베바시주맙 안내주사가 망막혈관직경, 안압, 망막신경섬유층 및 시신경에 미치는 영향
The Effect of Bevacizumab on Retinal Vessel Diameter, Intraocular Pressure, Retinal Nerve Fiber Layer and the Optic Disc
3
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
목적: 당뇨황반부종 환자에서 단회의 베바시주맙 안내주사가 망막혈관직경, 안압, 망막신경섬유층두께 및 시신경에 미치는 영향을 살펴보았다. 대상과 방법: 2009년 6월부터 2011년 6월까지 당뇨황반부종으로 베바시주맙 안내주사를 맞은 63안을 대상으로 주사 전과 주사 후 7일,1개월, 3개월, 6개월의 망막혈관직경, 안압, 망막신경섬유층두께, 수직시신경유두함몰비를 후향적으로 분석하였다. 안저사진과 Parr-Hurbard공식을 이용하여 중심망막동맥 및 정맥의 직경을 구하였다. 망막시신경섬유층두께는 빛간섭단층촬영 측정치를 이용하였고 시신경유두함몰비는 입체시신경유두 사진을 통해 평가하였다. 결과: 중심망막동맥직경은 주사 전과 비교하여 주사 후 7일, 1개월에 유의하게 감소하였지만(p＜0.001, p=0.036) 3개월, 6개월에는 유의한변화가 관찰되지 않았다(p=0.992, p=0.342). 중심망막정맥직경, 안압, 망막신경섬유층두께, 시신경유두함몰비에는 유의한 변화가 없었다. 결론: 단회의 베바시주맙 안내주사는 일시적인 중심망막동맥직경의 감소를 가져왔고 중심망막정맥직경, 안압, 망막신경섬유층두께, 시신경유두함몰비에는 영향을 주지 않았다.
Abstract
Purpose: To evaluate the effects of a single intravitreal bevacizumab injection on retinal vessel diameter, intraocular pressure(IOP), retinal nerve fiber layer (RNFL) thickness and the optic disc in patients with diabetic macular edema (DME). Methods: In this retrospective study, 63 eyes with DME were included. All patients received an intravitreal injection of 1.25mg bevacizumab. We reviewed retinal vessel diameter, IOP RNFL thickness and vertical cup-to-disc (C/D) ratios at thebaseline and 7 days, 1 month, 3 months and 6 months after injection. The diameter of the central retinal arteries and veinswere measured using retinal photographs. The central retinal arteriolar equivalent (CRAE) and central retinal venularequivalent (CRVE) were calculated using the revised Parr-Hubbard formula. RNFL thickness was obtained using opticalcoherence tomography. The vertical C/D ratio of the optic disc was evaluated using stereoscopic optic disc photography. Results: After bevacizumab injection, the CRAE significantly decreased at 7 days and 1 month postoperatively comparedto baseline (p < 0.001 and p = 0.036, respectively). However, the changes in the CRAE at 3 months and 6 months were notstatistically significant (p = 0.992 and p = 0.342, respectively). There were no statistically significant changes in the CRVE,mean IOP, RNFL thickness and vertical C/D ratios of the optic disc. Conclusions: A single intravitreal bevacizumab injection transiently decreased the diameters of central retinal arterioles,but induced no significant changes in central venular diameter, mean IOP, RNFL thickness or vertical C/D ratios of the opticdisc.
