초록 close

목적: 나이관련황반변성에 의한 맥락막신생혈관에서 bevacizumab 단독치료와 광역학요법과의 병합치료 효과를 알아보고자 하였다. 대상과 방법: 72명 72안을 대상으로 27안에서는 bevacizumab만을 주사하였고 45안에서는 광역학요법을 병행하여 6개월 뒤에 최대교정시력, 중심황반두께와 재 치료 여부를 비교하였다. 결과: 단독치료군의 경우 평균시력(LogMAR) 0.62±0.34에서 0.56±0.33 (p=0.03)으로, 병합치료군은 0.61±0.33에서 0.48±0.21 (p=0.001)로 유의한 향상을 보였으며, 치료 6개월 뒤 병합치료군에서 더 시력이 향상되었다(p=0.049). 중심황반두께는 모두 시술 전에 비해유의하게 감소하였으나(p=0.001), 두 군 간의 차이는 없었다. 재 치료는 단독치료군이 10안(37.0%)으로, 병합치료군 12안(26.7%)보다유의하게 높은 비율로 나타났다(p=0.02). 결론: 나이관련황반변성에 의한 맥락막신생혈관환자에서 bevacizumab 단독치료 및 광역학요법과의 병합치료 모두 시술 후 6개월까지 중심황반두께를 감소시키고 시력이 호전되었으며, 병합치료의 경우 최대교정시력과 재 치료율에서 더 좋은 결과를 보여주었다.


Purpose: To investigate the efficacy of the combined treatment of photodynamic therapy (PDT) with verteporfin and intravitreal bevacizumab in patients with neovascular age-related macular degeneration. Methods: Forty-five eyes received a single session of PDT following three intravitreal bevacizumab (1.25 mg) injections at six-week intervals (IVB+PDT group). Twenty-seven eyes received three intravitreal bevacizuamb (1.25 mg) injections only at six-week intervals (IVB group). Results: After the six months of follow up, the mean BCVA (LogMAR) changed significantly from 0.62±0.34 to 0.56±0.33 in the IVB group (p=0.03) and from 0.61±0.33 to 0.48±0.21 in the IVB+PDT group (p=0.001). The mean BCVA was more improved in the IVB+PDT group (p=0.049). The mean CMT changes were significant in both groups immediately after treatment, but there was no significant difference at six months between the two groups. Ten eyes (37.0%) in the IVB group and 12 eyes (26.7%)in the IVB+PDT group required retreatments during the six months of follow-up (p=0.02). Conclusions: Significant improvement in visual acuity and reduction in central macular thickness over a six-months period were observed in both groups. The mean visual acuity was significantly better and the rate of reinjections after the initial treatment schedule was lower in the IVB+PDT group.