Visual Prognosis of Macular Edema Associated with Macular Ischemia in Branch Retinal Vein Occlusion

망막분지정맥폐쇄에서 황반허혈에 동반된 황반부종의 시력 예후

Kang, Sug-Jae;Chin, Hee-Seung;Moon, Yeon-Sung
강석재;진희승;문연성

  • Published : 20020900

Abstract

Purpose : We compared the perifoveal capillary ring state and the size of the macular ischemic area in patients with the macular edema, then analyzed the effect of grid photocoagulation on macular edema. The aim of the present study was to evaluate visual prognosis and to determine treatment modality of macular edema with macular ischemia in branch retinal vein occlusion (BRVO). Methods : We did retrospective clinical analysis on the macular edema and macular circulatory state using clinical records, and performed fluorescein angiography in 89 patients (92 eyes) who were diagnosed with BRVO at Inha University Hospital from June 1996 through October 2000 and were followed for over 6 months. Results : The incidence of macular edema was not statistically correlated with occlusion site of retinal vein, size of macular ischemic area and perifoveal capillary ring state. The initial visual acuity was a statistically significant factor in the prognosis of final visual acuity. The macular ischemic area was statistically correlated with initial visual acuity, and the perifoveal capillary ring state was not correlated with initial and final visual acuities. The improvement of visual acuity after grid photocoagulation for macular edema was noted in patients with intact perifoveal capillary ring state and small macular ischemic area. Conclusions : The only facator to final visual acuity is initial visual acuity. Prospective study is needed to evaluate effect of early treatment of macular edema with grid photocoagulation at an early stage of BRVO in patients with intact perifoveal capillary ring state and small macular ischemic area.

목적 : 형광안저촬영상 황반허혈을 보인 환자군에서 중심와주위모세혈관망 상태 및 황반허혈범위와 황반부종의 관계를 비교하고, 격자광응고술의 효과를 분석하여, 황반부종과 황반허혈을 동반한 망막분지정맥폐쇄에서의 시력 예후를 평가하고자 하였다. 대상과 방법 : 1996년 6월부터 2000년 10월까지 인하대병원 안과에서 망막분지정맥폐쇄로 진단받고 6개월 이상 추적관찰을 받은 89명 92안을 대상으로 의무기록지와 형광안저혈관조영술을 이용하여 후향조사를 실시하였다. 결과 : 망막분지정맥폐쇄 위치, 황반허혈범위, 중심와주위모세혈관망 상태는 황반부종의 발생과 연관성이 없었다. 최종시력을 예측하는데 있어서는 초진시력이 의미있는 인자였다. 황반허혈범위는 초진시력과 의미있는 연관성이 있었고, 중심와모세혈관망 상태는 초진시력 및 최종시력과 연관성이 없었다. 황반허혈의 범위가 적은 경우와 중심와주위 모세혈관망이 잘 유지되어 있는 경우에 격자광응고술을 이용한 황반부종의 감소로 시력의 호전을 볼 수 있었다. 결론 : 최종시력을 예측할 수 있는 인자는 초진시력 뿐이었다. 황반부종과 황반허혈을 동반한 망막분지정맥폐쇄에서 황반허혈의 범위가 적고 중심와 주위 모세혈관망이 잘 유지된 경우에 발병 초기부터 격자광응고술을 이용한 적극적인 황반부종의 치료의 효과에 대한 전향적인 연구가 필요할 것으로 생각된다.

Keywords

References

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