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한국인 진행된 녹내장 환자에서 관찰되는 시야결손의 특성

Characteristics of Visual Field Defects in Korean Advanced Glaucoma

성미선|박상우|강연수|진형남
대한안과학회 (The Korean Ophthalmological Society)|2021.08|대한안과학회지 (Journal of The Korean Ophthalmological Society)|제62권 제8호|pp. 1105-1115

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키워드

Primary open angle glaucomaNormal tension glaucomaAdvanced glaucomaVisual field defect
주제분류안과학

초록

목적: 한국인의 진행된 녹내장 환자에서 관찰되는 시야결손의 특징을 알아보고자 하였다. 대상과 방법: Mean deviation (MD) -12 dB 이하의 진행된 녹내장 환자 109명의 109안을 대상으로 원발개방각녹내장과 정상안압녹내장 두 군으로 분류한 후 시야검사의 각 포인트별로 평균 numeric decibel을 수집하여 Python 3.5을 이용한 color topographic image 및 dot graph 형태로 시각화하였다. 또한, 전체 numeric display를 사분면 및 이분면으로 나누어 분석하여 결손이 심한 영역의 분포에 차이가 있는지 조사하였고, 중심 12점을 통한 중심시야결손의 정도를 비교하여 보았다. 결과: 시야결손의 양상은 두 군 모두에서 심한 상비측의 결손과 상대적으로 보존된 중심부와 하이측의 시야 양상을 보였지만, 정상안압녹내장에서 원발개방각녹내장보다 편향된 정도가 더 크게 나타났다(p<0.05). 원발개방각녹내장 환자는 미만성, 정상안압녹내장 환자는 보다 더 상비측으로 편향된 시야결손 및 상대적으로 보존된 하이측 시야를 나타내는 경향이 관찰되었다. 중심시야결손의 정도는 두 군에서 유의한 차이가 없었다. 결론: 진행된 한국인의 녹내장 환자들을 대상으로 한 본 연구에서 원발개방각녹내장 환자들과 정상안압녹내장 환자들 사이에 시야결손 양상에 차이가 있음을 확인할 수 있었다. 원발개방각녹내장 환자는 미만성, 정상안압녹내장 환자는 보다 더 상비측으로 편향된 시야결손 및 상대적으로 보존된 하이측 시야를 나타내는 경향이 있었다.

Abstract

Purpose: We investigated the clinical characteristics of visual field (VF) defects in Korean advanced glaucoma patients. Methods: The present study included 109 eyes of 109 advanced glaucoma patients whose mean deviation (MD) is under -12 dB. The subjects were classified into primary open angle glaucoma (POAG) and normal tension glaucoma (NTG) group. Average numeric decibel in each VF points were visualized with color topographic image and dot graph image using python 3.5. VF was divided into four quadrants or two half fields, and the differences in the degree of VF defects in each locations were assessed with raw decibel data. Additionally, mean sensitivity of central 12 points were compared between the two groups. Results: Generally the features of VF defects were severely depressed VF sensitivity at the superonasal quadrant and relatively preserved central area and inferotemporal quadrant in both of the glaucoma groups. But we found the extent of deflection for VF defect in the NTG eyes was higher than that of the POAG eyes (p < 0.05). The POAG eyes tended to show more diffuse and evenly distributed VF defect, whereas NTG eyes tended to have more severely depressed VF at the superonasal quadrant and relatively preserved VF at the inferotemporal quadrant. There was no significant difference in the degree of central VF defects between the two groups. Conclusions: The characteristics of VF defect in Korean advanced glaucoma revealed different features based on the glaucoma diagnosis. The POAG eyes tended to show diffuse VF defects, whereas NTG eyes tended to have more severely depressed VF sensitivity at the superonasal quadrant and relatively preserved VF at the inferotemporal quadrant.

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