본문 바로가기
KERD
논문KCI 등재

잠복 맥락막신생혈관을 동반한 나이관련황반변성에서베바시주맙 단독치료와 광역학요법 병합치료

Bevacizumab Monotherapy Versus Combined Therapy with Photodynamic Therapy for Occult Choroidal Neovascularization in Age-Related Macular Degeneration

김성우|허걸|오재령|권순선|오종현
대한안과학회 (The Korean Ophthalmological Society)|2013.10|대한안과학회지 (Journal of The Korean Ophthalmological Society)|제54권 제10호|pp. 1554-1560

2

조회

0

다운로드

0

인용

0

참고문헌

키워드

Photodynamic therapyAge-related macular degenerationBevacizumabOccult choroidal neovascularization
주제분류안과학

초록

목적: 잠복 맥락막신생혈관을 동반한 나이관련황반변성 환자에서 베바시주맙 단독치료와 광역학요법 병합치료의 결과를 비교하고자하였다. 대상과 방법: 베바시주맙 단독치료(IVB군) 또는 광역학요법 병합치료(PDT+IVB군)를 받은 잠복 맥락막신생혈관을 동반한 나이관련황반변성 환자들 중 경과관찰 기간이 12개월 이상인 경우를 대상으로 후향적으로 분석하였다. 광역학요법은 절반 에너지를 이용하였고, 두군 모두 베바시주맙 유리체강내주사를 3회 연속 시행한 후 필요한 경우에 재주사를 시행하였다. 최대교정시력, 중심황반두께, 재주사 횟수 등을 비교하였다. 결과: IVB군은 39안이었으며 PDT+IVB군은 25안이었다. 12개월에 PDT+IVB군에서는 평균최대교정시력이 치료전보다 향상되었지만(p=0.046) IVB 군에서는 그렇지 않았다(p=0.213). 두군 모두 평균중심황반두께가 유의하게 감소하였다(p＜0.001). 평균 재주사 횟수는IVB군은 1.6회, PDT+IVB군은 0.5회였고(p=0.001). 두군 모두 심각한 합병증은 없었다. 결론: 잠복 맥락막신생혈관을 동반한 나이관련황반변성 환자에서 광역학요법 병합치료는 시력을 향상시켰고 재주사 횟수를 감소시켰다.

Abstract

Purpose: To compare clinical outcomes between intravitreal bevacizumab (IVB) monotherapy and combined therapy with half-fluence rate verteporfin photodynamic therapy (PDT) for occult choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD). Methods: Medical records were reviewed in consecutive patients who underwent IVB monotherapy or combined therapy with PDT for occult CNV secondary to AMD and had a 12-month follow-up period. After 3 consecutive monthly IVB injections, both groups were eligible for additional IVB injections when necessary. Best-corrected visual acuity (BCVA), central macular thickness (CMT), and number of additional IVB injections were compared between the groups. Results: Thirty-nine eyes underwent IVB monotherapy (IVB group) and 25 eyes underwent combined therapy (PDT+IVB group). Mean BCVA improved significantly in the PDT+IVB group (p = 0.046) and not in IVB group (p = 0.213). A significant reduction in mean CMT occurred in both groups (p < 0.001). The mean number of additional IVB injections was 1.6 ± 1.33in the IVB group and 0.5 ± 1.01 in the PDT+IVB group (p = 0.001). There were no serious complications. Conclusions: Combined therapy with half-fluence rate PDT improved BCVA and reduced the number of additional IVB injections in the eyes with occult CNV secondary to AMD.

참고문헌 (33)

