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고도근시 녹내장에서 두 가지 빛간섭단층촬영의 구조-기능 관계 비교

The Structure-function Relationships between Two Different Optical Coherence Tomography in Patients with High Myopic Glaucoma

박찬기|정경인|김성아
대한안과학회 (The Korean Ophthalmological Society)|2020.10|대한안과학회지 (Journal of The Korean Ophthalmological Society)|제61권 제10호|pp. 1194-1202

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키워드

GlaucomaSwept-source optical coherence tomographyHigh myopiaSpectral domain optical coherence tomographyStructure-function relationship
주제분류안과학

초록

목적: 고도근시 녹내장 환자에서 스펙트럼영역 빛간섭단층촬영(spectral domain optical coherence tomography, SD-OCT)과 파장가변 빛간섭단층촬영(swept-source optical coherence tomography, SS-OCT)의 구조-기능 관계를 분석하고자 한다. 대상과 방법: 시야결손 전 개방각녹내장과 원발개방각녹내장 환자 중 안축장길이 28 mm 이상의 고도근시 43안, 안축장길이 21 이상 24 mm 미만인 30안을 대상으로 후향적 연구를 진행하였다. 시야검사의 시야감도와 mean deviation (MD), SD-OCT와 SS-OCT로 망막신경섬유층 두께를 측정하여, 구조-기능 관계를 분석하였다. 결과: 고도근시안에서 SS-OCT의 평균 망막신경섬유층 두께와 평균 시야감도는 유의한 상관관계를 보였고(p<0.001), 6개의 구역에서 유의한 구조-기능 관계를 보였다(p<0.05). 고도근시안에서 SD-OCT의 평균 망막신경섬유층 두께와 평균 시야감도 및 2개 구역을 제외하고는 유의한 관련성을 보이지 않았다. 비고도근시안에서 SS-OCT의 평균 망막신경섬유층 두께와 평균 시야감도 및 MD는 유의한 관계를 보였고(p≤0.001), SD-OCT의 평균 망막신경섬유층 두께와 MD와 유의한 관련성을 보였다(p=0.036). 비고도근시안에서 SS-OCT와 SD-OCT의 망막신경섬유층 두께와 상응하는 시야감도는 4개 구역에서 유의한 관계를 보였다(p<0.05). 결론: 고도근시 녹내장 환자에서 SS-OCT는 SD-OCT와 비교하여 상대적으로 우월한 구조-기능 관계를 보였다.

Abstract

Purpose: To evaluate the structure-function relationships between swept-source optical coherence tomography (SS-OCT) and spectral-domain optical coherence tomography (SD-OCT) in glaucoma patients with high myopia. Methods: Forty-three eyes with high-myopia (axial length over 28 mm) and 30 with emmetropia (axial length 21 to 24 mm) of patients with preperimetric glaucoma and primary open-angle glaucoma were retrospectively enrolled. Visual field (VF) sensitivity and mean deviation were evaluated via standard automated perimetry. Peripapillary retinal nerve fiber layer (RNFL) thickness was measured using SD-OCT and SS-OCT. The topographic relationships between structure and function were investigated. Results: In the high myopia group, the average (p < 0.001) and all six sectorial (all p < 0.05) RNFL thicknesses on SS-OCT correlated significantly with the corresponding VF sensitivities. In high myopia patients, the average RNFL thickness did not correlate with the mean sensitivity (MS). SD-OCT revealed no significant sectorial structure-function relationships in four sections, but did in two sectors (both p > 0.05). The emmetropic group exhibited a significant correlation between the average RNFL thickness, and the MS and VF mean deviation (MD) using SS-OCT (both p ≤ 0.001). The average RNFL thickness correlated significantly with the MD using SD-OCT (p = 0.036). In emmetropia patients, the superotemporal, inferotemporal, superonasal, and inferonasal RNFL thicknesses correlated with the corresponding VF sensitivities using both SS-OCT and SD-OCT (all p < 0.05). Conclusions: SS-OCT assessed structure-function relationships more accurately than did SD-OCT in glaucoma patients with high myopia.

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