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세 가지 기기를 이용하여 측정한 중심각막두께의 비교 및 반복성 비교

A Comparison of Central Corneal Thickness Measurements and Measurement Repeatability Using Three Imaging Modalities

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목적: 전안부 빛간섭단층촬영, 초음파 각막두께측정계 및 이중샤임플러그 전안부사진기(Galilei G4®)를 이용하여 중심각막두께의 측정치를 비교하고 각 기기들의 반복성을 비교하고자 한다. 대상과 방법: 정상인 60명 120안을 대상으로 전안부 빛간섭단층촬영, 초음파 각막두께측정계 및 이중샤임플러그 전안부사진기로 측정된 중심각막두께 검사치의 상관관계를 알아보고, 기기별 반복성을 비교하였다. 결과: 전안부 빛간섭단층촬영, 초음파 각막두께측정계 및 이중샤임플러그 전안부사진기를 이용하여 측정한 중심각막두께는 각각 511.23 ± 37.16 μm, 525.78 ± 39.22 μm, 531.43 ± 41.57 μm로 이중샤임플러그 전안부사진기가 가장 두껍게 측정되었고, 전안부 빛간섭단층촬영이 가장 얇게 측정되었으며, 각 측정치 사이에 통계적으로 유의한 차이를 보였다(p<0.05). 세 검사는 유의한 상관관계를 보였다(r>0.900, p<0.001). 검사자 내 반복성은 세 기기 모두 높은 신뢰도를 보였다(급내상관계수 ≥0.996). 결론: 세 검사 사이에 유의한 상관관계가 있었으며 세 검사 모두 높은 반복성을 보였다. 전안부 빛간섭단층촬영에 의해 측정된 중심각막두께는 이중샤임플러그 전안부사진기에 의해 측정된 중심각막두께보다 유의하게 얇게 측정되었고, 또한 이중샤임플러그 전안부사진기로 측정한 중심각막두께가 초음파 각막두께측정계로 측정한 값에 조금 더 유사한 값을 나타내어 결과 해석 시 이에 대한 고려가 필요할 것으로 생각된다.

Abstract

Purpose: To compare and analyze central corneal thickness (CCT) measurements and measurement repeatability according to the corneal thickness obtained with anterior segment optical coherence tomography (AS-OCT), ultrasound pachymetry (USP), and dual Scheimpflug imaging (Galilei G4®). Methods: CCT measurements obtained using AS-OCT, USP, and a dual rotating Scheimpflug camera in 120 eyes of 60 healthy subjects were compared and the repeatability was analyzed. Results: The average CCT measurements using AS-OCT, USP, and a dual rotating Scheimpflug camera were 511.23 ± 37.16, 525.78 ± 39.22, and 531.43 ± 41.57 μm, respectively. The CCT measurement using dual rotating Scheimpflug imaging was statistically significantly thicker than that measured using AS-OCT (p < 0.05). A significant linear correlation was observed among OCT, USP, and dual rotating Scheimpflug measurements (r > 0.900, p < 0.001). All three methods showed high repeatability (intraclass correlation coefficient ≥ 0.996) for intra-examiner CCT measurements. Conclusions: The CCT measurement results using the three methods were significantly correlated and showed high repeatability. However, the AS-OCT measurement was significantly thinner than that obtained using a dual rotating Scheimpflug camera. CCT measurement with a dual rotating Scheimpflug camera is a better alternative for USP than AS-OCT. Therefore, CCT should be interpreted in the context of the instrument used.

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