당뇨병유두병증에서 유리체강내 베바시주맙 주입술 후 망막신경섬유층 두께의 장기간 변화 2예
www.ophthalmology.org 1451 =ABSTRACT= Two Cases of Long-Term Changes in the Retinal Nerve Fiber Layer Thickness after Intravitreal Bevacizumab for Diabetic Papillopathy
0
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
목적: 당뇨병유두병증에서 유리체강내 베바시주맙 주입술 후 망막신경섬유층 두께 변화를 장기간 측정한 2예를 보고하고자 한다. 증례요약: 36세 당뇨환자가 우안 시력저하(20/200)로 내원하였고 안저검사상 양안 시신경유두부종이 관찰되었다. 스펙트럼영역 빛간섭단층촬영기로 측정한 우안의 망막신경섬유층 두께 278 μm로 증가 소견, 시야검사상 우안 코쪽에 국소적인 협착을 보였다. 우안베바시주맙 주입술을 하였고 3주 후 두께는 135 μm로 감소했으며 시력도 20/25로 호전되었으나, 좌안 시력저하(20/32)와 망막신경섬유층 두께가 207 μm로 증가하였다. 좌안 베바시주맙 주입술을 하였고, 3주 후 두께는 147 μm로 감소했고 시력도 20/20으로 호전되었다. 이 후 점차적으로 양안 망막신경섬유층 두께는 감소하였고, 1년 후 검사에서 우안 87 μm, 좌안 109 μm였다. 57세 당뇨환자가우안 시력저하(20/200)로 내원하였고 우안의 시신경유두부종과 망막신경섬유층의 두께가 252 μm로 증가된 소견 및 시야검사상 맹점확대를 보였다. 우안 베바시주맙 주입술 3주 후 두께는 136 μm로 감소했고 시력은 20/70으로 호전되었으며, 3개월 후 104 μm, 6개월에는 83 μm로 감소했다. 결론: 본 증례에서 유리체강내 베바시주맙 주입술 후 3주내 시력의 상승과 스펙트럼영역 빛간섭단층촬영기를 통한 1년간 평균 망막신경섬유층 두께의 감소를 확인할 수 있었다.
Abstract
Purpose: To report long-term changes in the average retinal nerve fiber layer (RNFL) thickness in 2 patients who had intravitreal bevacizumab (IVB) injection for diabetic papillopathy. Case summary: A 36-year-old patient with diabetes complained of decreased visual acuity (20/200) in the right eye. The fundus examination showed optic disc swelling in both eyes. The average RNFL thickness based on optical coherence tomography (OCT) increased to 278 μm and Goldmann perimetry showed nasal visual field defect in the right eye. The IVB was injected into the right eye. Three weeks after the IVB injection, RNFL thickness decreased to 135 μm and visual acuity improved to 20/25 in the right eye. However, RNFL thickness increased from 126 to 207 μm and visual acuity decreased to 20/32 in the left eye. Thus, IVB was injected into the left eye. In week 3, RNFL thickness decreased to 147 μm and visual acuity improved to 20/20 in the left eye. At 12 months after IVB injection, RNFL thickness was 87 μm in the right eye and 109 μm in the left eye. A 57-year-old patient with diabetes complained of decreased visual acuity (20/200) and showed optic disc swelling in the right eye. The average RNFL thickness increased to 252 μm and Goldmann perimetry showed an enlarged blind spot in the right eye. IVB was injected into the right eye. After 3 weeks, RNFL thickness decreased to 136μm and visual acuity improved to 20/70 in the right eye. Six months after IVB injection, RNFL thickness was 83 μm in the right eye. Conclusions: Visual acuity progressively improved within 3 weeks and RNFL thickness measured by spectral domain OCT showed progressive thickness reduction in 2 cases of diabetic papillopathy patients who had IVB injections.
참고문헌 (11)
- Appen RE, "Diabetic papillopathy", Am J Ophthalmol, 90, pp.203~209 (1980)
- Regillo CD, "Diabetic papillopathy. Patient characteristics and fundus findings", Arch Ophthalmol, 113, pp.889~895 (1995)
- Barr CC, "Acute disc swelling in juvenile diabetes. Clinical profile and natural history of 12 cases", Arch Ophthalmol, 98, pp.2185~2192 (1980)
- Pavan PR, "Optic disc edema in juvenile- onset diabetes", Arch Ophthalmol, 98, pp.2193~2195 (1980)
- Ostri C, "Bilateral diabetic papillopathy and metabolic control", Ophthalmology, 117, pp.2214~2217 (2010)
- Mansour AM, "Periocular corticosteroids in diabetic papillopathy", Eye (Lond), 19, pp.45~51 (2005)
- Al-Haddad CE, "Intravitreal triamcinolone acetonide for the management of diabetic papillopathy", Am J Ophthalmol, 137, pp.1151~1153 (2004)
- Ornek K, "Intravitreal bevacizumab for diabetic papillopathy", J Ocul Pharmacol Ther, 26, pp.217~218 (2010)
- Kupersmith MJ, "Baseline, one and three months changes in the peripapillary retinal nerve fiber layer in acute optic neuritis: relation to baseline vision and MRI", J Neurol Sci, 308(1-2), pp.117~123 (2011)
- Pro MJ, "Imaging of the optic disc and retinal nerve fiber layer in acute optic neuritis", J Neurol Sci, 250(1-2), pp.114~119 (2006)
- Sung KR, "Comparison of retinal nerve fiber layer thickness measured by Cirrus HD and Stratus optical coherence tomography", Ophthalmology, 116, pp.1264~1270 (2009)