상방주시 때 측정한 안구돌출계측치의 유용성
Usefulness of Exophthalmos Measurement on Upgaze
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목적: 정면주시 때 각막정점이 보이지 않는 환자에서 상방주시 후 안구돌출을 측정하는 방법의 유용성을 알아보고자 하였다. 대상과 방법: 안와골절, 가성종양, 갑상샘안병증, 정상인을 포함한 60명을 대상으로 Hertel 안구돌출계를 이용하여 각막정점, 아래 각막윤부, 아래눈꺼풀 가장자리에 인접한 공막을 기준점으로 측정하였다. 한 명의 환자당 세 명의 검사자가 연속적으로 측정하였다. 결과: 정상군에서 상대 안구돌출값은 정점기준, 윤부기준, 공막기준 시 각각 0.71 ± 0.75 mm, 0.67 ± 0.62 mm, 0.69 ± 0.60 mm였고, 안구돌출군에서는 각각 1.10 ± 0.99 mm, 1.13 ± 0.99 mm, 1.10 ± 0.91 mm, 안구함몰군에서는 각각 0.79 ± 0.90 mm, 0.74± 0.92 mm, 0.74 ± 0.87 mm로 기준점이 다르더라도 상대 안구돌출값의 차이는 통계적으로 유의하지 않았다(p＞0.05). 계측치에대해 Guttman split-half point를 구한 결과 모든 항목에서 높은 재현성을 보였다. 결론: 각막정점이 노출되지 않는 환자에서 각막윤부나 공막을 기준점으로 하는 안구돌출 측정방법이 유용하게 사용될 수 있을 것이다.
Abstract
Purpose: To evaluate the usefulness of exophthalmos measurement on upgaze in patients who are not able to expose corneal vertex on primary gaze. Methods: The present study included 39 patients with blow out fracture, pseudotumor, or thyroid associated ophthalmopathy and 21 people who don’t have any ocular disease. In total, 60 people had exophthalmometry using Hertel exophthalmometer on the basis of corneal vertex, inferior limbus, and inferior sclera by three examiners. Results: The relative exophthalmometry in normal group was 0.71 ± 0.75 mm, 0.67 ± 0.62 mm, and 0.69 ± 0.60 mm on the basis of corneal vertex, inferior limbus, and inferior sclera, respectively. The relative exophthalmometry in exophthalmic group was 1.10 ± 0.99 mm, 1.13 ± 0.99 mm, 1.10 ± 0.91 mm on the basis of corneal vertex, inferior limbus, and inferior sclera, respectively. The relative exophthalmometry in enophthalmic group was 0.79 ± 0.90 mm, 0.74 ± 0.92 mm, 0.74 ±0.87 mm on the basis of corneal vertex, inferior limbus, and inferior sclera, respectively. There was no statistically significant difference between different measuring points (p > 0.05). The inter-examiner reproducibility was shown to be highly reliable. Conclusions: The upgaze exophthalmometry on the basis of inferior limbus or inferior sclera would be useful in the patients who are not able to expose corneal vertex on primary gaze.
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