정상안압녹내장의 시야 진행과 시신경유두주위위축의 관련성
The Relations Between Progression of Peripapillary Chorioretinal Atrophy and Progression of Normal Tension Glaucoma
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목적: 본 연구는 정상안압녹내장의 시야 진행과 시신경유두주위위축 진행 간의 관련성에 관하여 알아보고자 하였다. 대상과 방법: 정상안압녹내장 환자 66명 66안을 대상으로 시야검사상 녹내장이 진행한 군과 그렇지 않은 군을 나누어 두 군 간에 시신경유두주위위축의 진행을 분석하였다. 정성적 평가를 위해 관찰자 간 및 관찰자 내 일치도를 검증하였다. 시신경유두주위위축부의진행은 베타영역을 대상으로, 면적의 평균값이 유의하게 증가한 경우와 측정오차 범위를 벗어난 면적이 증가한 경우, 이 두 가지 기준으로 각각 진행 여부를 판단하였다. 결과: 총 66안 중 시야검사상 진행이 발견된 군은 46안, 진행을 보이지 않은 군은 20안이었다. 시신경유두주위 위축 면적의 평균값은진행군과 비진행군에서 모두 유의한 증가 소견을 보이지 않았다(p＞0.05). Image J 프로그램을 이용한 측정 시 측정오차범위(15%)를초과하여 면적의 증가를 보이는 경우도 진행군과 비진행군에서 관찰되지 않았다. 결론: 정상안압녹내장에서 녹내장성 시야 진행이 되는 경우에도 베타영역의 진행 소견이 동반되지 않았음을 확인할 수 있었다.
Abstract
Purpose: To evaluate the relations between progression of glaucoma in visual field and peripapillary area change in normal tension glaucoma (NTG). Methods: We respectively evaluated 66 patients (66 eyes) with normal tension glaucoma; these patients were classified as progressive glaucoma group and non-progressive glaucoma group by visual field test. Interobserver and intraobserver agreement was evaluated for qualitative assessment. Zone β change was measured by Image J (National Institute of Health, Bethesda, USA) by two methods. One method used paired t-test and the other method used CV (correlation of variation)to define significant progression of zone β. Results: 46 patients (46 eyes) were classified as progressive glaucoma and 20 patients (20 eyes) were classified as non-progressive glaucoma. There was no statistically significant different change of zone β between two groups and there were no changes of zone β over coefficient of variation (CV). Conclusions: The measurement of change of zone β seems to be of no use in recognition of progression in normal tension glaucoma.
참고문헌 (28)
- Armaly MF., "Ocular pressure and visual fields. A ten-year follow- up study", Arch Ophthalmol, 81, pp.25~40 (1969)
- Levene RZ., "Low tension glaucoma: a critical review and new material", Surv Ophthalmol, 24, pp.621~664 (1980)
- Perkins ES, "The Bedford glaucoma survey. I. Long-term follow-up of borderline cases", Br J Ophthalmol, 57, pp.179~185 (1973)
- Van Buskirk EM, "Glaucomatous optic neuropathy", Am J Ophthalmol, 113, pp.447~452 (1992)
- Brubaker RF., "Delayed functional loss in glaucoma. LII Edward Jackson Memorial Lecture", Am J Ophthalmol, 121, pp.473~483 (1996)
- Araie M, "Factors contributing to the progression of visual field damage in eyes with normal-tension glaucoma", Ophthalmology, 101, pp.1440~1444 (1994)
- "Comparison of glaucomatous progression between untreated patients with normal-tension glaucoma and patients with therapeutically reduced intraocular pressures. Collaborative Normal-Tension Glaucoma Study Group", Am J Ophthalmol, 126, pp.487~497 (1998)
- Crichton A, "Unequal intraocular pressure and its relation to asymmetric visual field defects in low-tension glaucoma", Ophthalmology, 96, pp.1312~1314 (1989)
- Daugeliene L, "Risk factors for visual field damage progression in normal-tension glaucoma eyes", Graefes Arch Clin Exp Ophthalmol, 237, pp.105~108 (1999)
- Nakagami T, "Prognostic factors for progression of visual field damage in patients with normal-tension glaucoma", Jpn J Ophthalmol, 50, pp.38~43 (2006)
- Meyer JH, "Twenty four hour blood pressure monitoring in normal tension glaucoma", Br J Ophthalmol, 80, pp.864~867 (1996)
- Jonas JB, "Parapapillary chorioretinal atrophy in normal and glaucoma eyes. I. Morphometric data", Invest Ophthalmol Vis Sci, 30, pp.908~918 (1989)
- Jonas JB, "Glaucomatous parapapillary atrophy. Occurrence and correlations", Arch Ophthalmol, 110, pp.214~222 (1992)
- Jonas JB, "Parapapillary chorioretinal atrophy in normal and glaucoma eyes. II. Correlations", Invest Ophthalmol Vis Sci, 30, pp.919~926 (1989)
- Park KH, "Correlation between peripapillary atrophy and optic nerve damage in normal-tension glaucoma", Ophthalmology, 103, pp.1899~1906 (1996)
- Tezel G, "Comparative optic disc analysis in normal pressure glaucoma, primary open-angle glaucoma, and ocular hypertension", Ophthalmology, 103, pp.2105~2113 (1996)
- Kono Y, "Relationship between parapapillary atrophy and visual field abnormality in primary open-angle glaucoma", Am J Ophthalmol, 127, pp.674~680 (1999)
- Primrose J., "Early signs of the glaucomatous disc", Br J Ophthalmol, 55, pp.820~825 (1971)
- Rockwood EJ, "Acquired peripapillary changes and progression in glaucoma", Graefes Arch Clin Exp Ophthalmol, 226, pp.510~515 (1988)
- Tuulonen A, "Interobserver variation in the measurements of peripapillary atrophy in glaucoma", Ophthalmology, 103, pp.535~541 (1996)
- See JL, "Rates of neuroretinal rim and peripapillary atrophy area change: a comparative study of glaucoma patients and normal controls", Ophthalmology, 116, pp.840~847 (2009)
- Hodapp E, "Clinical Decisions in Glaucoma", pp.52~61 (1993), Mosby
- Uchida H, "Increasing peripapillary atrophy is associated with progressive glaucoma", Ophthalmology, 105, pp.1541~1545 (1998)
- Park KH, "Ability of peripapillary atrophy parameters to differentiate normal-tension glaucoma from glaucomalike disk", J Glaucoma, 10, pp.95~101 (2001)
- Kono Y, "Agreement of measurement of parapapillary atrophy with confocal scanning laser ophthalmoscopy and planimetry of photographs", J Glaucoma, 8, pp.105~110 (1999)
- Jonas JB., "Clinical implications of peripapillary atrophy in glaucoma", Curr Opin Ophthalmol, 16, pp.84~88 (2005)
- Hayreh SS, "Parapapillary chorioretinal atrophy in chronic high-pressure experimental glaucoma in rhesus monkeys", Invest Ophthalmol Vis Sci, 39, pp.2296~2303 (1998)
- Airaksinen PJ, "Change of peripapillary atrophy in glaucoma, In Glaucoma Update III", pp.97~102 (1987), Springer-Verlag