Journal of the Korean Ophthalmological Society 2002;43(4):700-706.
Published online April 1, 2002.
Different Modality of Treatment in the Neovascularization of Uveitis According to Nonperfusion Area.
Young Joo Shin, Jun Kyo Lee, Hum Chung
1Department of Ophthalmology, Seoul National University College of Medicine, Korea. chungh@snu.ac.kr
2Gong Eye Medical Center, Korea.
3Seoul Artificial Eye Center, Seoul National University Hospital Clinical Research Institute, Korea.
포도막염 환자에서 안내신생혈관발생에 대한 비관류지역범위에 따른 치료방법의 효과
신영주 ( Young Joo Shin ) , 이준교 ( Jun Kyo Lee ) , 정흠 ( Hum Chung )
Abstract
PURPOSE
To help the treatment decision of the intraocular neovascularization(NV) in uveitis patient by analyzing the effect of different treatment modality according to extent of nonperfusion area. METHODS: The authors reviewed the uveitic patients who occured intraocular NV from Jan. 1991 to Dec. 1999 at Seoul National University Hospital. The authors divided them into two groups in regard of the size of capillary nonperfusion by fluorescein angiography ; the nonischemic group in which the area of capillary nonperfusion is less than 10 disc area, and the ischemic group in which the area is more than 10 disc area. The regression of NV between the two groups was compared according to treatment modality such as medication, laser photocoagulation and vitrectomy. RESULTS: The NV occured 32 of total 64 eyes ; the nonischemic group included 32 eyes and ischemic group 32 eyes. The medication achieved a significant reduction of NV in nonischemic group(25 of 33 eyes) compared to ischemic group(p=0.01). The laser photocoagulation achieved a significant reduction of NV in ischemic group(16 of 24 eyes) compared to nonischemic group(p=0.064). In 30 eyes with vitrectomy, the NV reduced in 23 eyes and there was no statistical difference between the two groups in reduction of NV(p=0.398). CONCLUSION: This study suggests that retinal neovascularization can be induced by both retinal ischemia and inflammation, and the inflammation plays an important part in NV in nonischemic group, whereas the retinal ischemia plays a more important part in ischemic group. Therefore, the combined treatment with laser photocoagulation can result in a better outcome in the group with large ischemic area.
Key Words: Neovascularization in uveitis;Control of inflammation;Nonperfusion area


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