펜타캠을 이용한 유리체강내 주입술 후전방인자 변화 분석
The Change of Anterior Chamber Parameters with Pentacam® after Intravitreal Injection
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목적: Pentacam®을 이용하여 유리체강내 주입술시 주입 약제와 용량에 따른 전방인자 및 안압의 변화를 알아보고자 하였다. 대상과 방법: 76명(76안)을 대상으로 유리체강내 트리암시놀론 0.1 ml (12명, 12안), 유리체강내 트리암시놀론 0.05 ml (16명, 16안)와베바시주맙 0.05 ml 주입술(48명, 48안)을 시행하였고, 시술 전과 시술 후 5분째 Pentacam® 촬영을 시행하여 전방깊이, 전방각, 전방용적 및 각막두께를 비교하였다. 또한 시술 전 5분, 시술 직전, 시술 직후, 시술 후 5분, 30분, 1시간, 1일째 안압을 측정하여 비교하였다. 결과: 시술 전후의 전방깊이, 전방각, 전방용적, 시술 후 5분째 안압의 변화는 유리체강내 트리암시놀론 0.1 ml와 0.05 ml를 주입한두 군간에는 통계적으로 유의한 차이가 있었으나(p≤0.01, p≤0.01, p=0.022, p=0.021) 유리체강내 트리암시놀론 0.05 ml와 베바시주맙 0.05 ml를 주입한 두군 사이에는 통계적으로 유의한 차이가 없었다(p=0.430, p=0.855, p=0.640, p=0.807). 결론: 펜타캠으로 0.05 ml 유리체강내 주입술을 시행하였을 때 초기의 안압 상승은 주입한 약제와는 관련 없으며, 초기의 안압 상승이유리체강내 용적 증가에 기인하는 것을 확인하였다. 따라서 유리체강내 0.05 ml 주입술은 주입 후 30분 이내의 안압 조절을 위해서다른 시술이 필요하지 않은 안전한 용량의 시술로 생각된다.
Abstract
Purpose: To evaluate the changes of anterior chamber parameters and intraocular pressure (IOP) with Pentacam® after intravitreal injection. Methods: A total of 76 eyes of 76 patients received an intravitreal injection of either triamcinolone acetonide (TA) or bevacizumab. Twelve patients were treated with an intravitreal injection of TA 0.1 ml, 16 patients were treated with an intravitreal injection of TA 0.05 ml, while the remaining 48 patients received a bevacizumab 0.05 ml injection. All patients underwent anterior chamber depth, anterior chamber angle, and anterior chamber volume evaluation with Pentacam® before and 5 minutes after injection. Additionally, IOP measurements were taken 5 minutes before and 5 minutes, 30 minutes, 1hour and 1 day after injection. Results: Anterior chamber depth, anterior chamber angle, anterior chamber volume, and IOP changes in patients receiving TA 0.1 ml were 0.4 ± 0.11 mm, 10.2 ± 4.1°, 33.7 ± 5.9 mm3 and 18.8 ± 12.1 mm Hg, respectively. Anterior chamber depth, anterior chamber angle, anterior chamber volume, and IOP changes in patients receiving TA 0.05 ml were -0.01 ±0.05 mm, 2.4 ± 3.2°, 5.8 ± 9.5 mm3 and 4.8 ± 7.4 mm Hg, respectively. Anterior chamber depth, anterior chamber angle,anterior chamber volume, and IOP changes in patients receiving bevacizumab were 0.28 ± 0.99 mm, 0.8 ± 4.0°, 7.1 ± 9.6mm3 and 5.4 ± 6.3 mm Hg, respectively. There was a significant difference between TA 0.1 ml and 0.05 ml. However, there was no significant difference between TA 0.05 ml and bevacizumab 0.05 ml. Conclusions: Because of similar anterior chamber parameters changes after 0.05 ml intravitreal injection with TA or bevacizumab,early period IOP increases due to intravitreal volume expansion. Intravitreal 0.05 ml injections do not require any other procedures for controlling IOP 30 minutes after injection.
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