  1. Verteporfin Roundtable Participants, "Guidelines for using verteporfin (Visudyne) in photodynamic therapy for choroidal neovascularization due to age-related macular degeneration and other causes: update", Retina, 25, pp.119~134 (2005)
  2. Rosenfeld PJ, "Ranibizumab for neovascular age-related macular degeneration", N Engl J Med, 355, pp.1419~1431 (2006)
  3. Spaide RF, "Intravitreal bevacizumab treatment of choroidal neovascularization secondary to age-related macular degeneration", Retina, 26, pp.383~390 (2006)
  4. Brown DM, "Ranibizumab versus verteporfin for neovascular age-related macular degeneration", N Engl J Med, 355, pp.1432~1444 (2006)
  5. Regillo CD, "Randomized, double- masked, sham-controlled trial of ranibizumab for neovascular age-related macular degeneration: PIER Study year 1", Am J Ophthalmol, 145, pp.239~248 (2008)
  6. Sonmez K, "One-year outcomes of less frequent bevacizumab in age-related macular degeneration", Retina, 31, pp.645~653 (2011)
  7. Fung AE, "An optical coherencetomography-guided, variable dosing regimen with intravitreal ranibizumab (Lucentis) for neovascular age-related macular degeneration", Am J Ophthalmol, 143, pp.566~583 (2007)
  8. Cohen SY, "Results of one-year's treatment with ranibizumab for exudative age-related macular degeneration in a clinical setting", Am J Ophthalmol, 148, pp.409~413 (2009)
  9. Lalwani GA, "A variable-dosing regimen with intravitreal ranibizumab for neovascular age-related macular degeneration: year 2 of the PrONTO Study", Am J Ophthalmol, 148, pp.43~58 (2009)
  10. 유영주, "신생혈관성 나이관련황반변성에서 베바시주맙 주입과 광역학요법을 병합한 일차치료 효과", 대한안과학회지, 51(1), pp.35~41 (2010), 대한안과학회
  11. Rudnisky C, "Intravitreal bevacizumab alone versus combined verteporfin photodynamic therapy and intravitreal bevacizumab for choroidal neovascularization in age-related macular degeneration: visual acuity after 1 year of follow-up", Retina, 30, pp.548~554 (2010)
  12. Bashshur ZF, "Ranibizumab monotherapy versus single-session verteporfin photodynamic therapy combined with as-needed ranibizumab treatment for the management of neovascular age-related macular degeneration", Retina, 31, pp.636~644 (2011)
  13. Larsen M, "Verteporfin plus ranibizumab for choroidal neovascularization in age-related macular degeneration: twelve-month MONT BLANC study results", Ophthalmology, 119, pp.992~1000 (2012)
  14. Kaiser PK, "Verteporfin plus ranibizumab for choroidal neovascularization in age-related macular degeneration: twelve-month results of the DENALI study", Ophthalmology, 119, pp.1001~1010 (2012)
  15. Krebs I, "Comparison of Ranibizumab monotherapy versus combination of Ranibizumab with photodynamic therapy with neovascular age-related macular degeneration", Acta Ophthalmol, 91, pp.e178~e183 (2013)
  16. Cohen SY, "Types of choroidal neovascularisation in newly diagnosed exudative age-related macular degeneration", Br J Ophthalmol, 91, pp.1173~1176 (2007)
  17. Verteporfin In Photodynamic Therapy Study Group, "Verteporfin therapy of subfoveal choroidal neovascularization in age-related macular degeneration: two-year results of a randomized clinical trial including lesions with occult with no classic choroidal neovascularization-- verteporfin in photodynamic therapy report 2", Am J Ophthalmol, 131, pp.541~560 (2001)
  18. Soubrane G, "Verteporfin therapy in occult with no classic CNV due to AMD: results of the Photodynamic Therapy in Occult-Only Lesions study", Eye (Lond), 23, pp.791~800 (2009)
  19. Costagliola C, "Intravitreal bevacizumab for treatment-naive patients with subfoveal occult choroidal neovascularization secondary to age-related macular degeneration: a 12-month follow-up study", Retina, 29, pp.1227~1234 (2009)
  20. Furino C, "Intravitreal bevacizumab for treatment-naïve subfoveal occult choroidal neovascularization in age-related macular degeneration", Acta Ophthalmol, 87, pp.404~407 (2009)
  21. Japanese Age-Related Macular Degeneration Tial (JAT) Study Group., "Japanese age-related macular degeneration trial: 1-year results of photodynamic therapy with verteporfin in Japanese patients with subfoveal choroidal neovascularization secondary to age-related macular degeneration", Am J Ophthalmol, 136, pp.1049~1061 (2003)
  22. Costagliola C, "Low fluence rate photodynamic therapy combined with intravitreal bevacizumab for neovascular age-related macular degeneration", Br J Ophthalmol, 94, pp.180~184 (2010)
  23. Sacu S, "Reduced fluence versus standard photodynamic therapy in combination with intravitreal triamcinolone: short-term results of a randomised study", Br J Ophthalmol, 92, pp.1347~1351 (2008)
  24. Spaide R, "Ranibizumab according to need: a treatment for age-related macular degeneration", Am J Ophthalmol, 143, pp.679~680 (2007)
  25. Ciulla TA, "Antivascular endothelial growth factor therapy for neovascular age-related macular degeneration", Curr Opin Ophthalmol, 20, pp.158~165 (2009)
  26. Miller JW, "Photodynamic therapy with verteporfin for choroidal neovascularization caused by age-related macular degeneration: results of a single treatment in a phase 1 and 2 study", Arch Ophthalmol, 117, pp.1161~1173 (1999)
  27. Kiss CG, "Combination of verteporfin photodynamic therapy and ranibizumab: effects on retinal anatomy, choroidal perfusion and visual function in the protect study", Br J Ophthalmol, 92, pp.1620~1627 (2008)
  28. Antoszyk AN, "Ranibizumab combined with verteporfin photodynamic therapy in neovascular age-related macular degeneration (FOCUS): year 2 results", Am J Ophthalmol, 145, pp.862~874 (2008)
  29. Parodi MB, "Retinal pigment epithelium changes after photodynamic therapy for choroidal neovascularization in pathological myopia", Acta Ophthalmol Scand, 85, pp.50~54 (2007)
  30. Rouvas AA, "Enlargement of the hypofluorescent post photodynamic therapy treatment spot after a combination of photodynamic therapy with an intravitreal injection of bevacizumab for retinal angiomatous proliferation", Graefes Arch Clin Exp Ophthalmol, 246, pp.315~318 (2008)
  31. Michels S, "Influence of treatment parameters on selectivity of verteporfin therapy", Invest Ophthalmol Vis Sci, 47, pp.371~376 (2006)
  32. Moon SW, "Photodynamic therapy combined with intravitreal injection of vascular endothelial growth factor antibody for polypoidal choroidal vasculopathy", Ophthalmologica, 225, pp.169~175 (2011)
  33. 이자균, "결절맥락막혈관병증에서 베바시주맙 주입술과 광역학치료와의 병합치료의 비교", 대한안과학회지, 51(5), pp.684~692 (2010), 대한안과학회

