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세 가지 유형의 삼출성 나이관련황반변성에서 빛간섭단층촬영의 특징 비교

Comparison of Optical Coherence Tomography Characteristics among Three Subtypes of Exudative Age-related Macular Degeneration

윤희성|안동섭|안소은|양 헌
대한안과학회 (The Korean Ophthalmological Society)|2016.07|대한안과학회지 (Journal of The Korean Ophthalmological Society)|제57권 제7호|pp. 1093-1101

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키워드

Optical coherence tomographyAge-related macular degenerationPolypoidal choroidal vasculopathyRetinal angiomatous proliferation
주제분류안과학

초록

목적: 한 번도 치료 받지 않은 삼출성 나이관련황반변성 환자에서 전형적삼출성나이관련황반변성(typical neovascular age-related macular degeneration [nAMD]), 결절맥락막혈관병증(polypoidal choroidal vasculopathy, PCV), 망막혈관종성증식(retinal angiomatous proliferation, RAP) 세 가지 하위분류에 따른 빛간섭단층촬영의 특징을 비교하고자 하였다. 대상과 방법: 치료 기왕력이 없는 삼출성 나이관련황반변성 환자 153명 153안을 대상으로 하였다. 깊이증강모드 빛간섭단층촬영을이용하여 진단 시점에서의 중심하 맥락막두께와 중심망막두께를 측정하고 망막내낭포액, 망막하액을 비롯한 구조적 특징들을 확인하였다. 전체 환자군을 전형적 nAMD, PCV, RAP 세 그룹으로 나누고 특징들을 비교하였다. 결과: 총 153안 중에서 typical nAMD가 74안, PCV가 55안, RAP가 24안이었다. 연령과 최대교정시력은 그룹별 유의한 차이를 보이지않았다. 중심하 맥락막두께는 PCV가 가장 두껍고, typical nAMD, RAP 순서로 얇은 두께를 보였으며 통계적으로 유의한 차이를 보였다(p＜0.001). RAP에서 다른 두 군에 비해 유의하게 두꺼운 중심망막두께(p=0.004)와 높은 빈도의 망막내낭포액의 존재(p＜0.001)를 보였다. 결론: 삼출성나이관련황반변성은 세 가지 유형에 따라 서로 다른 빛간섭단층촬영의 특징을 보였다. PCV는 가장 두꺼운 맥락막두께를 보였고, RAP는 가장 얇은 맥락막두께와 두꺼운 중심망막두께, 그리고 높은 빈도의 망막내낭포액을 보였다. 삼출성나이관련황반변성을 유형별로 감별진단하는 데 빛간섭단층촬영의 특징 분석이 도움이 될 것으로 보인다.

Abstract

Purpose: To compare the characteristics of optical coherence tomography in eyes with treatment-naïve typical neovascular age-related macular degeneration (typical nAMD), polypoidal choroidal vasculopathy (PCV), and retinal angiomatous proliferation (RAP). Methods: One hundred fifty-three eyes newly diagnosed with exudative AMD were retrospectively collected. All study eyes were classified into three subtypes: typical nAMD, PCV, and RAP. Subfoveal choroidal thickness (SFCT) was measured using enhanced depth imaging optical coherence tomography (EDI-OCT). Central macular thickness (CMT) and other OCT features including intraretinal cystoid fluid and subretinal fluid were also evaluated in all eyes. SFCT, CMT and other OCT features were compared among the three subtypes of exudative AMD. Results: Seventy-four eyes with typical nAMD, 55 eyes with PCV, and 24 eyes with RAP were included. SFCT was significantly thickest in PCV and thinnest in RAP (p < 0.001). RAP showed the thickest CMT and the highest frequency of intraretinal cystoid fluid (p = 0.004, p < 0.001, respectively). Conclusions: In patients with exudative AMD, different characteristics of OCT were observed according to the three subtypes. Identification of OCT characteristics could help differentiate the subtypes of exudative AMD.

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