유리체황반견인증후군의 자연경과 및 유리체절제술의 수술 효과 = Natural History and Result of Vitrectomy in Vitreomacular Traction Syndrome

다국어 초록 (Multilingual Abstract)

Purpose: To investigate the natural history and the result of vitrectomy in patients with vitreomacular traction syndrome.
Methods: A total of 29 eyes from 26 patients were diagnosed with vitreomacular traction syndrome. Patients were classified into observation and surgery groups. Baseline and follow-up visual acuity (VA) and central macular thickness (CMT) were compared. Patients were also classified into 3 groups according to the severity of their retinal architecture on optical coherence tomography.
Results: The mean length of follow-up was 23.5 ± 14.6 months. At initial diagnosis, 23 eyes (79.3%) were classified into the observation group. In this group, vitreomacular traction of 9 eyes (39.1%) had spontaneously resolved, and 12 eyes (52.2%) were stationary. Progression to full-thickness macular hole was seen in 1 eye (4.3%), and vitrectomy was done in 1 eye (4.3%) during follow up. Mean VA and CMT of the observation group changed from 0.21 ± 0.24, 319 ± 53 μm to 0.22 ± 0.26, 304 ± 49 μm, which was not significantly different (p = 0.223). According to optical coherence tomography findings, 17 eyes had grade 1, 3 eyes had grade 2, and 3 eyes had grade 3. There were no intergroup differences in VA and CMT before and after follow up. In 6 eyes of the surgery group, vitrectomy was done at initial diagnosis.
VA changed from 0.49 ± 0.50 to 0.35 ± 0.36 (p = 0.293), CMT improved from 499 ± 243 μm to 252 ± 22 μm (p = 0.028). There were no differences in VA and CMT between the observation subgroup (grade 2, 3) and the surgery group.
Conclusions: At initial diagnosis of vitreomacular traction syndrome, careful examinations and continuous follow ups should be considered instead of immediate surgery.

국문 초록 (Abstract)

목적: 유리체황반견인증후군의 자연경과 및 유리체절제술의 수술 효과에 대해 알아보고자 하였다.
대상과 방법: 유리체황반견인증후군으로 진단받은 26명 29안을 경과 관찰군과 수술군으로 나누어 관찰 전후의 교정시력(logMAR), 중심황반두께를 조사하였다. 빛간섭단층촬영상 황반 형태의 중등도에 따라 3개의 grade로 나누어 분석하였다.
결과: 평균 경과 관찰 기간은 23.5 ± 14.6개월이었다. 경과 관찰군은 23안(79.3%)이었다. 이 중 유리체황반견인의 자연호전은 9안(39.1%), 유지는 12안(52.2%), 진행은 1안(4.3%)에서 관찰되었으며, 1안(4.3%)은 관찰 중 유리체절제술을 시행하였다. 경과 관찰군의 시력과 중심황반두께는 0.21 ± 0.24, 319 ± 53 μm에서 0.22 ± 0.26, 304 ± 49 μm로 관찰되었으나 유의한 차이를 보이지 않았다(p = 0.223). 경과 관찰군에서 grade 1, 2, 3는 17안, 3안, 3안이었으며 grade 간 시력 및 중심황반두께의 차이는 관찰전후 모두 없었다. 진단 직후 수술은 6안에서 시행됐으며, 수술 전후 평균 시력은 0.49 ± 0.50에서 0.35 ± 0.36으로 호전되었으나통계적으로 유의하지 않았고(p = 0.293), 중심황반두께는 499 ± 243 μm에서 252 ± 22 μm로 유의한 차이를 보였다(p = 0.028).
경과 관찰아군(grade 2, 3)과 수술군을 비교했을 때 시력과 중심황반두께의 차이가 없었다.
결론: 유리체황반견인증후군은 진단 직후 유리체절제술 대신 주의 깊은 경과 관찰을 고려해 볼 수 있다.

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