정상안압녹내장에서 시야손상 진행과 체질량지수
Progression of Visual Field Loss and Body Mass Index in Normal Tension Glaucoma
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목적: 정상안압녹내장 환자에서 체질량지수가 시야손상 진행과 관련성이 있는지를 평가하고자 하였다. 대상과 방법: 점안 안압하강제로 18개월 이상 치료 중인 정상안압녹내장 환자 78명 78안을 대상으로 의무기록을 후향적으로 검토하였다. 연령, 성별, 고혈압과 당뇨병의 유무, 굴절이상, 기저안압, 안압하강률, mean deviation (MD)과 pattern standard deviation (PSD) 을 포함한 기저 시야검사 지표, 시야손상 진행 속도(MD slope, dB/year), 사용 중인 점안 안압하강제의 개수, 체질량지수를 분석하였으며, 시야손상의 진행은 험프리자동시야계의 glaucoma change probability analysis (STATPAC 2)를 이용하여 판단하였다. 결과: 대상자들의 평균 추적관찰 기간은 4.4 ± 2.7년이었다. 시야손상 진행군은 18안, 비진행군은 60안이었다. 두 군 사이에 시야손상의 진행 속도(p<0.001)와 사용 중인 점안 안압하강제 개수(p=0.024)는 통계적으로 유의한 차이를 보였으나, 평균 추적관찰 기간, 연령, 성별, 고혈압과 당뇨의 유무, 굴절상태, 기저 안압, 안압 하강률, 기저 시야검사 지표, 체질량지수는 통계학적으로 유의한 차이를 보이지 않았다(모두 p>0.05). 그러나 다중회귀분석상 시야손상 진행군 내에서는 체질량지수가 낮은 것이 빠른 시야손상의 진행 속도와 통계학적으로 유의한 관련이 있었다(β=0.078, standard error=0.030, p=0.027). 결론: 정상안압녹내장 환자 중 안압하강제 치료에도 불구하고 시야손상이 진행하는 군에서는, 낮은 체질량지수가 시야손상의 진행과 관련이 있을 수 있음을 염두에 두어야 하겠다.
Abstract
Purpose: To evaluate the association between body mass index (BMI) and visual field (VF) progression in normal tension glaucoma (NTG) patients. Methods: We reviewed the medical records of 78 eyes of 78 NTG patients who were treated with eye drops for more than 18 months. Age, sex, existence of hypertension (HTN), diabetes mellitus (DM), refractive error, baseline intraocular pressure (IOP), IOP reduction ratio, baseline VF indices including mean deviation (MD) and pattern standard deviation, VF progression rate (MD slope, dB/year), number of eye drops, and BMI were analyzed. The progression of VF was determined by glaucoma change probability analyses (STATPAC 2) using a Humphrey field analyzer. Results: The mean follow-up in consecutive eyes was 4.4 ± 2.7 years. A total of 18 eyes showed progression and 60 eyes did not. The VF progression rate (p < 0.001) and number of eye drops (p = 0.024) showed statistical differences, but age, sex, existence of HTN and DM, refractive error, baseline IOP, IOP reduction ratio, baseline VF index, and BMI did not show a statistical difference between the two groups (all, p > 0.05). However, multiple linear regression analyses showed that a lower BMI was significantly associated with faster VF progression in the progression group (β = 0.078; standard error = 0.030; p = 0.027). Conclusions: In the group in which VF loss progressed despite treatment with eye drops, a lower BMI was associated with progression of VF loss in NTG patients.
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