56(10), pp.1580~1585 (2015), 대한안과학회
- Schatz H, "Retinal detachment secondary to branch vein occlusion: Part II", Ann Ophthalmol, 8, pp.1461~1471 (1976)
- Hoeh AE, "OCT patterns of macular edema and response to bevacizumab therapy in retinal vein occlusion", Graefes Arch Clin Exp Ophthalmol, 248, pp.1567~1572 (2010)
- Yuan A, "Comparison of intravitreal ranibizumab and bevacizumab for the treatment of macular edema secondary to retinal vein occlusion", Int J Ophthalmol, 7, pp.86~91 (2014)
- Aiello LP, "Hypoxic regulation of vascular endothelial growth factor in retinal cells", Arch Ophthalmol, 113, pp.1538~1544 (1995)
- Tsuiki E, "Enhanced depth imaging optical coherence tomography of the choroid in central retinal vein occlusion", Am J Ophthalmol, 156, pp.543~547 (2013)
- Du KF, "Subfoveal choroidal thickness in retinal vein occlusion", Ophthalmology, 120, pp.2749~2750 (2013)
- Maharaj AS, "Roles for VEGF in the adult", Microvasc Res, 74, pp.100~113 (2007)
- Saint-Geniez M, "VEGF expression and receptor activation in the choroid during development and in the adult", Invest Ophthalmol Vis Sci, 47, pp.3135~3142 (2006)
- Bolz M, "Optical coherence tomographic hyperreflective foci: a morphologic sign of lipid extravasation in diabetic macular edema", Ophthalmology, 116, pp.914~920 (2009)
- Coscas G, "Hyperreflective dots: a new spectral-domain optical coherence tomography entity for follow-up and prognosis in exudative age-related macular degeneration", Ophthalmologica, 229, pp.32~37 (2013)
- 이형우, "나이관련황반변성 환자에서 빛간섭단층촬영의 고반사점 및 치료 전 인자들과 시력과의 연관성", 대한안과학회지, 56(8), pp.1188~1194 (2015), 대한안과학회
- Kang JW, "Correlation between optical coherence tomogrphic hyperreflective foci and visual outcomes after intravitreal bevacizumab for macular edema in branch retinal vein occlusion", Graefes Arch Clin Exp Ophthalmol, 252, pp.1413~1421 (2014)