망막분지정맥폐쇄 환자에서 초기 망막출혈 흡수 비율과 장기임상양상과의 관계
Early Retinal Hemorrhage Absorption Rate and Long Term Clinical Outcomes in Branch Retinal Vein Occlusion
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목적: 망막분지정맥폐쇄 환자에서 진단 초기에 망막출혈 흡수 비율과 망막분지정맥폐쇄의 임상양상의 관계를 보고하고자 한다. 대상과 방법: 망막분지정맥폐쇄로 진단받은 66안을 대상으로 후향적인 조사가 이루어졌으며, 망막출혈의 흡수량을 비교하기 위하여 그리드(grid)라는 정량적인 측정 단위를 사용하였다. 그리드 총량의 변화값을 이용하여 초기의 망막출혈 흡수 비율을 측정하였고 장기적인 환자군의 임상적 양상과 유의성을 확인하였다. 결과: 망막분지정맥폐쇄로 진단받은 환자군의 초기 망막출혈 흡수 비율(Σgrid/month)은 16.5 ± 21.5였다. 12개월 동안 최대교정시력의 호전 정도는 0.3 ± 0.3이었고 초기 망막출혈 흡수 비율과 유의하였다(p<0.01). 초기 망막출혈 흡수 비율이 7.5보다 낮은 느린 집단과 높은 빠른 집단으로 분류하여 비교하였을 때, 관찰 기간 동안 최대교정시력의 호전 정도는 느린 집단에서 0.16 ± 0.23이고 빠른 집단에서 0.38 ± 0.28이며 유의하였다(p=0.01). 중심와두께의 완화 정도는 흡수 비율이 느린 집단에서 133.12 ± 142.93 μm였고, 빠른 집단에서 236.62 ± 131.55 μm였으며 유의성을 보였다(p<0.01). 결론: 망막분지정맥폐쇄 환자군에서 지속적인 경과 관찰이 이루어질 때, 초기의 망막출혈 흡수 변화 비율이 예후를 예측할 수 있는 하나의 지표로서 생각해 볼 수 있겠다.
Abstract
Purpose: We report the relationship between early retinal hemorrhage absorption rate (RHAR) and long-term clinical outcomesassociated with branch retinal vein occlusion (BRVO). Methods: This retrospective study included 66 eyes with BRVO. We used a grid as a quantitative measurement unit for measuringthe amount of hemorrhage, and calculated the RHAR by measuring variance between sums of the grids. We investigated therelationship of best corrected visual acuity (BCVA), central foveal thickness (CFT), and other long term clinical outcomes withRHAR. Results: The RHAR in BRVO patients measured 16.46 ± 21.48 Σgrid/time (month). Improvement of BCVA (logMAR) was 0.28 ±0.28 at 12 months, showing statistical significance with the RHAR (p < 0.01). We divided RHAR into two groups by 7.5 Σgrid/month; slow and fast RHAR groups. Improvement of BCVA (logMAR) was 0.16 ± 0.23 in the slow RHAR group, and 0.38 ±0.28 in the fast RHAR group, with statistical significance (p = 0.01). Regression of CFT was 133.12 ± 142.93 μm in the slowRHAR group, and 236.62 ± 131.55 μm in the fast RHAR group, with statistical significance (p < 0.01). Conclusions: RHAR may be a prognostic factor during follow-up in BRVO patients.
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