정상안과 녹내장안의 맥락막혈관지수 비교
Association between Choroidal Vascularity and Prelaminar Tissue Thickness in Healthy and Glaucomatous Eyes
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목적: 본 연구는 정상안과 녹내장안에서 맥락막혈관지수와 전사상판조직의 두께 사이에 의미 있는 관련성이 있는지를 분석하고자하였다. 대상과 방법: 녹내장 86안, 시야결손 전 녹내장 86안, 정상안 43안이 포함되었다. 총 맥락막 면적과 맥락막혈관지수를 브루크막 개방중심에서 3.5 mm 거리에서 스펙트럼영역 빛간섭단층촬영(spectral domain optical coherence tomography) 영상의 이진화 기법을이용하여 측정하였다. 맥락막혈관지수는 맥락막조직에서 맥락막혈관이 차지하는 면적의 비율로 도출하였다. 맥락막혈관지수와 전사상판조직의 두께 사이의 관련성을 분석하였다. 결과: 맥락막혈관지수는 녹내장군(61.67% ± 4.11%)에서 가장 낮았고 시야결손 전 녹내장군(63.36% ± 3.54%), 정상안군(64.84% ± 3.13%) (p＜0.001) 순으로 높았다. 녹내장(102.05 ± 44.01 μm)은 시야결손 전 녹내장군(106.16 ± 38.03 μm) 및 정상안(154.98 ± 79.46 μm)에 비해 전사상판조직의 두께가 유의하게 얇았다(p＜0.001). 다변수 회귀분석에서 맥락막혈관지수는 정상안과 녹내장안을포함한 모든 군에서 전사상판조직의 두께 및 총 맥락막 면적과 연관성을 보였다(p＜0.05). 결론: 맥락막혈관지수와 전사상판조직의 두께는 정상안보다 녹내장안에서 유의하게 낮았고, 두 변수는 정상안과 녹내장안을 포함한모든 군에서 양의 상관관계를 보였다. 이는 유두주위 맥락막 순환이 전사상판의 혈액 순환에 영향을 미치고 녹내장의 발병에 기여할수 있음을 시사한다.
Abstract
Purpose: To assess the association between the choroidal vascularity index (CVI) and prelaminar tissue thickness (PTT) in healthy and glaucomatous eyes. Methods: The study included 86 eyes with perimetric glaucoma (PG), 86 with pre‐perimetric glaucoma (PPG), and 43 agematched healthy eyes. Total choroidal area (TCA) and CVI were measured by image binarization of spectral‐domain optical coherence tomography (SD‐OCT) 3.5 mm from the center of Bruch’s membrane opening. The CVI was the percentage of choroidal vasculature to choroidal tissue. The association between CVI and PTT measured on a center‐horizontal scan of enhanced depth imaging SD‐OCT was assessed. Results: The CVI was lowest in PG (61.67% ± 4.11%), followed by PPG (63.36% ± 3.54%), and healthy (64.84% ± 3.13%) eyes (p < 0.001). PG (102.05 ± 44.01 μm) had a significantly thinner PTT than PPG (106.16 ± 38.03 μm) and the healthy (154.98 ± 79.46 μm) eyes (p < 0.001). In a multivariate regression analysis, CVI was associated with PTT and TCA in all subjects, including healthy and glaucomatous eyes (p < 0.05). Conclusions: The CVI and PTT had significantly lower values in glaucomatous eyes than in healthy eyes, and the two parameters were positively associated in all subjects, including healthy and glaucomatous eyes.
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