망막정맥폐쇄로 인한 황반부종에서 유리체내 베바시주맙주입술 후 황반하 맥락막 두께의 변화
Subfoveal Choroidal Thickness Changes after Intravitreal Bevacizumab in Macular Edema Secondary to Retinal Vein Occlusion
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목적: 황반부종을 동반한 망막정맥폐쇄환자에서 유리체내 베바시주맙 주사 전후 황반하 맥락막 두께의 변화를 알아보고자 하였다. 대상과 방법: 단안에 황반부종이 동반된 망막정맥폐쇄로 진단받고 유리체내 베바시주맙(bevacizumab) 주사를 시행받은 44명의 의무기록을 후향적으로 분석하였다. 베바시주맙 주사 전 환자들은 최대교정시력과 산동 후 안저검사, 형광안저혈관조영술 및 enhanced depth imaging 모드를 이용한 빛간섭단층촬영을 시행받았다. 주사 후 1달, 3달, 6달째 최대교정시력과 빛간섭단층촬영에서 측정된황반하 맥락막 두께 및 중심망막 두께의 변화를 건강한 반대안과 비교 분석하였다. 결과: 베바시주맙 주사 전 폐쇄안의 평균 황반하 맥락막 두께는 265.41 ± 43.02 μm로 반대안의 244.77 ± 30.35 μm보다 유의하게 두꺼웠다(p<0.001). 주사 후 1달, 3달, 6달에 황반하 맥락막 두께는 주사 전에 비해 유의하게 감소되었고(모두, p<0.001), 황반하 맥락막 두께의 변화와 망막중심 두께의 변화 사이에는 유의한 상관관계가 있었다(r=0.327, p=0.030). 황반하 맥락막 두께의 감소와 함께 평균 시력도 호전되었으나(p<0.001), 둘 사이에 유의한 상관관계는 확인되지 않았다(p=0.126). 결론: 황반부종을 동반한 망막정맥폐쇄안에서 황반하 맥락막 두께는 건강한 반대안에 비해 증가되어 있었다. 유리체내 베바시주맙주사 후 황반하 맥락막 두께는 유의하게 감소하였으며, 이는 중심망막 두께의 변화와 유의한 상관관계가 있었다.
Abstract
Purpose: To determine changes in subfoveal choroidal thickness (SCT) after intravitreal injection of bevacizumab in eyes with macular edema secondary to retinal vein occlusion (RVO). Methods: Forty-four patients treated with intravitreal bevacizumab for unilateral macular edema due to RVO were retrospectively reviewed. Before injection, patients underwent best-corrected visual acuity (BCVA) assessment, dilated fundus examination, fluorescein angiography, and enhanced depth imaging optical coherence tomography. Changes in BCVA, SCT, and central macular thickness (CMT) of the RVO eyes were evaluated and compared with those of the normal contralateral eyes at baseline and at 1, 3, and 6 months after injection. Results: The mean SCT in RVO eyes (265.41 ± 43.02 μm) was significantly thicker than that in the fellow eyes (244.77 ± 30.35 μm) at baseline (p < 0.001). The mean SCT was significantly reduced at 1, 3, and 6 months after intravitreal bevacizumab injection (all p < 0.001), and the change in SCT was significantly correlated with the change in CMT (r = 0.327, p = 0.030). While there was an improvement in BCVA together with a reduction in SCT (p < 0.001), no significant correlation was found (p = 0.126). Conclusions: Subfoveal choroidal thickness in RVO eyes with macular edema was greater than that in the normal fellow eyes, and decreased significantly after intravitreal bevacizumab injection. The SCT reduction was significantly correlated with CMT reduction.
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