한국인 정상안압녹내장 환자에서 안구반응분석기를 이용한 안압의 일중 변동
Diurnal Variation in Intraocular Pressure Measured by Ocular Response Analyzer in Korean Patients with Normal Tension Glaucoma
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목적: 한국인 정상안압녹내장 환자에서 Ocular reponse analyzer (ORA; Reichert Inc., Depew, NY, USA)로 측정한 안압 및 각막생체역학 인자의 일중변동에 대해 분석해 보고자 한다. 대상과 방법: 정상안압녹내장 환자 21안을 대상으로 48시간 동안 안압(Goldman’s applanation tonometer [GAT IOP], Goldmanncorrelated IOP [IOPg], corenal-compensated IOP [IOPcc]), 중심각막두께(Central corneal thickness, CCT), corneal hysteresis (CH) 및 corneal resistant factor (CRF)를 측정하였다. 측정 1일째와 측정 2일째에 걸쳐 각 인자들이 최고값과 최저값을 보인 시간을 기록하고, 각 인자들의 일중변화를 Repeated measures analysis of variance (Re-ANOVA)를 이용하여 분석하였다. 결과: 측정 1일째(Day 1)와 측정 2일째(Day 2)에 GAT IOP, IOPg 및 IOPcc 모두 6 PM에 최고 안압을 보였으며, 3 PM, 6 PM에도안압이 높게 측정되었다. 또한 9 PM, 12 AM에는 최저 안압을 보였으며, 유의한 하루 일중 변동을 보였다(Day 1 GAT IOP, IOPg, IOPcc, all p＜0.05; Day 2 p=0.052, p=0.056, p=0.001). 반면 CH와 CRF는 뚜렷한 하루 일중변동을 보이지 않았다(p＞0.05). 결론: 한국인 정상안압녹내장 환자에서 안압의 일중 변화는 기상 직후와 오후에 높은 안압을, 취침 전에 최저 안압을 보였으며, 의미있는 일중 변동을 나타내었다. 특히 오후 시간에도 상대적으로 높은 안압을 보였기에 실제 임상에서 오후 시간대에 안압을 측정하는 것은 높은 안압을 발견하는 데 도움이 될 수 있을 것으로 생각된다.
Abstract
Purpose: To analyze the diurnal change in intraocular pressure (IOP) and corneal biomechanical properties measured using the Ocular Response Analyzer (ORA; Reichert Inc., Depew, NY, USA) in Korean patients with normal tension glaucoma (NTG) patients. Methods: Intraocular pressure (Goldmann applanation tonometer IOP [GAT IOP], Goldmann-correlated IOP [IOPg], corneal- compensated IOP [IOPcc]) and corneal hysteresis (CH), corneal resistance factor (CRF) and central corneal thickness (CCT) were measured in 21 eye of NTG patients (12 males, 9 female) at 3 hour intervals for 48 hours using ORA. We recorded the time of each parameter that showed the lowest and the highest values of during the 48 hour testing period (Day 1 and Day 2) and evaluated the change of diurnal variation using Repeated measures analysis of variance (Re-ANOVA). Results: Peak IOP measured with GAT and ORA occurred at 6 AM-9 AM, 3 PM-6 PM and the trough IOP at 9 PM-12 AM during the 48 hour period. CCT, GAT IOP, IOPcc and IOPg measurements showed statistically significant variations (p<0.05). CH and CRF variations were not statistically significant (p>0.05). Conclusions: In Korean NTG patients, IOP exhibits significant diurnal variation, with higher values during the dawn and afternoon and lower values before retiring. Clinically, measurements of IOP performed in the afternoon could aid in the detection of relatively elevated IOP.
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