유리체강 내 약물주입술이 각막내피세포에 미치는 영향
The Effect of Intravitreal Injection on the Corneal Endothelium
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목적: 유리체강 내 약물주입술에 사용되는 다양한 약물이 각막내피세포에 미치는 영향을 알아보고자 하였다. 대상과 방법: 2016년 2월부터 2016년 10월까지 본원 안과에서 유리체강 내 주사 치료를 받은 환자 113명 118안(나이관련황반변성 61 안, 당뇨황반부종 40안, 망막정맥폐쇄에 동반된 황반부종 16안, 포도막염 1안)을 대상으로 주사 전후 중심각막내피세포의 변화 및 중심각막두께를 비접촉 경면현미경을 이용하여 후향적으로 분석하였다. 유리체강 내 주입한 약물(베바시주맙 21안, 라니비주맙 20안, 아플리버셉트 47안, 덱사메타손 이식제 30안), 수정체안과 위수정체안, 1회 주입안과 2회 이상 주입안으로 나누어 주사 전후 중심각막내피세포 및 중심각막두께의 변화를 비교하였다. 결과: 전체 환자군에서 중심각막내피세포수는 술 전 2,693.2 ± 298.2 cells/mm2, 술 후 1개월에 2,686.8 ± 288.7 cells/mm2로 주사 전후의 차이가 통계적으로 유의하지 않았다(p = 0.731). 약물 종류에 따라 군을 나누었을 때, 네 군 모두에서 주사 전후의 중심각막내피세포수는 통계적으로 유의한 차이가 없었다. 수정체안에서 술 전 2,611.7 ± 470.2 cells/mm2에서 술 후 1개월에 2,480.0 ± 436.4 cells/mm2로, 위수정체안에서 술 전 2,778.0 ± 149.3 cells/mm2에서 술 후 2,608.2 ± 334.8 cells/mm2로 다소 감소하는 경향을 보였으나 두 군 모두 통계적으로 유의하지는 않았다. 결론: 본 연구에서는 유리체강 내 약물주입술이 중심각막내피세포 및 중심각막두께에 통계적으로 유의한 변화를 가져오지 않아, 각막내피세포를 손상시킨다는 증거를 찾지 못하였다.
Abstract
Purpose: To evaluate the effect of intravitreal injection on the corneal endothelium according to the injected drug. Methods: The present study included 118 eyes of 113 patients who received intravitreal injection. Before each injection and 1 month after the injection, specular microscopy was performed to evaluate the corneal endothelial changes and central corneal thickness. We classified the patients according to the injected drug (bevacizumab 21 eyes, ranibizumab 20 eyes, aflibercept 47 eyes, dexamathasone implant 30 eyes), phakic or pseudophakic eyes, single or multiple injections and analyzed them retrospectively. Results: The mean corneal endothelial cell density was 2,693.2 ± 298.2 cells/mm2 before injection and 2,686.8 ± 288.7 cells/mm2 1 month after injection, and there was no statistically significant difference (p = 0.731). According to the kind of drug, the mean corneal endothelial cell density and central corneal thickness were not significantly different before and 1 month after injection in any of the 4 groups. Conclusions: There were no significant changes in corneal endothelium before and 1 month after intravitreal injection of the various drugs.
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