유리체강 내 주사 후 발생한 비문증과 Inverse Tapping Technique의 효과 = Subjective Visual Floaters after Intravitreal Injection and Effect of the Inverse Tapping Technique

국문 초록 (Abstract)

목적: 유리체강 내 항혈관내피성장인자 주사 후 비문증 발생 빈도와 주사 바늘을 아래로 하고 주사기를 두드려 공기방울의 주입을막는 방법(inverse tapping technique)의 효과를 분석하고자 한다.
대상과 방법: 삼출성 나이관련황반변성, 당뇨병성 황반부종으로 유리체강 내 주사 치료를 처음 시행받은 환자를 대상으로 inverse tapping technique 사용 여부로 실험군과 대조군을 나누었다. 연구에 동의한 환자들은 블록 무작위 배정법으로 무작위 배정을 통해inverse tapping군과 대조군으로 배정되었다. 주사 1주일 후 설문지를 이용해 비문증 발생 유무와 비문증을 호소한 환자에서 빛간섭단층촬영과 광각안저촬영을 시행하였다.
결과: 실험군 39명 중 2명(5.1%), 대조군 39명 중 8명(20.5%)이 주사 1주일 후 비문증을 호소하였고 통계적으로 유의한 차이를 보였다(p=0.042). 비문증을 호소한 환자군의 평균 연령이 호소하지 않은 환자군보다 통계적으로 유의하게 낮았다(48.40 ± 8.55 vs. 65.44 ± 11.50; p<0.001). 주사 치료 전 빛간섭단층촬영을 통해 평가한 후유리체박리의 존재 여부는 비문증을 호소한 환자군의 1안(10.0%) 에서 비문증을 호소하지 않은 환자군의 52안(76.5%)에서 관찰되었고, 통계적으로 유의한 차이를 보였다(p<0.001).
결론: 유리체강 내 주사 치료 후 발생하는 비문증은 연령과 후유리체박리의 발생 여부와 관련이 있으며, inverse tapping technique이주사 치료 후 비문증 발생을 줄이는 데 도움이 될 것으로 사료된다.

다국어 초록 (Multilingual Abstract)

Purpose: To analyze the incidence of vitreous floaters after intravitreal antivascular endothelial growth factor injection and the effectiveness of the inverse tapping technique, which involves tapping the syringe with the needle downwards to prevent the entry of air bubbles during injection.
Methods: The study enrolled patients undergoing their first intravitreal injection for exudative age-related macular degeneration or diabetic macular edema. The patients were divided into two groups: those who received an injection after inverse tapping (IT group) and controls who received the injection without tapping. Patients who consented to the study were randomly assigned to the IT group and the control group through block randomization. One week after injection, a questionnaire was used to assess the presence of vitreous floaters; those who reported them were examined via optical coherence tomography and wide fundus photography.
Results: Of the 39 patients in the IT group, two (5.1%) reported floaters 1 week after injection. By contrast, eight (20.5%) of the 39 controls reported them, with a significant difference (p = 0.042). Patients with floaters were significantly younger. Posterior vitreous detachment, as evaluated by pre-injection optical coherence tomography, was observed in 10.0% of those with floaters and 76.5% of those without them.
Conclusions: The occurrence of vitreous floaters after intravitreal injection is related to age and the presence of posterior vitreous detachment. The use of the inverse tapping technique may help reduce these after intravitreal injection.

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