망막분지정맥폐쇄의 황반부종과 당뇨황반부종에 무보존제 트리암시놀론 유리체내주사 후 안압상승 비교

• 영문명: Intraocular Pressure: Intravitreal Preservative-free Triamcinolone Injection in Diabetic Macular Edema and Branch Retinal Vein Occlusion
• 발행기관: 대한안과학회
• 저자명: 이찬호(Chan Ho Lee) 서영승(Young Seung Seo)
• 간행물 정보: 『대한안과학회지』Ophthalmological Society,volume61,number2, 167~174쪽, 전체 8쪽
• 주제분류: 의약학 > 기타의약학
• 파일형태: PDF
• 발행일자: 2020.02.28

국문 초록

목적: 당뇨황반부종과 황반부종이 동반된 망막분지정맥폐쇄에서 무보존제 트리암시놀론 유리체내주사 후 안압상승의 변화에 대해 고찰하고자 한다. 대상과 방법: 당뇨황반부종으로 진단받은 36명과 망막분지정맥폐쇄로 진단받은 44명을 대상으로 무보존제 트리암시놀론(Maqaid？？, Wakamoto Pharmaceutical Co., Ltd., Tokyo, Japan) 유리체내주사를 시행하여, 6개월간 안압 및 안압상승 비율과 기간을 비교하였고, 빛간섭단층촬영(optical coherence tomography)을 이용하여 중심와두께(central foveal thickness)를 비교하였다. 결과: 당뇨황반부종과 망막분지정맥폐쇄 사이에서 유리체내주사 당시, 1개월, 2개월, 3개월, 6개월 뒤 안압 차이는 통계적 유의성이 없었으나, 당뇨황반부종 14안(38.9%)에서 망막분지정맥폐쇄 7안(15.9%)에서 유의한 안압상승 비율을 보였다(p=0.02). 안압상승 기간은 망막분지정맥폐쇄에서 0.30 ± 1.20개월이었고, 당뇨황반부종에서 1.14 ± 1.85개월로 유의하게 길었다(p=0.03). 녹내장이 진행되어 수술을 받은 경우는 당뇨황반부종에서만 2안(5.6%)이었다. 중심와두께는 주사 후 6개월 뒤 당뇨황반부종에서 328 ± 103 μm, 망막분지정맥폐쇄에서 434 ± 189 μm로 유의한 차이를 보였다(p<0.01). 결론: 무보존제 트리암시놀론 유리체내주사는 당뇨황반부종과 망막분지정맥폐쇄에 동반된 황반부종에서 모두 치료 효과가 있었으나, 안압상승 합병증 측면에서 당뇨황반부종보다 망막분지정맥폐쇄에 동반된 황반부종에서 조금 더 안전하게 사용될 수 있다.

영문 초록

Purpose: To compare the intraocular pressure (IOP) in diabetic macular edema (DME) patients and macular edema associated with branch retinal vein occlusion (BRVO) patients after intravitreal preservative-free Triamcinolone injection. Methods: This study included 36 patients diagnosed with DME and 44 patients diagnosed with BRVO with macular edema. Both groups were treated with intravitreal preservative-free Triamcinolone (Maqaid？？, Wakamoto Pharmaceutical Co., Ltd., Tokyo, Japan) injection, and we compared the IOPs of the two groups determined before injection and at 1, 2, 3, and 6 months after injection. We also compared the IOP elevation ratios and durations, and central foveal thickness (CFT) changes using optical coherence tomography. Results: In both groups, there was no statistical significance in the IOP before injection and at 1, 2, 3, and 6 months after injection. However, the IOP elevation ratio in the DME patients (38.9%) was significantly higher than that in the BRVO patients (15.9%) (p = 0.02). The duration of IOP elevation in the DME patients (1.14 ± 1.85 months) was significantly longer than that in the BRVO patients (0.30 ± 1.20 months) (p = 0.03). When the IOP was not controlled, we used IOP-lowering agents, and two patients in the DME were treated with glaucoma surgery. There was no statistical significance in the CFT before injection and at 1, 2, or 3 months after injection between the two groups (p = 0.72, p = 0.26, p = 0.66, p = 0.34, respectively). However, the CFT after 6 months was 328 ± 103 μm in the DME group and 434 ± 189 μm in the BRVO; this difference was significant (p < 0.01). Conclusions: Intravitreal injection of preservative-free Triamcinolone was effective in the treatment of both DME patients and macular edema patients associated with BRVO. Furthermore, Triamcinolone was more safely injected in macular edema associated with BRVO patients than in DME patients.

목차

대상과 방법

결 과

고 찰

키워드

Branch retinal vein occlusion Central foveal thickness Diabetic macular edema Intraocular pressure Preservativefree Triamcinolone