급성 중심장액맥락망막병증 환자에서 유리체내베바시주맙 주입술의 유용성
The Efficacy of Intravitreal Bevacizumab Injection in Patients with Acute Central Serous Chorioretinopathy
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목적: 급성 중심장액맥락망막병증 환자에서 유리체내베바시주맙 주입술의 유용성에 대해 알아보고자 하였다. 대상과 방법: 급성 중심장액맥락망막병증으로 진단받은 80명 87안을 후향적으로 분석하였다. 모든 대상 환자의 초진 시와 추적 관찰시 최대교정시력과 중심황반두께의 변화를 확인하였다. 결과: 경과관찰 기간 동안 모든 환자들이 시력의 호전과 망막하액의 소실을 보였으나 logMAR로 측정한 최대교정시력은 베바시주맙주입군이 0.11, 보존적 치료군이 0.14로 두 군 사이에는 유의한 차이는 없었다(p=0.13). 중심황반두께도 베바시주맙 주입군이 185.33 μm, 보존적 치료군이 193.41 μm로 역시 통계적으로 유의한 차이가 없었다(p=0.908). 다만 재발률은 베바시주맙 주입군(47%)에서 보존적 치료군(70%)에 비해 유의하게 낮게 나타났다(p=0.03). 결론: 베바시주맙 주입군과 보존적 치료군에서 최대교정시력과 중심황반두께는 유의한 차이를 보이지 않았다. 하지만 주입군에서 낮은 재발률(p=0.03)을 보여 베바시주맙 주입술이 급성 중심장액맥락망막병증의 재발률을 낮추는 데 기여할 것으로 생각한다.
Abstract
Purpose: To evaluate the efficacy of intravitreal bevacizumab injection (IVB) in acute central serous chorioretinopathy. Methods: Retrospective chart review of 87 eyes of 80 patients. They received intravitreal bevacizumab injection (n = 40)and observed without any treatment or any medication (n = 47) for initial treatment of acute CSC. Patient demographics and best-corrected visual acuity (BCVA), central macular thickness (CMT) at baseline were analyzed. Then we had regular follow-ups of BCVA and CMT. Results: All patients showed improvement in visual acuity and resolution of subretinal fluid following treatment. In the bevacizumab-treated group, the mean BCVA improved from 0.22 ± to 0.11, mean CMT fell from 361.33 to 185.33 (μm) and recurrence rate was 47%. The conservative-treated group showed an improvement in BCVA from 0.23 at baseline to 0.14,mean CMT fell from 349.65 to 193.41 (μm) and recurrence rate was 70% (p = 0.130, p = 0.908 and p = 0.030, respectively). However, the change of BCVA and CMT of 2 groups showed no differences at any follow-up visit. Recurrence rate was significantly low in bevacizumab-treated group. Conclusions: The bevacizumab-treated group had relatively low rates of recurrence in acute CSC patients compared to the observation group. However, intravitreal bevacizumab showed no positive effect in BCVA and CMT of acute CSC patients compared to the observation group. Further investigation will be helpful to understand this therapy in patients with CSC.
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