치료 병력이 없는 85세 이상 습성 나이관련황반변성 환자들의 치료 결과 = Treatment Results of Treatment-naïve Neovascular Age-related Macular Degeneration in Patients Over 85 Years of Age

다국어 초록 (Multilingual Abstract)

Purpose: To investigate the characteristics and treatment results of patients aged ≥ 85 years who were diagnosed with treatment- naïve neovascular age-related macular degeneration (nAMD).
Methods: The medical records of patients diagnosed with treatment-naïve nAMD who were ≥ 85 years old at the time of diagnosis with at least 12 months follow-up were retrospectively reviewed. The number of intravitreal injections of anti-vascular endothelial growth factor (VEGF) and agents used during the entire period were investigated. Best-corrected visual acuity and optical coherence tomography results before and after treatment were analyzed. Visual acuity of the fellow eye was also collected.
Results: A total of 40 eyes of 40 patients with mean age of 87.5 ± 2.4 were included in the study. The mean logarithm of the minimal angle of resolution visual acuity was 0.85 ± 0.57, and the mean of the fellow eye was 0.93 ± 0.99. Compared to before the treatment, there was no significant difference after intravitreal injection in terms of visual acuity. Central retinal thickness showed significant reduction at all time points after treatment.
Conclusions: In patients aged ≥ 85 years at the time of diagnosis, intravitreal injections of anti-VEGF prevented deterioration of visual acuity and showed successful anatomical outcomes. Especially, many had poor visual acuity in the fellow eye, suggesting the importance of maintaining visual acuity. Therefore, active treatment is necessary in the elderly.

참고문헌 (Reference)

1 이윤곤 ; 한상윤 ; 한재욱 ; 김종우 ; 김철구 ; 이동원 ; 김재휘, "습성 나이관련황반변성으로 진단된 90세 이상 초고령 환자의 특성" 대한안과학회 59 (59): 444-450, 2018

2 Tyler Hyungtaek Rim ; Se Woong Kang ; Jae Pil Shin ; Seung-Young Yu ; Su Jeong Song ; Christopher Seungkyu Lee ; Sung Soo Kim ; the Epidemiologic Survey Committee of the Korean Ophthalmological Society, "나이관련황반변성 관련요인: 국민건강영양조사 2008-2012" 한국망막학회 3 (3): 34-48, 2018

3 박규형 ; 송수정 ; 이원기 ; 윤희성 ; 고형준 ; 김철구 ; 김윤영 ; 강세웅 ; 김하경 ; 이병로 ; 남동흔 ; 이필영 ; 김형수 ; 김형찬 ; 김시열 ; 정인영 ; 김광수 ; 허걸 ; 오재령 ; 김신동 ; 이상준 ; 김영덕 ; 김순현 ; 이태곤 ; 조성원 ; 이동초 ; 장무환 ; 김시동 ; 조영욱 ; 배선량 ; 이주은 ; 엄부섭 ; 윤일한 ; 권순일 ; 강재훈 ; 김종인 ; 문상웅 ; 유형곤 ; 윤영희 ; 장광열 ; 이성철 ; 이성진 ; 박태관 ; 온영훈 ; 권오웅 ; 장우혁 ; 양연식 ; 이석준 ; 이수영 ; 김창룡 ; 이정희 ; 문연성 ; 안재균 ; 조남천 ; 최광주 ; 조영준 ; 김상국 ; 박성표 ; 남우호 ; 조희윤 ; 김준현 ; 정흠, "국내의 나이관련황반변성에 대한 기초역학조사" 대한안과학회 51 (51): 516-523, 2010

4 Wang JJ, "Visual impairment, age-related cataract, and mortality" 119 : 1186-1190, 2001

5 Hong T, "Visual impairment and the incidence of falls and fractures among older people : longitudinal findings from the blue mountains eye study" 55 : 7589-7593, 2014

6 Lee DJ, "Visual acuity impairment and mortality in US adults" 120 : 1544-1550, 2002

7 McCarty CA, "Vision impairment predicts 5 year mortality" 85 : 322-326, 2001

8 Escourrou E, "The shift from old age to very old age : an analysis of the perception of aging among older people" 23 : 3-, 2022

9 Thompson JR, "The association between visual impairment and mortality in elderly people" 18 : 83-88, 1989

10 Rosenfeld PJ, "Ranibizumab for neovascular age-related macular degeneration" 355 : 1419-1431, 2006

11 Klein BE, "Performance-based and self-assessed measures of visual function as related to history of falls, hip fractures, and measured gait time. The Beaver Dam Eye study" 105 : 160-164, 1998

12 Subhi Y, "Neovascular age-related macular degeneration in the very old(≥90 years) : epidemiology, adherence to treatment, and comparison of efficacy" 2017 : 7194927-, 2017

13 Heier JS, "Intravitreal aflibercept(VEGF trap-eye)in wet age-related macular degeneration" 119 : 2537-2548, 2012

14 Chatziralli I, "Intravitreal aflibercept for neovascular age-related macular degeneration in patients aged 90 years or older : 2-year visual acuity outcomes" 32 : 1523-1529, 2018

15 Yanagi Y, "Incidence of fellow eye involvement in patients with unilateral exudative age-related macular degeneration" 136 : 905-911, 2018

16 Ryu SY, "Incidence and characteristics of cataract surgery in South Korea from 2011 to 2015 : a nationwide population-based study" 48 : 319-327, 2020

17 Rajala U, "High cardiovascular disease mortality in subjects with visual impairment caused by diabetic retinopathy" 23 : 957-961, 2000

18 Dugel PU, "HAWK and HARRIER : phase 3, multicenter, randomized, double-masked trials of brolucizumab for neovascular age-related macular degeneration" 127 : 72-84, 2020

19 Statistics Korea, "Future Population Estimates: 2020-2070 Press Releases" Statistics Korea

20 이상범 ; 오재훈 ; 박종호 ; 최승필 ; 위정희, "Differences in youngest-old, middle-old, and oldest-old patients who visit the emergency department" 대한응급의학회 5 (5): 249-255, 2018

21 Ueta T, "Development of typical age-related macular degeneration and polypoidal choroidal vasculopathy in fellow eyes of Japanese patients with exudative age-related macular degeneration" 146 : 96-101, 2008

22 Congdon N, "Causes and prevalence of visual impairment among adults in the United States" 122 : 477-485, 2004

23 Statistics Korea, "2020 Life Table Press Release" Statistics Korea