레이저광응고술 전후 맥락막두께 변화와 빛간섭단층혈관조영술을 이용한 망막혈관 밀도 분석
Analysis of Choroidal Thickness and Vascular Density Using Optical Coherence Tomography Angiography after Laser Photocoagulation
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목적: 레이저광응고술 후 맥락막두께 변화와 빛간섭단층혈관조영술을 이용한 황반부 및 시신경유두부위의 혈관 밀도 변화를 알아보고자 하였다. 대상과 방법: 당뇨망막병증환자 중 범망막광응고술을 실시한 25안을 대상으로 후향적 연구를 실시하였다. 빛간섭단층혈관조영술을 이용하여 황반부 및 시신경유두부위를 9영역으로 나누어 각 부위별 혈관 밀도를 정량적으로 측정한 뒤 레이저 시행 전, 시행 후 1주, 1개월, 3개월에 측정된 혈관 밀도와 맥막락두께 변화를 분석하였다. 결과: 범망막광응고술군에서 치료 전 황반부의 평균 혈관 밀도는 평균 13.5 ± 3.6 mm-1, 1주 후 14.7 ± 3.1 mm-1, 1개월 뒤 13.7 ± 2.6 mm-1, 3개월 뒤 12.8 ± 3.8 mm-1였다. 시신경유두부위는 치료 전 14.7 ± 5.2 mm-1, 1주 후 14.1 ± 4.7 mm-1, 1개월 뒤 14.8 ± 5.3 mm-1, 3개월 뒤 15.0 ± 4.7 mm-1였다. 평균 맥락막두께는 치료 전 327.5 ± 57.9 μm, 1주 후 334.4 ± 52.5 μm, 1개월 뒤 291.2 ± 52.9 μm, 3개월 뒤 286.3 ± 44.4 μm였다. 결론: 황반부 표층 혈관 밀도는 치료 1주 후 증가하였다가 1개월 후부터 감소하였고, 시신경유두부위는 치료 1주 후 감소하다가 1개월 후부터 다시 증가하였으며, 맥락막두께는 치료 1주 후 일시적으로 증가한 뒤 다시 감소하였다.
Abstract
Purpose: To evaluate the changes in choroidal thickness and superficial vascular density of the macula and optic disc using optical coherence tomography angiography after laser photocoagulation. Methods: We conducted a retrospective chart review of 25 eyes of diabetic retinopathy patients who underwent panretinal photocoagulation. The macula and optic disc were divided into nine areas, and the vascular density of each area was quantitatively measured using optical coherence tomography angiography. The changes in vascular density and choroidal thickness were analyzed before laser photocoagulation and at 1 week after, 1 month after, and 3 months after treatment. Results: In the panretinal photocoagulation group, the average vascular densities of the macula were 13.5 ± 3.6 mm-1 before treatment, and 14.7 ± 3.1 mm-1 after 1 week, 13.7 ± 2.6 mm-1 after 1 month, and 12.8 ± 3.8 mm-1 after 3 months of treatment. The average vascular densities of the optic disc were 14.7 ± 5.2 mm-1 before treatment, and 14.1 ± 4.7 mm-1 after 1 week, 14.8 ± 5.3 mm-1 after 1 month, and 15.0 ± 4.7 mm-1 after 3 months of treatment. The average subfoveal choroidal thicknesses were 327.5 ± 57.9 μm before treatment, and 334.4 ± 52.5 μm after 1 week, 291.2 ± 52.9 μm after 1 month, and 286.3 ± 44.4 μm after 3 months of treatment. Conclusions: The vascular density of the macula increased temporarily after 1 week of treatment but decreased afterwards. The vascular density of the optic disc decreased after 1 week of laser treatment but increased over time. The subfoveal choroidal thickness increased after 1 week of laser treatment but decreased afterwards.
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