참고문헌 (32)
- Andreoli CM, "Anti-vascular endothelial growth factor therapy for ocular neovascular disease", Curr Opin Ophthalmol, 18, pp.502~508 (2007)
- Chong V, "Biological, preclinical and clinical characteristics of inhibitors of vascular endothelial growth factors", Ophthalmologica, 227(1), pp.2~10 (2012)
- Caldwell RB, "Vascular endothelial growth factor and diabetic retinopathy: pathophysiological mechanisms and treatment perspectives", Diabetes Metab Res Rev, 19, pp.442~455 (2003)
- Harris A, "Regulation of retinal and optic nerve blood flow", Arch Ophthalmol, 116, pp.1491~1495 (1998)
- Tilton RG, "Role for nitric oxide in the hyperpermeability and hemodynamic changes induced by intravenous VEGF", Invest Ophthalmol Vis Sci, 40, pp.689~696 (1999)
- Nishijima K, "Vascular endothelial growth factor-A is a survival factor for retinal neurons and a critical neuroprotectant during the adaptive response to ischemic injury", Am J Pathol, 171, pp.53~67 (2007)
- Drance SM, "Studies of factors involved in the production of low tension glaucoma", Arch Ophthalmol, 89, pp.457~465 (1973)
- Mitchell P, "Retinal vessel diameter and open-angle glaucoma: the Blue Mountains Eye Study", Ophthalmology, 112, pp.245~250 (2005)
- Chen SD, "Neuroprotection in glaucoma: present and future", Chin Med J (Engl), 126, pp.1567~1577 (2013)
- Weinreb RN, "Glaucoma neuroprotection: What is it? Why is it needed?", Can J Ophthalmol, 42, pp.396~398 (2007)
- Bakri SJ, "Pharmacokinetics of intravitreal bevacizumab (Avastin)", Ophthalmology, 114, pp.855~859 (2007)
- Krohne TU, "Intraocular pharmacokinetics of ranibizumab following a single intravitreal injection in humans", Am J Ophthalmol, 154, pp.682-6.e2~ (2012)
- Patel RD, "Review of ranibizumab trials for neovascular age-related macular degeneration", Semin Ophthalmol, 26, pp.372~379 (2011)
- Nicholson BP, "A review of clinical trials of anti-VEGF agents for diabetic retinopathy", Graefes Arch Clin Exp Ophthalmol, 248, pp.915~930 (2010)
- van der Reis MI, "A systematic review of the adverse events of intravitreal anti-vascular endothelial growth factor injections", Retina, 31, pp.1449~1469 (2011)
- Mendrinos E, "Retinal vessel analyzer measurements of the effect of panretinal photocoagulation on the retinal arteriolar diameter in diabetic retinopathy", Retina, 30, pp.555~561 (2010)
- Chang M, "Retinal vessel diameter, retinal nerve fiber layer thickness, and intraocular pressure in korean patients with normal-tension glaucoma", Am J Ophthalmol, 151, pp.100-5.e1~ (2011)
- Knudtson MD, "Revised formulas for summarizing retinal vessel diameters", Curr Eye Res, 27, pp.143~149 (2003)
- Foxton RH, "VEGF-A is necessary and sufficient for retinal neuroprotection in models of experimental glaucoma", Am J Pathol, 182, pp.1379~1390 (2013)
- Papadopoulou DN, "Intravitreal ranibizumab may induce retinal arteriolar vasoconstriction in patients with neovascular age-related macular degeneration", Ophthalmology, 116, pp.1755~1761 (2009)
- Tatlipinar S, "Short-term effects of a single intravitreal bevacizumab injection on retinal vessel calibre", Clin Exp Optom, 95, pp.94~98 (2012)
- Jonas JB, "Parapapillary retinal vessel diameter in normal and glaucoma eyes. I. Morphometric data", Invest Ophthalmol Vis Sci, 30, pp.1599~1603 (1989)
- Rader J, "Peripapillary vasoconstriction in the glaucomas and the anterior ischemic optic neuropathies", Am J Ophthalmol, 117, pp.72~80 (1994)
- Rankin SJ, "Peripapillary focal retinal arteriolar narrowing in open angle glaucoma", J Glaucoma, 5, pp.22~28 (1996)
- Kahook MY, "Sustained elevation in intraocular pressure associated with intravitreal bevacizumab injections", Ophthalmic Surg Lasers Imaging, 40, pp.293~295 (2009)
- Bakri SJ, "Immediate intraocular pressure changes following intravitreal injections of triamcinolone, pegaptanib, and bevacizumab", Eye (Lond), 23, pp.181~185 (2009)
- Good TJ, "Sustained elevation of intraocular pressure after intravitreal injections of anti-VEGF agents", Br J Ophthalmol, 95, pp.1111~1114 (2011)
- Hoang QV, "Clinical predictors of sustained intraocular pressure elevation due to intravitreal anti-vascular endothelial growth factor therapy", Retina, 33, pp.179~187 (2013)
- Wehrli SJ, "A lack of delayed intraocular pressure elevation in patients treated with intravitreal injection of bevacizumab and ranibizumab", Retina, 32, pp.1295~1301 (2012)
- Horsley MB, "Retinal nerve fiber layer thickness in patients receiving chronic anti-vascular endothelial growth factor therapy", Am J Ophthalmol, 150, pp.558-61.e1~ (2010)
- Seth RK, "Assessment of optic nerve cup-to-disk ratio changes in patients receiving multiple intravitreal injections of antivascular endothelial growth factor agents", Retina, 29, pp.956~959 (2009)
- Martinez-de-la-Casa JM, "Retinal nerve fiber layer thickness changes in patients with age-related macular degeneration treated with intravitreal ranibizumab", Invest Ophthalmol Vis Sci, 53, pp.6214~6218 (2012)