본문 바로가기
KERD
논문KCI 등재

망막분지정맥폐쇄 황반부종에서의 유리체강내 트리암시놀론 주입술 후 시력호전의 예후인자

Prognostic Factors after Intravitreal Triamcinolone Injection for Macular Edema due to Branch Retinal Vein Occlusion

김숙진|문연성
대한안과학회 (The Korean Ophthalmological Society)|2012.01|대한안과학회지 (Journal of The Korean Ophthalmological Society)|제53권 제1호|pp. 49-58

0

조회

0

다운로드

0

인용

0

참고문헌

키워드

Macular edemaBranch retinal vein occlusionIntravitreal triamcinolone acetonide injectionGrid photocoagulation
주제분류안과학

초록

목적: 망막분지정맥폐쇄 황반부종에서의 유리체강내 트리암시놀론 주입술 후 시력 호전과 연관된 예후 인자를 알아보고자 하였다. 대상과 방법: 망막분지정맥폐쇄 황반부종으로 유리체강내 트리암시놀론 주입술을 시행한 68명 68안을 대상으로 후향적 분석을 실시하였다. 환자군은 최종시력에 따라 스넬렌 시력표에서 2줄 이상 시력호전이 이루어진 군과 그렇지 못한 군으로 분류하였다. 두 군 사이에서 임상적 특징과 검사 소견 등을 비교하였다. 결과: 시력 호전군은 38안(56%), 시력 비호전군은 30안(44%)이었다. 시력 비호전군에서 증상 발현 후 첫 주입술까지의 기간은 시력호전군보다 더 길었다. 술 전 시력이 좋았던 경우, 1달 이내 시력 호전이 이루어진 경우가 시력 호전군에서 통계학적으로 유의하게더 많았다. 황반 허혈이 있는 안이 시력 비호전군 에서 더 많았으며 망막하액의 존재는 시력 호전 인자로 작용하였다. 결론: 증상 시작 후 조기 치료가 이루어진 경우, 주입술 전 시력이 좋았던 경우, 첫 번째 주입술 후 좋은 치료 반응을 보인 경우, 황반허혈이 없는 경우, 망막하액이 있는 경우 등이 좋은 시력 예후 인자로 작용하였다.

Abstract

Purpose: To evaluate prognostic factors for improvement of visual acuity after intravitreal triamcinolone acetonide injection (IVTA) for treatment of macular edema (ME) secondary to branch retinal vein occlusion (BRVO). Methods: Sixty-eight eyes of 68 consecutive patients treated with IVTA for ME due to BRVO were retrospectively reviewed. Patients were categorized into 2 groups according to the final visual acuity. The ‘gainer group’ consisted of eyes with a gain of 2 or more Snellen chart lines and the ‘non-gainer group’ consisted of eyes with less than 2 lines improvement or which had worsened at the last follow-up visit. Comparative clinical characteristics and ophthalmoscopic examinations were analyzed between the 2 groups. Results: Out of the 68 eyes, 38 (56%) showed improved vision and were categorized as the gainer group; 30 eyes (44%)were categorized as the non-gainer group. The duration of symptoms in the non-gainer group was longer than the gainer group. Additionally, patients with a better baseline vision were expected to show greater improvement. The number of early visual acuity gainers who showed visual improvement at 1 month after IVTA was significantly higher in the gainer group. The number of eyes with angiographically documented macular ischemia was significantly higher in the non-gainer group. Existence of subretinal fluid has been identified as a positive factor for visual improvement. Conclusions: The cases with early treatment, good baseline visual acuity, case of favorable response to the initial IVTA,absence of macular ischemia, and baseline subretinal fluid are favorable prognostic factors for the outcome of visual acuity after IVTA for ME due to BRVO.

참고문헌 (44)

