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망막분지정맥폐쇄에서 황반부종 치료로 유리체강내 베바시주맙 주입술의 장기 효과

Intravitreal Bevacizumab Injection for Macular Edema Secondary to Branch Retinal Vein Occlusion: Long-Term Results

이수정|박정민|안성민
대한안과학회 (The Korean Ophthalmological Society)|2014.03|대한안과학회지 (Journal of The Korean Ophthalmological Society)|제55권 제3호|pp. 379-386

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키워드

Macular edemaBevacizumabRetinal vein occlusionRetinal ischemiaInitial loading
주제분류안과학

초록

목적: 망막분지정맥폐쇄의 황반부종에서 연속적인 3회의 유리체강내 베바시주맙 주입술의 장기효과에 대해 알아보고자 하였다. 대상과 방법: 망막분지정맥폐쇄 56안에 대하여 1개월 간격으로 연속적인 3회의 유리체내 베바시주맙 주입술을 한 환자군과 최초 1회주입한 환자군으로 구분하고 황반 부종 재발시에 각각 추가 주입하여 최소 12개월 이상 최대교정시력, 중심황반두께 및 망막허혈 상태변화를 분석하였다. 결과: 12개월 뒤에 두 군 모두에서 통계학적으로 유의한 시력호전 및 중심황반두께 감소가 있었다(p＜0.05). 그러나 시력호전 정도나중심황반두께 감소 폭은 연속적인 3회의 베바시주맙 주입술을 시행한 군에서 더 좋았다. 형광안저촬영 영상으로 망막허혈 상태의 변화를 분석한 결과, 베바시주맙이 망막허혈을 증가시키지는 않았다. 경과 관찰 기간 동안 결막하출혈, 경미한 안압 상승 이외의 안과적및 전신적 합병증은 없었다. 결론: 망막분지정맥폐쇄의 황반부종에서 유리체강내 베바시주맙 주입술은 안전하고 효과적인 치료가 될 수 있으며 연속 3회 주입시에는 1회 주입시보다 더 의미 있는 시력호전 및 중심황반두께 감소를 기대할 수 있다.

Abstract

Purpose: To evaluate the long-term results of intravitreal bevacizumab injection for macular edema secondary to branchretinal vein occlusion (BRVO). Methods: Fifty-six eyes with macular edema secondary to BRVO were treated with intravitreal bevacizumab injection. They were classified into two groups, one group that received three initial intravitreal bevacizumab loadings at monthly intervalsand a second group that received only one initial injection. In the two groups, additive injection was performed atrecurrence. The best corrected visual acuity (BCVA), central macular thickness (CMT) and retinal ischemic change wasanalyzed for more than 12 months postoperatively. Results: After 12 months of follow-up, mean BCVA improved and mean CMT reduced significantly in both groups (p <0.05). However, the range of BCVA improvement and CMT reduction was wider in the three-injection group than in the single-injection group. Fluorescein angiography revealed posterior retinal ischemic changes; bevacizumab didn’t seem to aggravatethe ischemic change. No drug-related ocular or systemic side effects were observed in the follow-up period afterintravitreal bevacizumab treatment except subconjunctival hemorrhage and a mild increase of intraocular pressure. Conclusions: In patients with macular edema secondary to BRVO, intravitreal bevacizumab injection was a safe and effectivetreatment, and a more significant visual improvement and reduction of macular edema was achieved after three initialloadings rather than after a single injection.

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