망막정맥폐쇄환자에서 황반부종의 양상에 따른 단기 시력예후

• Published in: Daihan angwa haghoi jabji Vol. 53; no. 9; pp. 1276 - 1284
• Main Authors: 박가희, Ka Hee Park, 노인호, In Ho Rho
• Format: Journal Article
• Language: Korean
• Published: 대한안과학회 15.09.2012
• Subjects: Bevacizumab; Macular edema; Optical coherence tomography; Retinal vein occlusion; 안과학; Retinal vein occlusion; Macular edema; Optical coherence tomography; Bevacizumab
• ISSN: 0378-6471; 2092-9374

목적: 망막정맥폐쇄 환자에서 황반부종의 양상이 시력에 영향을 주는지에 대해 알아보고자 한다. 대상과 방법: 망막정맥폐쇄로 진단받은 33안을 빛간섭단층촬영에서 나타난 황반부종의 양상에 따라 분류하고 유리체강내 베바시주맙 주입을 시행한 후 시력(logMAR)을 측정하여 비교 분석하였다. 결과: 대상안은 망막중심정맥폐쇄 9안, 망막분지정맥폐쇄 24안이었으며 평균 경과관찰기간은 3.6개월이었다. 국소적 황반부종을 보인 15안은 0.61 ± 0.34에서 0.26 ± 0.29로 유의한 시력의 호전이 있었으나(p<0.01) 전반적 황반부종을 보인 26안은 0.85 ± 0.44에서 0.73 ± 0.37로 유의한 호전을 보이지 않았다(p=0.07). 또한 장액성 망막박리가 동반되지 않은 16안은 0.76 ± 0.43에서 0.38 ± 0.36로 유의하게 호전되었으나(p<0.01) 장액성 망막박리가 동반된 17안은 0.73 ± 0.40에서 0.64 ± 0.42로 유의한 호전을 보이지 않았다 (p=0.07). 결론: 국소적 황반부종 군과 장액성 망막박리가 동반되지 않은 군에서 유의한 시력의 호전을 보여 망막정맥폐쇄환자에서 황반부종의 양상이 시력예후에 영향을 미치는 인자가 될 수 있을 것으로 보인다. Purpose: To study the short-term visual outcomes affected by the patterns of macular edema in retinal vein occlusion patients. Methods: In a retrospective study, 33 eyes of 33 consecutive patients with macular edema from retinal vein occlusion received an intravitreal injection of bevacizumab. Macular edema was classified according to OCT patterns and the effect on visual outcome evaluated: Diffuse macular edema (DME) vs. focal macular edema (FME), and macular edema with serous retinal detachment (SRD) vs. macular edema without serous retinal detachment (non-SRD). Results: Nine patients had CRVO, 24 patients had BRVO and the follow-up period was 3.6 months. In the FME group, the mean baseline BCVA was 0.61 ± 0.34 and the final BCVA was 0.26 ± 0.29, a difference that was statistically significant (p< 0.01). In the DME group, the mean baseline BCVA was 0.85 ± 0.44 and the final BCVA was 0.73 ± 0.37, a difference that was not statistically significant (p = 0.07). In the non-SRD group, the mean baseline BCVA was 0.76 ± 0.43 and the final BCVA was 0.38 ± 0.36, a difference that was statistically significant (p < 0.01). In the SRD group, the mean baseline BCVA was 0.73 ± 0.40 and the final BCVA was 0.64 ± 0.42, a difference that was not statistically significant (p = 0.07). Conclusions: Visual outcome was significantly better in the FME and non-SRD groups. The patterns of macular edema measured according to OCT were a prognostic factor for visual outcome.