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출혈우세병변이 동반된 연령관련 황반변성 환자에서의 유리체강 내 라니비주맙 주입술의 효과

Intravitreal Ranibizumab Therapy for Neovascular Age-Related Macular Degeneration with a Predominantly Hemorrhagic Lesion

박성표|조윤정
대한안과학회 (The Korean Ophthalmological Society)|2011.07|대한안과학회지 (Journal of The Korean Ophthalmological Society)|제52권 제7호|pp. 838-845

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키워드

Age-related macular degenerationRanibizumabPredominantly hemorrhagic lesion
주제분류안과학

초록

목적: 출혈우세병변이 있는 연령관련 황반변성에서 유리체강 내 라니비주맙 주입술의 효과를 평가하고자 한다. 대상과 방법: 출혈우세병변이 동반된 연령관련 황반변성으로 유리체강 내 라니비주맙 주입술을 시행한 환자들 중 추적관찰 기간이 4개월 이상인 경우를 대상으로 술 전과 술 후의 최대교정시력, 빛간섭단층촬영에서 중심황반두께, 안저촬영에서 병변 및 출혈병변 크기변화를 비교 분석하였다. 결과: 총 19안 중 19안으로 평균 최대교정시력(logMAR)는 술 전 0.62 ± 0.39에서 술 후 1개월째 0.54 ± 0.4, 2개월째 0.42 ± 0.4로각각 술 전보다 유의하게 호전되었다(p＜0.001, p＜0.001). 중심황반두께는 술 전과 비교하여 술 후 1, 2, 4개월까지 유의한 감소를보였다(p=0.006, p＜0.001, p＜0.001). 황반하출혈도 초진 시 2.87 ± 2.44 DA (disk areas)에서 치료 4개월 후 0.9 ± 1.28 DA로 유의한 크기의 감소를 보였다(p＜0.01). 결론: 유리체강 내 라니비주맙 단독요법이 출혈우세병변이 동반된 연령관련 황반변성 환자에서 시력을 보존하는 데 유용하게 이용될수 있다.

Abstract

Purpose: To report the efficacy and safety of intravitreal ranibizumab monotherapy in patients with age-related macular degeneration with a predominantly hemorrhagic lesion. Methods: Nineteen eyes of 19 patients with submacular hemorrhage involving the fovea were treated with intravitreal ranibizumab (0.5 mg/0.05 ml) injections as needed. All patients completed at least 4 months of follow-up. Ophthalmologic examinations, fluorescence angiographic evaluations, optical coherence tomography (OCT) examination,and hemorrhage size were analyzed before the injections, and at 1,2,4,6, and 12 months follow-up. Results: The average VA and mean central retinal thickness (CRT) before ranibizumab treatment were 0.62 ± 0.39 log MAR and 335.76 ± 111.22 μm, respectively. Additionally, the VA and CRT four months after the initial injections were 0.54± 0.43 log MAR and 241.42 ± 107.55 μm, respectively. The mean size of the hemorrhage was significantly reduced from 2.87 ± 2.44 DA (disk areas) at baseline to 0.9 ± 1.28 DA at four month follow up. Conclusions: Intravitreal injection of ranibizumab is an effective treatment option for patients with age-related macular degeneration with a predominantly hemorrhagic lesion.

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