유리체강내 덱사메타존 임플란트 삽입술 후 안압 상승의 발생률과 위험인자
Risk Factors and Incidence of Elevated Intraocular Pressure after Dexamethasone Intravitreal Implant
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목적: 유리체강내 덱사메타존 임플란트 삽입술 후 안압 상승의 발생률과 안압 상승에 영향을 미치는 위험인자에 대해 알아보고자 한다. 대상과 방법: 유리체강내 덱사메타존 임플란트 삽입술을 받은 환자 중 3개월 이상 경과관찰한 79명 86안을 대상으로 의무기록을 후향적으로 조사하였고, 안압 상승은 안압이 21 mmHg 초과한 경우로 정의하였다. 결과: 유리체강내 덱사메타존 임플란트 삽입술 후 29안(33.7%)에서 안압이 상승하였고, Kaplan-Meier 분석으로 측정한 삽입술 후 81일째 안압 상승의 발생률은 25.6 ± 4.7%였다. Cox multivariate analysis를 이용하여 성별, 삽입술 횟수, 원인 안과 질환, 당뇨병, 녹내장 과거력의 영향을 보정한 안압 상승의 위험인자는 55세 미만의 젊은 연령(p=0.045), 주사 전 안압이 15 mmHg 이상(p<0.001), 안내수술의 과거력이었다(p=0.039). 결론: 유리체강내 덱사메타존 임플란트 삽입술 후 안압 상승의 발생률은 약 33.7%였다. 삽입술 전 안내 수술의 과거력이 있고, 나이가 55세 미만, 안압이 15 mmHg 이상이 안압 상승의 위험인자로 발견되었다. 유리체강내 덱사메타존 임플란트 삽입술 전 안압 상승의 위험인자를 파악하고, 삽입술 후 위험인자를 가지고 있는 환자들에 대한 주의가 필요할 것으로 생각된다.
Abstract
Purpose: To report the incidence of intraocular pressure (IOP) elevation and identify the risk factors of IOP elevation after intravitreal dexamethasone 0.7 mg (Ozurdex®, Allergan, Irvine, CA, USA) implant. Methods: A total of 86 eyes of 79 patients who underwent intravitreal dexamethasone implantation and who were followed for ≥ 3 months were included in the present study. IOP elevation was defined as a pressure > 21 mm Hg at some time during follow-up. Results: Twenty-nine eyes (33.7%) had an IOP > 21 mm Hg after dexamethasone intravitreal implant. The incidence of IOP elevation increased rapidly at 2‒3 months after dexamethasone intravitreal implant. The Kaplan-Meier estimated incidence of IOP elevation was 25.6 ± 4.7% (mean ± standard error) at 81 days. Cox multivariate analysis showed the significant risk factors of IOP elevation to be age < 55 years (p = 0.045), baseline IOP ≥ 15 mm Hg (p < 0.001), and history of intraocular surgery (p = 0.039). Conclusions: This study demonstrates the incidence of IOP elevation to be 33.7% and describes the risk factors associated with IOP elevation. Clinicians should be cautious regarding the possibility of IOP elevation after intravitreal dexamethasone implant, especially in the presence of identified risk factors.
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