  1. Greer DV, "Macular oedema and retinal branch vein occlusion", Aust J Ophthalmol, 8, pp.207~209 (1980)
  2. "Argon laser photocoagulation for macular edema in branch vein occlusion. The Branch Vein Occlusion Study Group", Am J Ophthalmol, 98, pp.271~282 (1984)
  3. Klein R, "The Wisconsin epidemiologic study of diabetic retinopathy. IV. Diabetic macular edema", Ophthalmology, 91, pp.1464~1474 (1984)
  4. Domalpally A, "The standard care vs corticosteroid for retinal vein occlusion (SCORE) study system for evaluation of optical coherence tomograms: SCORE study report 4", Arch Ophthalmol, 127, pp.1461~1467 (2009)
  5. Scott IU, "SCORE Study report1: baseline associations between central retinal thickness and visualacuity in patients with retinal vein occlusion", Ophthalmology, 116, pp.504~512 (2009)
  6. Scott IU, "A randomized trial comparing the efficacy and safety of intravitreal triamcinolone with standard care to treat vision loss associated with macular edema secondary to branch retinal vein occlusion", Arch Ophthalmol, 127, pp.1115~1128 (2009)
  7. Haller JA, "Randomized, sham-controlled trial of dexamethasone intravitreal implant in patients with macular edema due to retinal vein occlusion", Ophthalmology, 117, pp.1134~1146 (2010)
  8. Campochiaro PA, "Ranibizumab for macular edema following branch retinal vein occlusion: six-month primary end point results of a phase Ⅲ study", Ophthalmology, 117, pp.1102~1112 (2010)
  9. Russo V, "Bevacizumab compared with macular laser grid photocoagulation for cystoid macular edema in branch retinal vein occlusion", Retina, 29, pp.511~515 (2009)
  10. 김호숭, "망막분지정맥폐쇄에 합병된 황반부종에서 유리체강내 트리암시놀론주입술과 베바시주맙주입술의 비교", 대한안과학회지, 51(8), pp.1071~1076 (2010), 대한안과학회
  11. Byun YJ, "Intravitreal triamcinolone acetonide versus bevacizumab therapy for macular edema associated with branch retinal vein occlusion", Graefes Arch Clin Exp Ophthalmol, 248, pp.963~971 (2010)
  12. Wilson CA, "Treatment with intravitreal steroid reduces blood-retinal barrier breakdown due to retinal photocoagulation", Arch Ophthalmol, 110, pp.1155~1159 (1992)
  13. Aref AA, "Management of macular edema secondary to branch retinal vein occlusion: an evidence-based update", Adv Ther, 28, pp.28~39 (2011)
  14. Negi AK, "Intravitreal triamcinolone improves vision in eyes with chronic diabetic macular oedema refractory to laser photocoagulation", Eye (Lond), 19, pp.747~751 (2005)
  15. Jonas JB, "Duration of the effect of intravitreal triamcinolone acetonide as treatment for diffuse diabetic macular edema", Am J Ophthalmol, 138, pp.158~160 (2004)
  16. Bashshur ZF, "Intravitreal triamcinolone for the management of macular edema due to nonischemic central retinal vein occlusion", Arch Ophthalmol, 122, pp.1137~1140 (2004)
  17. Karacorlu M, "Intravitreal triamcinolone acetonide for the treatment of chronic pseudophakic cystoid macular oedema", Acta Ophthalmol Scand, 81, pp.648~652 (2003)
  18. Karacorlu M, "Intravitreal triamcinolone acetonide for the treatment of cystoid macular edema secondary to Behçet disease", Am J Ophthalmol, 138, pp.289~291 (2004)
  19. Sutter FK, "Intravitreal triamcinolone for radiation-induced macular edema", Arch Ophthalmol, 121, pp.1491~1493 (2003)
  20. Scott IU, "Intravitreal triamcinolone acetonide for idiopathic cystoid macular edema", Am J Ophthalmol, 136, pp.737~739 (2003)
  21. Michels RG, "The natural course of retinal branch vein obstruction", Trans Am Acad Ophthalmol Otolaryngol, 78, pp.166~177 (1974)
  22. Tao Y, "Intravitreal triamcinolone", Ophthalmologica, 225, pp.1~20 (2011)
  23. Shulman S, "Prognostic factors for visual acuity improvement after intravitreal triamcinolone injection", Eye (Lond), 21, pp.1067~1070 (2007)
  24. Adamis AP, "Is diabetic retinopathy inflammatory disease?", Br J Ophthalmol, 86, pp.363~365 (2002)
  25. Nauck M, "Induction of vascular endothelial growth factor by platelet-activating factor and platelet-derived growth factor is downregulated by corticosteroids", Am J Respir Cell Mol Biol, 16, pp.398~406 (1997)
  26. Chen SD, "Intravitreal triamcinolone for the treatment of ischemic macular edema associated with branch retinal vein occlusion", Am J Ophthalmol, 141, pp.876~883 (2006)
  27. Cekiç O, "Intravitreal triamcinolone injection for treatment of macular edema secondary to branch retinal vein occlusion", Retina, 25, pp.851~855 (2005)
  28. Ozkiris A, "Intravitreal triamcinolone acetonide for treatment of persistent macular oedema in branch retinal vein occlusion", Eye (Lond), 20, pp.13~17 (2006)
  29. Jonas JB, "Predictive factors for visual acuity after intravitreal triamcinolone treatment for diabetic macular edema", Arch Ophthalmol, 123, pp.1338~1343 (2005)
  30. Shilling JS, "Retinal branch vein occlusion: a study of argon laser photocoagulation in the treatment of macular oedema", Br J Ophthalmol, 68, pp.196~198 (1984)
  31. 최창욱, "망막분지정맥폐쇄로 인한 황반부종에서 허혈성과 비허혈성 간의 유리체강내 스테로이드주사의 효과 차이", 대한안과학회지, 48(1), pp.49~54 (2007), 대한안과학회
  32. Chung EJ, "Prognostic factors for visual outcome after intravitreal bevacizumab for macular edema due to branch retinal vein occlusion", Graefes Arch Clin Exp Ophthalmol, 246, pp.1241~1247 (2008)
  33. Catier A, "Characterization of macular edema from various etiologies by optical coherence tomography", Am J Ophthalmol, 140, pp.200~206 (2005)
  34. Marmor MF, "Mechanisms of fluid accumulation in retinal edema", Doc Ophthalmol, 97, pp.239~249 (1999)
  35. Yamaguchi Y, "Serous macular detachment in branch retinal vein occlusion", Retina, 26, pp.1029~1033 (2006)
  36. Brasil OF, "Predictive factors for short-term visual outcome after intravitreal triamcinolone acetonide injection for diabetic macular oedema: an optical coherence tomography study", Br J Ophthalmol, 91, pp.761~765 (2007)
  37. Shah SP, "Factors predicting outcome of vitrectomy for diabetic macular oedema: results of a prospective study", Br J Ophthalmol, 90, pp.33~36 (2006)
  38. Yamaike N, "Three-dimensional imaging of cystoid macular edema in retinal vein occlusion", Ophthalmology, 115, pp.355~362 (2008)
  39. Hoeh AE, "OCT patterns of macular edema and response to bevacizumab therapy in retinal vein occlusion", Graefes Arch Clin Exp Ophthalmol, 248, pp.1567~1572 (2010)
  40. Kondo M, "Intravitreal injection of bevacizumab for macular edema secondary to branch retinal vein occlusion: results after 12 months and multiple regression analysis", Retina, 29, pp.1242~1248 (2009)
  41. Jaissle GB, "Predictive factors for functional improvement after intravitreal bevacizumab therapy for macular edema due to branch retinal vein occlusion", Graefes Arch Clin Exp Ophthalmol, 249, pp.183~192 (2011)
  42. Scott IU, "Baseline predictors of visual acuity and retinal thickness outcomes in patients with retinal vein occlusion: Standard Care Versus COrticosteroid for REtinal Vein Occlusion Study report 10", Ophthalmology, 118, pp.345~352 (2011)
  43. Joo Youn Oh, "Early versus Late Intravitreal Triamcinolone Acetonide for Macular Edema associated with Branch Retinal Vein Occlusion", Korean Journal of Ophthalmology, 21(1), pp.18~20 (2007), 대한안과학회
  44. Ota M, "Foveal photoreceptor layer in eyes with persistent cystoid macular edema associated with branch retinal vein occlusion", Am J Ophthalmol, 145, pp.273~280 (2008)

