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범망막광응고술 후 시신경유두주위 망막신경섬유층과 황반부 망막신경절세포-내망상층 두께 변화

Long-term Changes in the Peripapillary RNFL and Macular GCIPL Thicknesses after Panretinal Photocoagulation in Diabetic Retinopathy Patients

박동호|김대우|윤정현
대한안과학회 (The Korean Ophthalmological Society)|2018.10|대한안과학회지 (Journal of The Korean Ophthalmological Society)|제59권 제10호|pp. 938-945

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키워드

Diabetic retinopathyGlaucomaPanretinal photocoagulationRetinal nerve fiber layer thicknessGanglion cell-inner plexiform layer thickness
주제분류안과학

초록

목적: 본 연구에서는 당뇨망막병증 환자를 대상으로 범망막광응고술(panretinal photocoagulation, PRP) 후 시신경유두주위 망막신경섬유층(peripapillary retinal nerve fiber layer, pRNFL)과 황반부 망막신경절세포-내망상층(macular ganglion cell-inner plexiform layer, mGCIPL)의 장기간 두께 변화를 추적관찰 하고자 하였다. 대상과 방법: PRP를 시행한 당뇨망막병증 환자 35명, 60안의 의무기록을 후향적으로 분석하였다. PRP 전과 이후 1, 3, 6, 9, 12, 24, 36개월 간격으로 pRNFL과 mGCIPL 두께 변화에 대해 살펴보았다. 결과: PRP 시행 1년 후 pRNFL과 mGCIPL의 평균과 각 영역의 두께는 시술 시행 전과 비교할 때 증가하였다(p<0.05, 모두). 이후 평균 두께는 지속적으로 감소하는 경향을 보였고(p<0.05, 모두), 시행 후 3년째 pRNFL과 mGCIPL의 평균 두께(93.93 ± 7.49 μm, 81.87 ± 14.00 μm, 각각)는 시술 전의 두께(92.27 ± 7.76 μm, 85.00 ± 4.80 μm, 각각)와 비교할 때 통계적으로 유의한 차이를 보이지 않았다(p=0.121, p=0.622, 각각). 결론: pRNFL과 mGCIPL의 두께는 PRP 후 1년까지 증가하였지만 3년 후에는 시술 전과 큰 차이를 보이지 않았다. PRP를 시행한당뇨망막병증 환자의 녹내장 진단과 진행 여부를 판단함에 있어 이 점을 고려해야 할 것으로 생각된다.

Abstract

Purpose: To investigate longitudinal changes in the thicknesses of the peripapillary retinal nerve fiber layer (pRNFL) and the macular ganglion cell-inner plexiform layer (mGCIPL) in patients with diabetic retinopathy 3 years after panretinal photocoagulation (PRP). Methods: We retrospectively reviewed the medical records of 60 eyes of 35 patients who were diagnosed with diabetic retinopathy and treated with PRP. The pRNFL and mGCIPL thicknesses were measured by optical coherence tomography at baseline, and then at 1, 3, 6, 9, 12, 24, and 36 months after PRP. Results: The pRNFL and mGCIPL thicknesses (average and all sections) at 1 year after PRP increased significantly from baseline (p < 0.05, respectively). The average pRNFL and mGCIPL thicknesses showed a tendency to decrease continuously from 2 years after PRP (p < 0.05, respectively). There was no statistically significant difference in the average thicknesses of the pRNFL and the mGCIPL between pre-PRP (92.27 ± 7.76 μm, and 85.00 ± 4.80 μm, respectively) and 3 years after PRP (93.93 ± 7.49 μm, and 81.87 ± 14.00 μm, respectively) (p = 0.121, and p = 0.622, respectively). Conclusions: Although the pRNFL and the mGCIPL thicknesses increased at 1 year after PRP, there was no statistical difference in the average thicknesses of the pRNFL and the mGCIPL between pre-PRP and 3 years after PRP. These results should be considered with respect to the diagnosis and progression of glaucoma in patients with diabetic retinopathy who undergo PRP.

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관련 논문AI추천

Peripapillary Retinal Nerve Fiber Layer Thickness Change After Panretinal Photocoagulation in Patients With Diabetic Retinopathy김호영, 조호균대한안과학회 · Korean Journal of Ophthalmology2009 · 제23권 제1호범망막 레이저 광응고술 후 맥락막 두께 변화유성, 강현구, 김용일, 이규원대한안과학회 · 대한안과학회지2016 · 제57권 제2호Changes in Peripapillary Retinal Nerve Fiber Layer Thickness after Pattern Scanning Laser Photocoagulation in Patients with Diabetic Retinopathy박이령, 지동현대한안과학회 · Korean Journal of Ophthalmology2014 · 제28권 제3호당뇨망막병증 환자에서 패턴 범망막광응고술 후 중심와아래 맥락막두께의 변화김상원, 안소은, 윤희성, 전혜민, 채수혜대한안과학회 · 대한안과학회지2016 · 제57권 제8호당뇨망막병증에서 패턴 범망막광응고술과 기존 범망막광응고술과의 치료 효과 비교양지욱, 이영춘대한안과학회 · 대한안과학회지2010 · 제51권 제12호당뇨황반부종 호전 후 황반부 신경절세포-내망상층 두께와 시력과의 관계김성택, 박지만, 이영창대한안과학회 · 대한안과학회지2015 · 제56권 제9호

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