망막혈관종성증식에 동반된 망막색소상피파열에서 항혈관내피세포성장인자 주입술의 임상결과
Intravitreal Anti-Vascular Endothelial Growth Factor for Retinal Pigment Epithelial Tear in Retinal Angiomatous Proliferation
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목적: 망막혈관종성증식에 동반된 망막색소상피파열 환자를 대상으로 유리체강내 항혈관내피세포성장인자 주입술의 임상 결과를 알아보고자 한다. 대상과 방법: 망막혈관종성증식에 동반된 망막색소상피파열로 진단 받은 후 유리체강내 항혈관내피세포성장인자 주입술로 치료 받은 14명(14안)을 대상으로 후향적 의무기록 분석을 시행하였다. 망막색소상피파열이 발생하였을 때, 발생 후 6개월 및 최종 추적관찰 시의 시력을 서로 비교하였다. 결과: 환자의 평균 연령은 75.1 ± 7.0세였으며, 평균 추적관찰 기간은 23.7 ± 13.7개월이었다. 추적관찰 기간 중 평균 2.8 ± 1.3회의 유리체강내 항혈관내피세포성장인자 주입술을 시행하였다. 망막색소상피파열 발생 당시의 평균 최대교정시력(logarithm of minimal angle of resolution)은 1.25 ± 0.44였으며, 점차 악화되는 경향을 보여 6개월 및 최종 추적관찰 시의 평균 시력은 각각 1.44 ± 0.56, 1.65 ± 0.39로 측정되었다. 발생 당시의 시력과 비교하여 6개월의 시력은 차이가 없었으나(p=0.258) 최종 추적관찰 시의 시력은 유의하게 악화된 결과를 보였다(p=0.002). 결론: 본 연구에서 망막혈관종성증식에서 발생한 망막색소상피파열은 항혈관내피세포성장인자 치료에도 불구하고 매우 불량한 예후를 보였다. 이와 같은 본 연구의 결과는 망막색소상피파열을 예방하거나 보다 효과적으로 치료할 수 있는 방안에 대한 추가 연구가 필요하다는 점을 시사한다.
Abstract
Purpose: To evaluate the treatment outcomes of intravitreal anti-vascular endothelial growth factor (VEGF) therapy for retinal pigment epithelial (RPE) tear in retinal angiomatous proliferation (RAP). Methods: In the present study we retrospectively analyzed the medical records of 14 patients (14 eyes) diagnosed with RPE tear secondary to RAP treated with intravitreal anti-VEGF. Best-corrected visual acuity (BCVA) when the RPE tear developed was compared with BCVA at 6 months and at the final follow-up. Results: The mean age of the study patients was 75.1 ± 7.0 years and the mean follow-up period was 23.7 ± 13.7 months. During the follow-up period, patients were treated with a mean of 2.8 ± 1.3 intravitreal anti-VEGF injections. The mean logarithm of minimal angle of resolution BCVA when the RPE tear developed, at 6 months and at the final follow-up was 1.25 ± 0.44, 1.44 ± 0.56, and 1.65 ± 0.39, respectively. The BCVA at 6 months was not different from the baseline value (p = 0.258), whereas the BCVA at the final follow-up was significantly worse than the baseline value (p = 0.002). Conclusions: The prognosis of RPE tear in RAP is poor despite anti-VEGF therapy. This result suggests further investigations regarding the prevention of RPE tear or more effective treatment method for this condition are necessary.
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