관련 논문AI추천

삼출성 나이관련황반변성과 결절맥락막혈관병증에서 광역학치료와 베바시주맙 병합치료구기홍, 엄부섭, 이미현, 이지은대한안과학회 · 대한안과학회지2011 · 제52권 제7호맥락막신생혈관을 동반한 삼출성 나이관련황반변성 환자에서 광역학치료 후 10년간의 경과관찰김하경, 남우호, 배소현, 조두영, 한재룡대한안과학회 · 대한안과학회지2012 · 제53권 제1호Combined Treatment of Photodynamic Therapy and Bevacizumab for Choroidal Neovascularization Secondary to Age-Related Macular Degeneration김정림, 김현웅, 이지은, 정인영, Hyung Gon Yoo, Mi Hyun Lee대한안과학회 · Korean Journal of Ophthalmology2011 · 제25권 제4호광역학치료와 베바시주맙을 이용한 특발 중심와부근 모세혈관확장증 I형의 치료김인근, 박정민, 이지은대한안과학회 · 대한안과학회지2016 · 제57권 제12호만성 중심장액맥락망막병증에서 절반에너지 광역학치료와베바시주맙 주입술의 12개월간 치료효과 비교김영승, 김형석, 이영훈, 이태곤, 진선영대한안과학회 · 대한안과학회지2013 · 제54권 제10호결절맥락막혈관병증에서 광역학요법과 항혈관내피세포성장인자 주입술 병합치료의 장기추적 관찰결과김성우, 오재령, 한지윤대한안과학회 · 대한안과학회지2017 · 제58권 제6호

이 간행물의 다른 논문 (24건)

만성 누소관염의 임상양상과 치료노주헌, 박재홍pp. 1481-1487원발성 콩다래끼 환자에서 병소 내 트리암시놀론주사요법과 절개배농술의 치료 효과 비교김성진, 이종욱pp. 1488-1493개방형고리를 이용한 수정체전낭 원형절개술의 유용성이용은, 황규연, 주천기, 김수아pp. 1494-1500라섹과 M-라섹 후 각막내피세포의 변화이담호, 이승재, 경학수pp. 1501-15072.2 mm 미세각막절개 백내장수술 시 회전진동방식 초음파유화술과 직선운동방식 초음파유화술을 이용한 임상결과 비교임성아, 김현승, 황형빈pp. 1508-1513
원문 보기