허혈성 망막중심정맥폐쇄에서 유리체내 베바시주맙 주입 후 임상경과
Clinical Course after Intravitreal Bevacizumab Injection in Ischemic Central Retinal Vein Obstruction
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목적: 허혈성 망막중심정맥폐쇄환자에서 유리체내 베바시주맙 주입 후 임상경과를 알아보고자 하였다. 대상과 방법: 망막중심정맥폐쇄로 진단받은 환자 중 베바시주맙 주입 후 1년이상 추적관찰이 가능했던 56명 56안에 대해 허혈성 및비허혈성 망막중심정맥폐쇄로 분류하고, 시력과 중심황반두께의 변화, 전안부 신생혈관과 신생혈관녹내장 및 합병증의 발생을 후향적으로 조사하였다. 결과: 전체 평균 베바시주맙 주입 횟수는 2.07회였고, 허혈성 망막중심정맥폐쇄 환자에서는 1.62회였다. 신생혈관녹내장의 발생은 비허혈성 망막중심정맥폐쇄 환자에서는 없었으며, 허혈성 망막중심정맥폐쇄 환자 26안 중 14안(58.3%)에서 발생하였고, 진단받기까지 평균기간은 28.75주였다. 허혈성 망막중심정맥폐쇄 환자의 logMAR 시력은 평균 1.56 ± 0.65에서 주입 후 평균 1.44 ± 0.93으로 좋아졌으나 통계적으로 유의하지는 않았다(p=0.45). 결론: 허혈성 망막중심정맥폐쇄에서 베바시주맙 주입은 시술 후 1년 뒤 황반부종을 개선시키나 시력향상과 신생혈관녹내장의 발생에는 큰 영향을 미치지 않았다.
Abstract
Purpose: To determine the clinical outcome of intravitreal bevacizumab injection in patients with ischemic central retinal vein obstruction (CRVO). Methods: The present study was conducted retrospectively on 56 eyes of 56 patients who were diagnosed with CRVO and classified according to ischemic and non-ischemic type and underwent an intravitreal bevacizumab injection. The present study measured changes in visual acuity and central macular thickness, neovascularization in the anterior segment, development of neovascular glaucoma and other clinical complications. Results: The average number of bevacizumab injections in both groups was 2.07 and 1.62 in the ischemic type. No patients developed neovascular glaucoma in the non-ischemic type group, 14 of 26 eyes in the ischemic type group developed neovascular glaucoma and the mean time to diagnosis was 28.75 weeks. log MAR visual acuity of the ischemic type group prior to injection was 1.56 ± 0.65 on average which improved to 1.44 ± 0.97 (p = 0.45). Conclusions: Intravitreal bevacizumab injection improves the condition of cystic macular edema clinically, but does not affect the development of neovascular glaucoma and improvement of visual acuity in ischemic type CRVO.
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