망막혈관종성증식에서 유리체강내 라니비주맙과 애플리버셉트 주입술의 단기 임상결과 비교

Comparison of Short-Term Clinical Outcomes between Intravitreal Ranibizumab and Aflibercept in Retinal Angiomatous Proliferation

목적: 망막혈관종성증식에서 유리체강내 라니비주맙과 애플리버셉트 주입술을 이용하여 치료한 6개월의 임상 결과를 보고하고자 한다. 대상과 방법: 망막혈관종성증식으로 진단 후 유리체강내 라니비주맙 혹은 애플리버셉트 주입술로 치료 받은 31안(28명)을 대상으로 후향적 의무기록 분석을 시행하였다. 진단 후 1개월 간격으로 3회의 주사 후, 이후에는 재발하는 경우 추가 치료를 시행하였다. 치료전 및 첫 번째 주사 후 3, 6개월에 최대교정시력 및 중심망막두께를 측정하여 비교하였다. 결과: 라니비주맙군은 16안, 애플리버셉트군은 15안이었다. 치료 전 및 치료 후 3개월, 6개월에 측정된 평균 최대교정시력(logMAR)은 라니비주맙군에서 0.78 ± 0.50, 0.47 ± 0.30, 0.59 ± 0.41, 애플리버셉트군에서 0.96 ± 0.52, 0.83 ± 0.52, 0.74 ± 0.56이고, 평균 중심망막두께는 라니비주맙군에서 315.75 ± 115.44, 188.38 ± 57.33, 218.50 ± 96.49 μm, 애플리버셉트군에서 249.00 ± 74.88, 143.73 ± 32.73, 196.73 ± 94.08 μm였다. 두 군 모두에서 진단 후 6개월에 측정된 최대교정시력은 진단 당시와 비교하여 유의하게 호전되었으며(p＜0.05), 중심망막두께 역시 유의하게 감소하였다(p＜0.05). 두 군 사이에 시력(p=0.770) 및 중심망막두께 (p=0.470)의 감소 정도는 유의한 차이가 없었다. 결론: 유리체강내 라니비주맙 혹은 애플리버셉트 주입술은 망막혈관종성증식 환자에서 시력을 호전시키고 황반두께를 정상화시키는데 효과적인 방법으로 생각된다.

Purpose: To evaluate the 6-month outcomes of intravitreal ranibizumab and aflibercept treatment for patients with retinal angiomatous proliferation (RAP). Methods: A retrospective review of medical records of 28 patients (31 eyes) diagnosed with RAP was performed. All patients were initially treated with 3 consecutive intravitreal ranibizumab or aflibercept injections after diagnosis. Additional treatment was performed when exudation recurred. The best-corrected visual acuity (BCVA) and central foveal thickness were measured before the first injection and 3 and 6 months after the first injection. The values measured before the treatment were compared with those after treatment. Results: Sixteen eyes were treated with ranibizumab and 15 eyes with aflibercept. The logarithm of minimal angle of resolution (log MAR) values of BCVA before the first injection and 3 and 6 months after the first injection were 0.78 ± 0.50, 0.47 ± 0.30 and 0.59 ± 0.41 in the ranibizumab group and 0.96 ± 0.52, 0.83 ± 0.52 and 0.74 ± 0.56 in the aflibercept group, respectively. Central foveal thickness was 315.75 ± 115.44, 188.38 ± 57.33 and 218.50 ± 96.49 μm in the ranibizumab group and 249.00 ± 74.88, 143.73 ± 32.73 and 196.73 ± 94.08 μm in the aflibercept group, respectively. BCVA was significantly improved and central foveal thickness was significantly reduced at 6 months (p < 0.05) compared to measurements before the first injection in both groups. However, BCVA improvement and central foveal thickness were not significantly different between the 2 groups. Conclusions: Both intravitreal ranibizumab and aflibercept treatments were beneficial for both normalizing macular thickness and improving visual acuity in patients with RAP. The efficacy of the 2 drugs was not noticeably different.