특발망막앞막에서 수술 전 정면빛간섭단층촬영 영상과 수술 후 시력 호전과의 관계
The Correlation between Preoperative En Face Optical Coherence Tomography and Postoperative Visual Prognoses in Idiopathic Epiretinal Membranes
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
목적: 특발망막앞막 환자에서 수술 전 정면빛간섭단층촬영(En Face optical coherence tomography) 영상과 술 후 예후와의 관련성에 대하여 알아보고자 한다. 대상과 방법: 2005년 1월부터 2016년 1월까지 특발망막앞막으로 진단된 후 망막앞막 제거술을 받은 환자 중 12개월 이상 경과 관찰한 환자 59명 59안의 의무기록을 후향적으로 분석하였다. 술 전 En Face 영상을 early treatment diabetic retinopathy study (ETDRS) subfields에 준하여, 3개의 원(6,000 μm diameter circle, 3,000 μm diameter circle, 1,000 μm diameter circle)과 1개의 사각형(6,000 × 6,000 μm square), 총 4가지로 나누었고, 그래픽 편집 소프트웨어(Adobe Photoshop CS6, Adobe Systems, San Jose, CA, USA)를 통해 영상의 black pixel 값을 측정하여, 망막앞막의 유착이 없는 부위를 수치화하였다. 이후 Black pixel 값, 수술 전후 시력 및 수술 전후 중심망막두께와의 상관관계에 대하여 분석하였다. 결과: 망막앞막 제거술 후 최대교정시력은 유의하게 증가하였고(p＜0.001), 중심망막두께는 유의하게 감소하였다(p＜0.001). 6,000 × 6,000 μm square 및 6,000 μm diameter circle의 En Face 영상 black pixel 값이 증가할수록 수술 전후 최대교정시력 호전 정도가 증가하였으며, 이는 통계학적으로 유의하였다(r=0.645, p＜0.001) (r=0.590, p＜0.001). 결론: 망막앞막 환자의 수술 전 En Face 영상에서 망막앞막과 망막의 유착이 없는 부위의 면적이 클수록 수술 후 최대교정시력의 증가량이 많았다. 따라서 망막앞막의 수술 후 시력 예후 예측 인자로서 정면빛간섭단층촬영 영상이 유용할 것으로 생각된다.
Abstract
Purpose: To investigate the correlation between en face optical coherence tomography and improvements in the postoperative prognoses of idiopathic epiretinal membranes. Methods: The medical records of 59 epiretinal membrane patients who had epiretinal membrane peeling between January 2005 and January 2016, and were followed up for > 12 months, were retrospectively reviewed. The preoperative en face images were divided into four sections involving three circular areas (6,000 μm diameter circle, 3,000 μm diameter circle, and 1,000 μm diameter circle) and one square (6,000 × 6,000 μm). The surface area where no epiretinal adhesion was present was quantified by measuring the number of black pixels using image-editing software (Adobe Photoshop CS6, Adobe Systems, San Jose, CA, USA). Then the correlations among the value of black pixels, preoperative and postoperative visual acuities, and central retinal thickness were analyzed. Results: The best-corrected visual acuity (BCVA) was significantly increased after epiretinal membrane peeling (p < 0.001), and the central retinal thickness was significantly decreased (p < 0.001). As the number of black pixels in the circles and the square in the en-face images increased, the postoperative BCVA significantly increased (r = 0.645, p < 0.001; r = 0.590, p < 0.001, respectively). Conclusions: As the nonadhesive surfaces of the epiretinal membrane and the retina in preoperative en face images became wider, the increments of the BCVA after surgery were greater. Therefore, en face optical coherence tomography can be used to predict prognosis after epiretinal membrane peeling.