관련 논문AI추천

황반부종이 합병된 망막분지정맥폐쇄에서 자연경과와 유리체강내 트리암시놀론 주입술의 결과 비교권순일, 김영욱, 박인원대한안과학회 · 대한안과학회지2011 · 제52권 제8호분지망막정맥폐쇄에 동반된 불응성 황반부종에서 유리체내 트리암시놀론 주사의 단기 치료 효과안현민, 최경섭대한안과학회 · 대한안과학회지2016 · 제57권 제11호망막분지정맥폐쇄에 동반된 황반부종의 유리체내 베바시주맙 및 후테논낭하 트리암시놀론 병합요법이미리, 이성진, 조아란, 최경식대한안과학회 · 대한안과학회지2012 · 제53권 제2호망막분지정맥폐쇄에 의한 황반부종에서 덱사메타손 주입술 후 유병기간에 따른 임상경과 비교권수현, 김인택, 박동호, 신재필대한안과학회 · 대한안과학회지2015 · 제56권 제8호망막분지정맥폐쇄에 동반된 황반부종에서 유리체강내 베바시주맙주입술의 반복성에 관련된 인자강경태, 김광수, 김유철대한안과학회 · 대한안과학회지2015 · 제56권 제10호망막분지정맥폐쇄에 동반된 황반부종에서 황반 허혈과조기치료가 시력 예후에 미치는 영향곽형우, 서경훈, 양지호, 유승영대한안과학회 · 대한안과학회지2014 · 제55권 제2호

이 간행물의 다른 논문 (24건)

굴절교정레이저각막절제술에서 각막기하중심-보정 연마중심의 정확도에 난시교정량이 미치는 영향이상범, 박대영pp. 1-10노안이 동반된 근시 환자에서 비구면 미세단안시 라식을 이용한 노안 교정수술의 임상결과배건호, 정태영, 금지은, 정의상pp. 11-19수입공여각막의 내피세포감소에 영향을 미치는 인자에 대한 분석김만수, 공석준, 조경진pp. 20-26안구표면질환에서 실리콘 링을 이용한 일시적 양막반의 치료 효과양재니, 박대진, 심현찬pp. 27-36녹내장환자에서 중심각막내피세포 검사의 중요성오태훈, 김현승, 김재우, 장동진, 문정일pp. 37-42
원문 보기