나이관련황반변성에서 라니비주맙과 애프리버셉트 후 맥락막두께의 변화 비교: 6개월 결과
Comparison of Choroidal Thickness Change between Ranibizumab and Aflibercept in Age-related Macular Degeneration: Six Month Results
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목적: 삼출성 나이관련황반변성 환자에서 유리체강내 애프리버셉트와 라니비주맙 주입술 후 맥락두께의 변화를 비교해 보고자 한다. 대상과 방법: 삼출성 나이관련황반변성 환자 중 1개월 간격으로 3회 애프리버셉트 또는 라니비주맙 주입술 후 필요할 때마다 추가 주사를 하면서 6개월 이상 경과관찰한 50명 53안을 대상으로 후향적으로 분석하였다. 스펙트럼영역 빛간섭단층촬영을 이용하여 주사 전, 첫 번째 주사 후 1개월, 2개월, 3개월, 6개월에 황반하 맥락막두께를 측정하여 변화를 연구하였다. 결과: 황반하 맥락막두께는 애프리버셉트 주입군(25안)에서 주사 전과 첫 번째 주사 후 1개월, 2개월, 3개월, 6개월에 각각 244.94 ± 103.77 μm, 219.04 ± 95.89 μm, 208.74 ± 91.03 μm, 203.64 ± 91.35 μm, 226.98 ± 96.79 μm였으며, 라니비주맙 주입군(28안) 에서는 222.68 ± 102.04 μm, 210.23 ± 95.91 μm, 203.66 ± 99.39 μm, 197.27 ± 100.25 μm, 210.32 ± 111.86 μm였다. 황반하맥락막두께의 변화량은 첫 번째 주사 후 1개월, 2개월, 3개월에 애프리버셉트 주입군이 라니비주맙 주입군보다 의미있게 더 많이 감소하였으며(p<0.05), 6개월에는 두 군 간에 의미 있는 차이는 없었다(p>0.05). 결론: 매달 3회 연속 주사 중에는 애프리버셉트 주입군에서 라니비주맙 주입군보다 황반하 맥락막두께가 더 많이 감소하였으나, 치료 시작 6개월 후에는 의미있는 차이는 없었다.
Abstract
Purpose: To compare the changes in subfoveal choroidal thickness between intravitreal aflibercept and ranibizumab injection in wet age-related macular degeneration (AMD). Methods: Fifty patients with wet AMD patients who were treated with aflibercpet or ranibizumab were evaluated retrospectively. All patients were treated with pro re nata after 3 consecutive monthly injections and were followed up for at least 6 months. We measured subfoveal choroidal thickness (SFCT) using enhanced depth imaging spectral-domain optical coherence tomography before the first injection and 1, 2, 3, and 6 months after initial injection. Results: The SFCT measures before initial injection and 1, 2, 3, and 6 months after initial injection were 244.94 ± 103.77 μm, 219.04 ± 95.89 μm, 208.74 ± 91.03 μm, 203.64 ± 91.35 μm, and 226.98 ± 96.79 μm in the aflibercept group (25 eyes) and 222.68 ± 102.04 μm, 210.23 ± 95.91 μm, 203.66 ± 99.39 μm, 197.27 ± 100.25 μm, and 210.32 ± 111.86 μm in the ranibizumab group (28 eyes). Mean change in SFCT was greater in the aflibercept group at 1 month, 2 months, and 3 months after initial injection (p < 0.05), but there was no significant difference in the mean change in SFCT between the two groups at 6 months after initial injection (p > 0.05). Conclusions: The decrease in SFCT was greater after aflibercept injection than ranibizumab injection in 3 consecutive months. However, at 6 months after initial injection, the difference in the change in SFCT was not significant.
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