정상안압녹내장에서 초기 시야결손 유형과 각막생체역학인자의 관련성
The Association between Corneal Biomechanical Properties and Initial Visual Field Defect Pattern in Normal Tension Glaucoma
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초록
목적: 정상안압녹내장 환자에서 안구반응분석기(Ocular Response Analyzer, ORA; Reichert Instruments, Depew, NY, USA)를 이용하여 초기 시야결손 유형과 각막생체역학인자의 관련성에 대해 알아보고자 한다. 대상과 방법: 정상안압녹내장 환자 41명을 대상으로 시야검사상 초기 중심부근암점(initial paracentral scotomas)을 보이는 군(21안)과 초기 주변부암점(initial peripheral scotomas)을 보이는 군(20안)으로 나누어 ORA를 이용하여 각막생체역학인자-corneal hysteresis (CH), corneal resistance factors (CRF), Goldmann-correlated IOP (IOPg), corneal-compensated IOP (IOPcc) 및 중심각막두께, 골드만압평안압을 측정하여 두 군 간 비교 분석하였다. 결과: 초기 주변부암점군에서 초기 중심부근암점근에 비해 통계적으로 유의하게 연령이 젊었으며(49.45 ± 13.33 years vs. 58.14 ± 12.49 years, p=0.035), 근시를 보이는 것으로 나타났다(-2.42 ± 2.22 diopter vs. -0.89 ± 2.22 diopter, p=0.034). 초기 중심부근암점군에서 CRF가 유의하게 낮았으며(9.45 ± 1.95 mmHg vs. 10.58 ± 2.0 mmHg, p=0.041), CH, IOPg, IOPcc는 초기시야결손유형에 따라 통계적으로 유의한 차이를 보이지 않았다. 결론: 정상안압녹내장에서 초기 중심부근암점군과 초기 주변부암점군 간 CRF가 유의한 차이를 보였다. CRF의 차이값은 정상안압녹내장에서 초기 중심부 시야 결손을 예측하는 데 도움이 될 수 있을 것으로 생각한다.
Abstract
Purpose: To investigate the association between corneal biomechanical properties and initial visual field defect pattern in normal tension glaucoma using an Ocular Response Analyzer (ORA; Reichert Instruments, Depew, NY, USA). Methods: Forty-one patients with normal tension glaucoma were divided into 2 subgroups, 21 patients with initial paracentral scotomas and 20 patients with initial peripheral scotomas. The corneal biomechanical properties of corneal hysteresis (CH), corneal resistance factor (CRF), Goldmann-correlated intraocular pressure (IOPg), corneal-compensated IOP (IOPcc) measured by the ORA, central corneal thickness, and Goldmann applanation tonometry were comparatively analyzed between the 2 groups. Results: The patients with initial peripheral scotomas were significantly younger than those with initial paracentral scotomas (49.45 ± 13.33 years vs. 58.14 ± 12.49 years, p = 0.035) and showed more myopia (-2.42 ± 2.22 diopter vs. -0.89 ± 2.22 diopter, p = 0.034). The mean CRF was significantly lower in the initial paracentral scotoma group than in the initial peripheral scotoma group. (9.45 ± 1.95 mmHg vs. 10.58 ± 2.05 mmHg; p = 0.041). No significant difference in CH, IOPg, or IOPcc was seen between the groups. Conclusions: CRF was significantly different between the initial paracentral scotoma group and initial peripheral scotoma group in normal tension glaucoma. Thus, CRF may be useful to predict initial central field loss in normal tension glaucoma.
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