참고문헌 (27)
- Koutsandrea CN, "Indocyanine green-assisted epiretinal membrane peeling evaluated by optical coherence tomography and multifocal electroretinography", Clin Ophthalmol, 1, pp.535~544 (2007)
- Smiddy WE, "Idiopathic epiretinal membranes. Ultrastructural characteristics and clinicopathologic correlation", Ophthalmology, 96, pp.811~820 (1989)[DOI]
- Michels RG, "Vitreous surgery for macular pucker", Am J Ophthalmol, 92, pp.628~639 (1981)[DOI]
- de Bustros S, "Vitrectomy for macular pucker: use after treatment of retinal tears or retinal detachment", Arch Ophthalmol, 106, pp.758~760 (1988)[DOI]
- Ando F, "Anatomical and visual outcomes after episcleral macular buckling compared with those after pars plana vitrectomy for retinal detachment caused by macular hole in highly myopic eyes", Retina, 27, pp.37~44 (2007)[DOI]
- McDonald HR, "Surgical management of idiopathic epiretinal membranes", Ophthalmology, 93, pp.978~983 (1986)[DOI]
- de Bustros S, "Nuclear sclerosis after vitrectomy for idiopathic epiretinal membranes", Am J Ophthalmol, 105, pp.160~164 (1988)[DOI]
- Margherio RR, "Removal of epimacular membranes", Ophthalmology, 92, pp.1075~1083 (1985)[DOI]
- van Velthoven ME, "Recent developments in optical coherence tomography for imaging the retina", Prog Retin Eye Res, 26, pp.57~77 (2007)[DOI]
- Ko TH, "Comparison of ultrahighand standard-resolution optical coherence tomography for imaging macular pathology", Ophthalmology, 112, pp.1922.e1~1922.e15 (2005)
- Schmidt-Erfurth U, "Three-dimensional ultrahigh-resolution optical coherence tomography of macular diseases", Invest Ophthalmol Vis Sci, 46, pp.3393~3402 (2005)[DOI]
- Odrobina D, "Long-term evaluation of vitreomacular traction disorder in spectral-domain optical coherence tomography", Retina, 31, pp.324~331 (2011)[DOI]
- Kinoshita T, "Morphologic differences in epiretinal membranes on ocular coherence tomography as a predictive factor for surgical outcome", Retina, 31, pp.1692~1698 (2011)[DOI]
- Falkner-Radler CI, "Spectral-domain optical coherence tomography for monitoring epiretinal membrane surgery", Ophthalmology, 117, pp.798~805 (2010)[DOI]
- Kim J, "Long-term temporal changes of macular thickness and visual outcome after vitrectomy for idiopathic epiretinal membrane", Am J Ophthalmol, 150, pp.701~709 (2010)[DOI]
- Shiono A, "Photoreceptor outer segment length: a prognostic factor for idiopathic epiretinal membrane surgery", Ophthalmology, 120, pp.788~794 (2013)[DOI]
- Theodossiadis PG, "The photoreceptor layer as a prognostic factor for visual acuity in the secondary epiretinal membrane after retinal detachment surgery: imaging analysis by spectral-domain optical coherence tomography", Am J Ophthalmol, 151, pp.973~980 (2011)[DOI]
- Seidel G, "Association of preoperative optical coherence tomography markers with residual inner limiting membrane in epiretinal membrane peeling", PLoS One, 8, pp.e66217~ (2013)[DOI]
- Kim JS, "Retinal adherence and fibrillary surface changes correlate with surgical difficulty of epiretinal membrane removal", Am J Ophthalmol, 153, pp.692~697 (2012)[DOI]
- Wilkins JR, "Characterization of epiretinal membrane using optical coherence tomography", Ophthalmology, 103, pp.2142~2151 (1996)[DOI]
- Pavlidis M, "Determination of a new parameter, elevated epiretinal membrane, by En Face OCT as a prognostic factor for pars plana vitrectomy and safer epiretinal membrane peeling", J Ophthalmol, 2015, pp.838646~ (2015)
- 권순일, "The Clinical Course of the Idiopathic Epiretinal Membrane After Surgery", Korean Journal of Ophthalmology, 23(4), pp.249~252 (2009), 대한안과학회
- Suh MH, "Associations between macular findings by optical coherence tomography and visual outcomes after epiretinal membrane removal", Am J Ophthalmol, 147, pp.473~480 (2009)[DOI]
- Rice TA, "Prognostic factors in vitrectomy for epiretinal membranes fo the macula", Ophthalmology, 93, pp.602~610 (1986)[DOI]
- Pournaras CJ, "Macular epiretinal membranes", Semin Ophthalmol, 15, pp.100~107 (2000)[DOI]
- Donati G, "Complications of surgery for epiretinal membranes", Graefes Arch Clin Exp Ophthalmol, 236, pp.739~746 (1998)[DOI]
- Ando A, "Surgical outome on combined procedures of lens extraction, intraocular lens implantation, and vitrectomy during removal of the epiretinal membrane", Ophthalmic Surg Lasers, 29, pp.974~979 (1998)