결절맥락막혈관병증에서 광역학치료의 효과에 대한 다기관 연구

• Published in: Daihan angwa haghoi jabji Vol. 50; no. 3; pp. 365 - 375
• Main Authors: 신재필, Jae Pil Shin, 고형준, Hyoung Jun Koh, 권오웅, Oh Woong Kwon, 김시열, Si Yeol Kim, 김하경, Ha Kyoung Kim, 남동흔, Dong Heun Nam, 남우호, Woo Ho Nam, 박규형, Kyu Hyung Park, 엄부섭, Boo Sup Oum, 오재령, Jae Ryung Oh, 유승영, Seung Young Yu, 윤일한, Ill Han Yoon, 윤희성, Hee Sung Yoon, 이성철, Sung Chul Lee, 이은구, Eun Goo Lee, 이재흥, Jae Heung Lee, 이정희, Jeong Hee Lee, 정인영, In Young Chung, 진희승, Hee Seung Chin, 허걸, Kuhl Huh, 곽형우, Hyung Woo Kwak
• Format: Journal Article
• Language: Korean
• Published: 대한안과학회 15.03.2009
• Subjects: Photodynamic therapy; Polypoidal choroidal vasculopathy; Verteporfin; 안과학; Polypoidal choroidal vasculopathy; Verteporfin; Photodynamic therapy
• ISSN: 0378-6471; 2092-9374

목적: 결절맥락막혈관병증(PCV)에서 verteporfin을 이용한 광역학치료(PDT)의 효과를 알아보고자 하였다. 대상과 방법: PCV로 PDT 후 6개월 이상 경과 관찰한 환자들의 자료를 14개 병원에서 수집하여 최대교정시력, 형광안저혈관조영(FAG) 및 인도사이아닌그린혈관조영(ICGA), 빛간섭단층촬영(OCT), 합병증 등을 분석하였다. 결과: 총 86명(86안)의 환자(남자 75.6%, 나이 65.9±8.3세, 경과관찰기간 14.8±10.2개월)의 술전 LogMAR 평균시력은 0.55±0.32이었고 평균 2±1.2회의 PDT를 시행한 후 최종시력은 0.53±0.54로 의미 있는 시력차이는 없었다(p=0.639). 61안(70.9%)에서 시력이 향상 또는 보존되었고 2줄 이상 시력향상 및 감소는 각각 33안(38.4%), 21안(24.4%)이었다. FAG에서 62.5%에서 형광누출이 감소되었고 57.3%에서 폴립의 감소를 보였다. PDT와 관련된 전신 합병증은 없었으나 망막하출혈이 증가한 경우가 10안(11.6%)에서 나타났다. 결론: 결절맥락혈관병증에서 광역학치료는 시력을 보존하고 혈관누출을 감소시키며 망막두께를 감소시키는 안전한 치료 방법이다. <대한안과학회지 2009;50(3):365-375> Purpose: To evaluate the efficacy of photodynamic therapy (PDT) with verteporfin for polypoidal choroidal vasculopathy (PCV) in Korean patients. Methods: Clinical data of patients who were treated with PDT for PCV and followed up for more than 6 months were collected from 14 hospitals around the country. The changes in the best corrected visual acuity, angiographic outcome, retinal thickness measured by optical coherence tomography (OCT), and adverse effects of treatment were evaluated. Results: Eighty six patients (86 eyes) were recruited (male: 75.6%, age: 65.9±8.3 years, mean follow-up: 14.8±10.2 months). The mean logMAR visual acuity at baseline was 0.55±0.32 and did not show any statistically significant difference from the final mean logMAR visual acuity (0.53±0.54) (p=0.639). The mean treatment session number of PDT was 2±1.2. Visual acuity stabilized or improved in 70.9% of patients. Visual acuity improved by more than 2 lines in 33 eyes (38.4%) and worsened by more than 2 lines in 21 eyes (24.4%) of patients. Vascular leakage decreased in 62.5% of patients in fluorescein angiography and polypoidal lesions disappeared or were reduced in 57.3% of patients in indocyanine green angiography. There was no systemic adverse effect of PDT, but increased subretinal hemorrhage after PDT occurred in 10 eyes (11.6%). Conclusions: In polypoidal choroidal vasculopathy, photodynamic therapy with verteporfin is safe and effective for preserving visual acuity and reducing vascular leakage and retinal thickness. J Korean Ophthalmol Soc 2009;50(3):365-375