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당뇨황반부종의 치료로서 덱사메타손 및 베바시주맙 주입 시 미세혈관류 회전율의 변화

Microaneurysm Turnover after the Use of Dexamethasone and Bevacizumab to Treat Diabetic Macular Edema

대한안과학회지 2018년 59권 4호 p.332 ~ 337
김선태 ( Kim Seon-Tae ) - 동아대학교 의과대학 안과학교실

정우진 ( Jeong Woo-Jin ) - 동아대학교 의과대학 안과학교실

Abstract

Purpose: To evaluate microaneurysm (MA) turnover and changes in central retinal thickness after intravitreal dexamethasone implantation or intravitreal bevacizumab injection to treat diabetic macular edema.

Methods: Sixty eyes with diabetic macular edema were evaluated. In all, 30 eyes received intravitreal dexamethasone implants (group A) and 30 received bevacizumab injections (group B). All patients were followed-up at 3 and 6 months. MA formation, disappearance, and turnover (MA formation rate minus disappearance rate) were evaluated. When the disappearance rate was greater than the formation rate (so the turnover was ≤0), the microaneurysms were considered to have resolved. Central retinal thickness (CRT) was measured using optical coherence tomography at all visits.

Results: In group A, MA turnover was 86.6% at 3 months and 53.3% at 6 months, and thus decreased slightly over time, but was not eliminated. In group B, MA turnover was 56.6% at 3 months and 13.3% at 6 months; the between-group difference was statistically significant (p = 0.014). CRT decreased in both groups, but significantly less so in group B 3 months after injection. However, no significant between-group difference was apparent 6 months after injection.

Conclusions: There were no significant between-group differences in either CRT or MA turnover 3 months after injection. However, at 6 months, dexamethasone implantation showed slightly better results than intravitreal bevacizumab injection. However, further research on long-term MA turnover is required.

키워드

Bevacizumab; Central macular thickness; Dexamethasone; Microaneurysm turnover; Microaneurysm
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