망막분지정맥폐쇄에서 정상안압녹내장의 이환유무에 따른 유리체강 내 베바시주맙 주입술 효과분석
Bevacizumab Therapy for Branch Retinal Vein Occlusion Associated with Normal Tension Glaucoma
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목적: 정상안압녹내장을 동반한 망막분지정맥폐쇄의 치료에 유리체강 내 베바시주맙 주입술의 효과를 평가하고자 한다. 대상과 방법: 황반부종이 있는 망막분지정맥폐쇄로 유리체강 내 베바시주맙 주입술을 시행한 환자들 중 추적관찰 기간이 6개월 이상인경우를 대상으로 정상안압녹내장이 동시이환된 16안과 이환되지 않은 대조군 48안을 비교분석하였다. 술 전과 술 후 1, 3, 6개월의최대교정시력(logMAR)과 빛간섭단층촬영에서 중심황반두께, 안저촬영에서 병변의 위치를 측정하였다. 결과: 정상안압녹내장이 동시이환된 군이 이환되지 않은 군보다 망막분지정맥폐쇄 병변의 위치가 시신경유두와 가까운 것으로 나타났다. 술 전 최대교정시력과 중심황반두께는 두 군 간 차이가 없었으며, 술 후 최대교정시력과 중심황반두께는 두 군에서 모두 유의하게호전되었다. 호전 정도에서 중심황반두께는 두 군 간 차이를 보이지 않았으나, 최대교정시력의 호전 정도는 정상안압녹내장이 동시이환된 군에서 이환되지 않은 군보다 유의하게 적었다. 평균 시술 횟수는 두 군 간 유사했으며, 시술 관련 합병증은 발생하지 않았다. 결론: 유리체강 내 베바시주맙 주입술은 정상안압녹내장을 동반한 망막분지정맥폐쇄의 치료에 효과가 있다. 하지만 정상안압녹내장이동반된 경우 중심황반두께의 호전에 비하여 최대교정시력의 호전에는 제한이 있었다.
Abstract
Purpose: To evaluate the therapeutic efficacy of intravitreal bevacizumab (IVB) in the treatment of branch retinal vein occlusion (BRVO) in eyes with normal tension glaucoma (NTG). Methods: We included 16 NTG eyes and 48 age- and sex-matched eyes without NTG that had received IVB for BRVO with more than 6 months of follow-up. The main outcome measures were log MAR best-corrected visual acuity (BCVA) and central macular thickness (CMT) at baseline and 1, 3, and 6 months after IVB. We compared the results according to the comorbidity associated with NTG. Results: The obstruction site of BRVO was significantly closer to the optic disc in eyes with NTG than in eyes without NTG. Baseline log MAR BCVA and CMT were similar between the two groups. After IVB, postoperative BCVA was significantly improved and CMT was significantly reduced, irrespective of the comorbidity associated with NTG. However, vision improvement was more limited in eyes with NTG, while CMT was similarly reduced compared with that in eyes without NTG. The mean numbers of injections were similar between the two groups, and there were no injection-related complications. Conclusions: IVB may have therapeutic efficacy in the treatment of BRVO associated with NTG. However, the comorbidity associated with NTG may limit vision improvement, although anatomic recovery of CMT is achieved.
참고문헌 (17)
- Phillips S, "Branch retinal vein occlusion, In Retina, 4th ed", pp.1349~1354 (2006), Mosby
- Beaumont PE, "Cup-to-disc ratio, intraocular pressure, and primary open-angle glaucoma in retinal venous occlusion", Ophthalmology, 109, pp.282~286 (2002)
- Klein BE, "The relationship of optic disk cupping to retinal vein occlusion: the Beaver Dam Eye Study", Am J Ophthalmol, 141, pp.859~862 (2006)
- Rath EZ, "Risk factors for retinal vein occlusions. A case-control study", Ophthalmology, 99, pp.509~514 (1992)
- Grieshaber MC, "What is the link between vascular dysregulation and glaucoma?", Surv Ophthalmol, 52(Suppl 2), pp.144~154 (2007)
- 김상진, "Four cases of normal-tension glaucoma with disk hemorrhage combined with branch retinal vein occlusion in the contralateral eye", American Journal of Ophthalmology, 137(2), pp.357~359, Elsevier BV
- Sonnsjö B, "Disc haemorrhages, precursors of open angle glaucoma", Prog Retin Eye Res, 21, pp.35~56 (2002)
- "Argon laser photocoagulation for macular edema in branch vein occlusion. The Branch Vein Occlusion Study Group", Am J Ophthalmol, 98, pp.271~282 (1984)
- Park SP, "Changes of aqueous vascular endothelial growth factor and interleukin-6 after intravitreal triamcinolone for branch retinal vein occlusion", Clin Experiment Ophthalmol, 36, pp.831~835 (2008)
- Lee H, "Intravitreal triamcinolone as primary treatment of cystoid macular edema secondary to branch retinal vein occlusion", Retina, 25, pp.551~555 (2005)
- Rabena MD, "Intravitreal bevacizumab(Avastin) in the treatment of macular edema secondaryto branch retinal vein occlusion", Retina, 27, pp.419~425 (2007)
- 박성표, "Changes of aqueous vascular endothelial growth factor and pigment epithelium-derived factor following intravitreal bevacizumab for macular oedema secondary to branch retinal vein occlusion", CLINICAL AND EXPERIMENTAL OPHTHALMOLOGY, 37, pp.490~495 (2009), BLACKWELL PUBLISHING
- Wu L, "Comparison of two doses of intravitreal bevacizumab (Avastin) for treatment of macular edema secondary to branch retinal vein occlusion: results from the Pan-American Collaborative Retina Study Group at 6 months of follow-up", Retina, 28, pp.212~219 (2008)
- Lindblom B, "Open angle glaucoma and non-central retinal vein occlusion-- the chicken or the egg?", Acta Ophthalmol Scand, 76, pp.329~333 (1998)
- Flammer J, "The impact of ocular blood flow in glaucoma", Prog Retin Eye Res, 21, pp.359~393 (2002)
- Flammer J, "Vasospasm, its role in the pathogenesis of diseases with particular reference to the eye", Prog Retin Eye Res, 20, pp.319~349 (2001)
- Park SP, "Aqueous vascular endothelial growth factor levels are associated with serous macular detachment secondary to branch retinal vein occlusion", Retina, 30, pp.281~286 (2010)