부분조절내사시 환자에서 아트로핀을 이용한 조절마비굴절검사의 유용성
Usefulness of Cycloplegic Refraction with Atropine in Patients with Partially Accommodative Esotropia
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목적: 부분조절내사시 환자의 조절마비굴절검사에서 atropine (Isopto atropine 1% eye drop®, Alcon, Fort Worth, TX, USA)의 유용성을 분석하고자 하였다. 대상과 방법: 2017년 11월부터 2020년 12월까지 부산대학교병원에서 부분조절내사시로 진단 후 cyclopentolate와 atropine을 각각 사용한 조절마비굴절검사를 모두 시행한 환자의 의무기록을 후향적으로 분석하였다. Atropine을 사용한 검사 이후 안경을 교체한 경우 1군, 그렇지 않은 경우 2군으로 하여 두 군의 임상양상을 비교 분석하였다. Atropine 조절마비굴절검사값을 기준으로 안경을 교체한 경우 이에 따른 사시각의 변화를 분석하였다. 결과: 총 23명의 환자가 연구에 포함되었고 평균 나이는 58.2 ± 22.3개월이었다. 두 검사의 간격은 평균 5.2 ± 4.1개월이었다. Atropine을 사용한 조절마비굴절검사 후 구면렌즈대응치는 +3.04 ± 1.70 diopters (D)로, cyclopentolate 사용 시의 +2.31 ± 1.75 D보다 컸다(p=0.001). 19명(83%)의 환자가 1군, 4명(17%)의 환자가 2군에 포함되었다. 두 군의 임상양상의 차이는 없었다. Atropine을 사용한 검사 후 안경을 교체한 1군에서 안경 착용 시 근거리 사시각이 28.7 ± 14.0 prism diopters (PD)에서 20.7 ± 11.6 PD로 유의하게 감소하였다(p=0.002). 결론: 부분조절내사시 환자에서 atropine을 이용한 조절마비굴절검사는 잠복원시 발견 및 향후 치료에 유용할 수 있다.
Abstract
Purpose: To investigate the usefulness of atropine (Isopto atropine 1% eye drops®; Alcon, Fort Worth, TX, USA) for cycloplegic refraction in patients with partially accommodative esotropia. Methods: We retrospectively analyzed the medical records of patients with partially accommodative esotropia who underwent cycloplegic refraction using both cyclopentolate and atropine at Pusan National University Hospital between November 2017 and December 2020. Patients who replaced their glasses after cycloplegic refraction with atropine were included in group 1 and all other patients were included in group 2. Clinical features and the angle of ocular deviation were compared between the two groups. Results: This study included 23 patients with a mean age of 58.2 ± 22.3 months and mean interval between the two examinations of 5.2 ± 4.1 months. Spherical equivalent was larger after cycloplegic refraction using atropine compared to cyclopentolate (+3.04 ± 1.70 and +2.31 ± 1.75 diopters, respectively; p = 0.001). Groups 1 and 2 included 19 (83%) and 4 (17%) patients, respectively. Clinical characteristics did not significantly differ between the two groups. In group 1, the angle of ocular deviation at near fixation significantly decreased from 28.7 ± 14.0 to 20.7 ± 11.6 prism diopters (p = 0.002) after correction of the refractive error. Conclusions: Cycloplegic refraction with atropine may be useful for detecting latent hyperopia and managing strabismus in patients with partially accommodative esotropia.
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