약시가 없는 굴절부등 환자의 입체시 평가
Stereoacuity in Patients with Non-Amblyopic Anisometropia
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목적: 굴절부등 환자를 안경 착용군과 미착용군으로 구분하여 입체시검사 결과를 비교하고, 굴절부등 정도와 입체시 사이의 연관성을알아보고자 하였다. 대상과 방법: 약시가 없는 굴절부등 환자 중 입체시가 시행된 환자의 의무기록을 후향적으로 조사하였다. 안경 착용군(30명)과 안경미착용군(33명)으로 나누어 임상 특성을 살펴보고, 두 군 간의 워트4등검사, 티트무스검사, 랑II검사, 티엔오검사 결과를 비교 분석하였다. 굴절부등 정도와 입체시 사이의 연관성을 함께 분석하였다. 결과: 평균 나이는 안경 미착용군 12.2 ± 3.7세, 착용군 11.8 ± 4.0세였으며, 평균 굴절부등 정도는 안경 미착용군 2.12 ± 1.21 diopters (D), 착용군 1.81 ± 1.25 D로 유의한 차이가 없었다. 안경 미착용군은 워트4등검사에서 원거리 억제 비율이 안경 착용군에비해 유의하게 높았고, 입체시검사 모두에서 안경 착용군에 비해 나쁜 입체시를 보였다. 굴절부등 정도와 입체시는 안경 미착용군에서 티트무스검사, 랑II검사, 티엔오검사 모두에서 유의한 상관관계를 보였으나(r=0.690, r=0.614, r=0.655, 모두 p<0.001), 안경 착용군에서는 티엔오검사에서만 약한 상관관계를 보였다(r=0.366, p=0.047). 결론: 굴절부등 환자에서 안경 착용군이 미착용군보다 좋은 입체시를 보였다. 안경 미착용군에서는 굴절부등이 심할수록 입체시가유의하게 더 낮았으나, 안경 착용군에서는 상관성이 뚜렷하지 않았다. 이번 연구결과를 토대로, 굴절부등이 있는 소아청소년 및 젊은성인의 경우, 양안시 개선을 위해 안경착용을 권유할 수 있겠다.
Abstract
Purpose: To compare the stereoacuity between patients with uncorrected and corrected non-amblyopic anisometropia, and to evaluate the correlation between the degrees of anisometropia and stereoacuity. Methods: We retrospectively reviewed the records of patients with non-amblyopic anisometropia who underwent the stereoacuity test. Patients were divided into uncorrected anisometropia (n = 33) and corrected by spectacles (n = 30) groups. The clinical characteristics and sensory status of patients were evaluated using the Worth 4-dot, Titmus, Lang II, and TNO tests, and compared between the groups. Correlation analysis was performed between the degree of anisometropia and the level of stereopsis. Results: The uncorrected and corrected anisometropia groups did not significantly differ in mean age (12.2 ± 3.7 and 11.8 ± 4.0 years) or degree of anisometropia (2.12 ± 1.21 and 1.81 ± 1.25 diopters). The rate of sensory fusion in the distant Worth 4-dot test was lower in the uncorrected anisometropia than the corrected anisometropia group. The level of stereopsis was also worse in the uncorrected anisometropia than the corrected anisometropia group in all stereoacuity tests. There was a strong positive correlation between the degree of anisometropia and the level of stereoacuity on the Titmus, Lang II, and TNO tests (r = 0.690, r = 0.614, and r = 0.655, respectively; all p < 0.001) in the uncorrected anisometropia group. However, the corrected anisometropia group showed a weak positive correlation between the degree of anisometropia and the level of stereoacuity only on the TNO test (r = 0.366; p = 0.047). Conclusions: Stereoacuity was better in the corrected anisometropia group than in the uncorrected group. It significantly worsened with increasing anisometropia in the uncorrected group, but only a weak correlation was observed in the corrected group. Therefore, prescribing glasses could be recommended to improve stereopsis in adolescents and young adults with anisometropia.
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