당뇨황반부종에서 베바시주맙 단일주입과 저용량베바시주맙-트리암시놀론 혼합주입 단기효과 비교
Comparison of Intravitreal Bevacizumab Alone Injection and Intravitreal Combination Low-Dose Bevacizumab-Triamcinolone Injection or Diabetic Macular Edema
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목적: 당뇨황반부종 환자에서 저용량의 베바시주맙과 트리암시놀론을 유리체강 내로 혼합하여 주입한 경우와 베바시주맙을 유리체강내에 단독 주입하였을 때의 단기간 황반 부종에 대한 효과와 안압 변동에 대해 비교하고자 하였다. 대상과 방법: 당뇨황반부종 환자 총 40명을 대상으로 저용량의 베바시주맙 0.625 mg/0.025 mL와 트리암시놀론 1 mg/0.025 mL를혼합하여 유리체강 내로 주입한 20안과 베바시주맙 1.25 mg/0.05 mL를 유리체강 내로 단독 주입한 20안을 대상으로 시술 전, 1개월,2개월, 3개월의 황반 두께, 최대 교정시력, 안압을 비교하였다. 결과: 저용량의 저용량의 베바시주맙과 트리암시놀론을 혼합하여 유리체강 내로 주입한 군과 베바시주맙을 단독으로 유리체강 내로주입한 군에서 모두 시술 후 1개월, 2개월, 3개월째 최대 교정시력은 유의한 증가소견을 보여 주었으며(p＜0.05) 안압의 변동은 3개월간 의미 있는 증가는 없었다(p＞0.05). 또한 시술 후 1개월, 2개월, 3개월의 황반 두께는 양군 모두에서 유의한 감소 소견을 보여 주었다(p＜0.05). 시술 후 3개월간 최대 교정시력, 안압변동, 황반 두께 변화에서 양군을 비교한 결과 의미 있는 차이는 없었다(p＞0.05). 결론: 당뇨황반부종 환자의 유리체강 내 단독 베바시주맙 주입과 유리체강 내 저용량의 베바시주맙-트리암시놀론 혼합 주입은 모두단기간에 시력호전과 부종감소의 효과가 있다. 당뇨황반부종 환자에서 유리체강 내 단독 베바시주맙 주입뿐만 아니라 유리체강 내저용량의 베바시주맙-트리암시놀론 혼합 주입을 고려해 볼 수 있다.
Abstract
Purpose: To report the effects and intraocular pressure results of intravitreal bevacizumab alone injection compared with intravitreallow-dose bevacizumab combined with low-dose triamcinolone injection in patients with diabetic macular edema. Methods: In total, 40 eyes of 40 patients diagnosed with diabetic macular edema were evaluated. Of these, 20 eyes of 20 patientswere injected with intravitreal bevacizumab (1.25 mg/0.05 mL) and 20 eyes of 20 patients were injected with low-dosebevacizumab (0.625 mg/0.025 mL) combined with low-dose triamcinolone (1 mg/0.025 mL). The best corrected visual acuity(BCVA), central macular thickness, and intraocular pressure of treated eyes were measured before injection and at 1 month, 2months, and 3 months after injection. Results: In both the intravitreal bevacizumab and the low-dose bevacizumab combined with low-dose triamcinolone groups,BCVA increased significantly at 1 month, 2 months, and 3 months after injection (p < 0.05). In addition, in both groups, neither intraocularpressure (IOP) nor central macular thickness increased significantly at 1 month, 2 months, or 3 months after injection (p> 0.05). The BCVA, IOP, and central macular thickness (CMT) at 1 month, 2 months, and 3 months after injection showed no significantdifferences between the intravitreal bevacizumab group and the low-dose bevacizumab combined with low-dose triamcinolonegroup (p > 0.05). Conclusions: The BCVA of both groups increased significantly, and the CMT of both groups decreased significantly in patientswith diabetic macular edema. The injection of low-dose intravitreal bevacizumab combined with low-dose intravitreal triamcinolonemay be useful for the treatment of diabetic macular edema.
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