당뇨망막병증에서 유리체강내 베바시주맙 주사 후 망막미세혈관류의 변화
The Change of Microaneurysm in Diabetic Retinopathy Patients Who Undergo Intravitreal Avastin (Bevacizumab) Injection
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목적: 유리체강내 베바시주맙을 주사하였던 당뇨망막병증 환자에서 형광안저촬영을 비교하여 미세혈관류의 변화를 확인하고자 하였다. 대상과 방법: 2008년 6월에서 2013년 5월(5년)까지의 의무기록을 후향적으로 분석하였고, 당뇨망막병증으로 단안에 1.25 mg/0.05mL 유리체강내 베바시주맙 주사를 맞은 31명 31안을 대상으로 하였으며 반대 안 31안을 대조군으로 파악하였다. 양안 모두에 주사를맞거나 유리체출혈에 의해 형광안저촬영을 할 수 없는 경우는 제외하였다. 시술 전과 시술 후 2-4개월에 형광안저촬영을 이용하여시신경유두부와 황반부를 반지름으로 하는 동일지점에서 미세혈관류의 변화를 측정하였다. 결과: 시술 전 미세혈관류의 개수가 평균 42.58 ± 33.93에서 시술 후 28.74 ± 28.06으로 통계적으로 유의한 감소를 보였다(p ＜0.05). 또한 미세혈관류의 변화를 시술을 시행한 눈과 반대편 대조군과 비교하였을 때에도 35.70 ± 24.79%와 13.95 ± 38.21%로통계학적 유의성을 관찰할 수 있었다(p＜0.05). 결론: 유리체강내 베바시주맙 주사가 당뇨망막병증환자에서 신생혈관과 황반부종 감소뿐만 아니라 미세혈관류의 감소를 보여주었으며 이는 망막내 미세혈관변화에 대한 전향적 분석을 위한 좋은 선행자료로 사용 가능성을 제시하였다.
Abstract
Purpose: To evaluate microvascular change (microaneurysm) in diabetic retinopathy patients who undergo intravitreal bevacizumabinjection using fluorescein angiography (FAG). Methods: Thirty one eyes of 31 diabetic retinopathy patients undergoing intravitreal bevacizumab injection (1.25 mg/0.05 mL) inonly 1 eye were included in this study. The control group (31 eyes) consisted of the fellow eyes. We excluded cased with intravitrealbevacizumab injection in both eyes and medial opacity obscuring three fundus image due to vitreous hemorrhage. The microaneurysmalchange was analyzed at the same site the circle with optic disc radius and macula using FAG 2 to 4 months afterinjection. Results: The average number of microaneurysms was 42.58 ± 33.93 and significantly decreased to 28.74 ± 28.06 after intravitrealbevacizumab injection (p < 0.05). The decrease of 35.70 ± 24.79% in the treatment group was statistically higher than13.95 ± 38.21% in the control group with the fellow eyes (p < 0.05). Conclusions: In the present study, intravitreal bevacizumab injection reduced neovascularization, cystoid macular edema. Therefore this data can be used for future research on microvascular changes in the retina.
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