망막정맥폐쇄 환자에서 황반허혈과 최종시력과의 연관성 = Macular Ischemia Correlated with Final Visual Outcome in Retinal Vein Occlusion Patients

다국어 초록 (Multilingual Abstract)

Purpose: To identify the correlation between final visual outcome after at least 6 months of follow-up and the extent of macular ischemia on the first visit. Methods: We performed a retrospective clinical analysis of macular ischemia using clinical records, fundus examinations, and fluorescein angiographies in 83 patients (86 eyes) diagnosed with retinal vein occlusion from January 1998 to July 2012 and followed up for over 6 months. We evaluated the extent and the location of macular ischemia, macular edema, initial and final visual acuities and systemic disease based on fluorescein angiography and optical coherence tomography performed within 2 weeks of the first visit. The patients were divided into the following 4 groups based on the extent and location of macular ischemia and edema: superotemporal, superonasal, inferotemporal, and inferonasal. Results: Retinal vein occlusions (RVOs) consisted of 24 central RVOs (CRVOs) and 62 branch RVOs (BRVOs). Mean initial acuity (log MAR) was 0.35 ± 0.31 (36 eyes) in the no macular ischemia group, 0.40 ± 0.21 (11 eyes) in the 1-quadrant macular ischemia group, 0.71 ± 0.32 (26 eyes) in the 2-quadrant macular ischemia group and 0.73 ± 0.36 (13 eyes) in the over 3 quadrants macular ischemia group. Mean final acuity (log MAR) was 0.23 ± 0.23 in the no macular ischemia group, 0.40 ± 0.30 in the 1-quadrant macular ischemia group, 0.51 ± 0.32 in the 2-quadrant macular ischemic group and 0.73 ± 0.31 in the over 3 quadrants macular ischemia group. Conclusions: The initial and final visual outcomes were worse when more quadrants were affected by macular ischemia. The extent of macular ischemia was correlated with initial visual acuity and final visual outcome but not with macular edema. J Korean Ophthalmol Soc 2014;55(10):1493-1498

참고문헌 (Reference)

1 강석재, "망막분지정맥폐쇄에서 황반허혈에 동반된 황반부종의 시력 예후" 대한안과학회 43 (43): 9-1628, 2002

2 Clemett RS, "The visual prognosis in retinal branch vein occlusion" 93 : 523-535, 1973

3 Min WK, "The natural course and visual prognosis of branch retinal vein occlusion" 35 : 664-672, 1994

4 Kim HC, "The macular circulatory change in branch retinal vein occlusion" 40 : 1911-1917, 1999

5 Chung JH, "The macular circulation state on BRVO according to occlusion site" 41 : 1556-1562, 2000

6 Sohn JH, "The effect of laser treatment on branch retinal vein occlusion" 34 : 523-529, 1993

7 Kwon OW, "Size of capillary nonperfusion and their prognosis in branch retinal vein occlusion patients" 34 : 1162-1166, 1993

8 Merin S, "Retinal ischemia (capillary nonperfusion)in diabetic retinopathy of patients with and without systemic hypertension" 177 : 76-81, 1978

9 Shilling JS, "Retinal branch vein occlusion: a study of argon laser photocoagulation in the treatment of macular oedema" 68 : 196-198, 1984

10 Glacet-Bernard A, "Prognostic factors for retinal vein occlusion: prospective study of 175 cases" 103 : 551-560, 1996

11 Son MH, "Macular ischemia in temporal branch retinal vein occlusion: fluorescein angiographic classification and visual prognosis" 37 : 608-613, 1996

12 Shukla D, "Macular ischaemia as a marker for nephropathy in diabetic retinopathy" 52 : 205-210, 2004

13 Roseman RL, "Krypton red laser photocoagulation for branch retinal vein occlusion" 94 : 1120-1125, 1987

14 Finkelstein D, "Ischemic macular edema. Recognition and favorable natural history in branch vein occlusion" 110 : 1427-1434, 1992

15 Chen SD, "Intravitreal triamcinolone for the treatment of ischemic macular edema associated with branch retinal vein occlusion" 141 : 876-883, 2006

16 Park H, "Clinical characteristics and classifications of retinal vein occlusion" 37 : 1022-1031, 1996

17 Lang GE, "Clinical and fluorescein angiography findings in patients with retinal vein occlusion. A unicenter study of 211 patients" 201 : 234-239, 1992

18 "Classification of diabetic retinopathy from fluorescein angiograms. ETDRS report number 11. Early Treatment Diabetic Retinopathy Study Research Group" 98 : 807-822, 1991

19 이주용, "Baseline Characteristics and Risk Factors of Retinal Vein Occlusion: A Study by the Korean RVO Study Group" 대한의학회 28 (28): 136-144, 2013

20 Sohn JH, "Arteriovenous sheathotomy for persistent macular edema in branch retinal vein occlusion" 20 : 210-214, 2006