근시 환자의 임상진료 시 초광각 주사레이저검안경으로 발견 가능한주변부 망막 소견 및 유용성
Identifiable Peripheral Retinal Lesions Using Ultra-Widefield Scanning Laser Ophthalmoscope and Its Usefulness in Myopic Patients
0
조회
0
다운로드
5
인용
0
참고문헌
키워드
초록
목적: 근시 환자 및 고도근시 환자에서 발견할 수 있는 주변부 망막의 특징적인 소견을 확인하며, 임상진료에서 초광각 주사레이저검안경의 유용성을 알아보고자 하였다. 대상과 방법: 149명의 환자를 대상으로 초광각 주사레이저검안경을 이용하여 안저촬영을 시행한 후 망막 전문의에 의해 이루어진 산동 후 안저검사와 비교하여 초광각 주사레이저검안경 검사상 발견된 주변부 망막 소견의 민감도 및 특이도를 확인하였다. 결과: 격자형 망막변성은 근시 환자군의 24.1%, 고도근시 환자군의 36.6%, 그냥 흰자리는 근시 환자군의 17.7%, 고도근시 환자군의20.7%, 망막열공은 근시 환자군의 5.1%, 고도근시 환자군의 7.5%, 망막박리는 근시 환자군의 1.3%, 고도근시 환자군의 4.2%에서 관찰되었다. 격자형 망막변성만이 고도근시 환자군에서 유의하게 높은 빈도를 나타냈다(p=0.043). 검사의 민감도는 근시 환자군에서 격자형 망막변성 84.2%, 그냥 흰자리 100.0%, 망막열공 75.0%, 망막박리 100.0%였고, 고도근시 환자군에서 격자형 망막변성 91.0%, 그냥흰자리 100.0%, 망막열공 43.8%, 망막박리 66.7%였다. 검사의 특이도는 모든 경우에서 100.0%였다. 결론: 초광각 주사레이저검안경은 주변부 망막 소견의 진단 시 근시 환자 및 고도근시 환자에서 각각 90.8%, 91.0%, 합계 90.9%의높은 민감도를 나타내었다. 따라서 초광각 주사레이저검안경은 근시 환자의 일상적인 안과 진료 시 보조 장비로 유용하게 사용될수 있다.
Abstract
Purpose: To investigate identifiable peripheral retinal lesions in patients with myopia or high myopia and to evaluate the usefulnessof ultra-widefield scanning laser ophthalmoscope in retina clinic settings. Methods: We evaluated fundus images of 149 patients acquired using an ultra-widefield scanning laser ophthalmoscope. Manual fundus examination by a retinal specialist was performed and sensitivity and specificity were calculated by comparingthe findings of the two different fundus examination methods. Results: Variable peripheral retinal lesions were observed: lattice degeneration (24.1% in myopia, 36.6% in high myopia), whitewithout pressure (17.7% in myopia, 20.7% in high myopia), retinal break (5.1% in myopia, 7.5% in high myopia) and retinal detachment(1.3% in myopia, 4.2% in high myopia). The incidence of lattice degeneration was significantly higher in myopic eyesthan in highly myopic eyes (p = 0.043). The examination sensitivities were as follows: lattice degeneration (84.2% in myopia,91.0% in high myopia), white without pressure (100.0% in both myopia and high myopia), retinal break (75.0% in myopia, 43.8%in high myopia) and retinal detachment (100.0% in myopia, 66.7% in high myopia). The examination specificities were 100.0% inall cases. Conclusions: Diagnostic sensitivities of ultra-widefield scanning laser ophthalmoscope were 90.8% in patients with myopia,91.0% in patients with high myopia and 90.9% in totally myopic patients, which were relatively high values. Therefore, the ultra-widefield scanning laser ophthalmoscope is useful as auxiliary equipment for myopic patients in retina clinic settings.
참고문헌 (12)
- French AN, "Prevalence and 5-to 6-year incidence and progression of myopia and hyperopia in Australian schoolchildren", Ophthalmology, 120, pp.1482~1491 (2013)
- He M, "Refractive error and visual impairment in urban children in southern china", Invest Ophthalmol Vis Sci, 45, pp.793~799 (2004)
- Fan DS, "Prevalence, incidence, and progression of myopia of school children in Hong Kong", Invest Ophthalmol Vis Sci, 45, pp.1071~1075 (2004)
- Pan CW, "Prevalence of refractive errors in a multiethnic Asian population: the Singapore epidemiology of eye disease study", Invest Ophthalmol Vis Sci, 54, pp.2590~2598 (2013)
- Hyams SW, "Peripheral retina in myopia. With particular reference to retinal breaks", Br J Ophthalmol, 53, pp.300~306 (1969)
- Pierro L, "Peripheral retinal changes and axial myopia", Retina, 12, pp.12~17 (1992)
- Kim HW, "The relationship of axial length and peripheral retinal degeneration", J Korean Ophthalmol Soc, 37, pp.999~1004 (1996)
- Bansal AS, "Peripheral retinal findings in highly myopic children < or =10 years of age", Retina, 30(4 Suppl), pp.S15~S19 (2010)
- Lai TY, "Peripheral and posterior pole retinal lesions in association with high myopia: a cross-sectional community-based study in Hong Kong", Eye(Lond), 22, pp.209~213 (2008)
- Chou B, "Limitations of the Panoramic 200 Optomap", Optom Vis Sci, 80, pp.671~672 (2003)
- Yura T, "The relationship between the types of axial elongation and the prevalence of lattice degeneration of the retina", Acta Ophthalmol Scand, 76, pp.90~95 (1998)
- Cheng SC, "Use of the Optomap with lid retraction and its sensitivity and specificity", Clin Exp Optom, 91, pp.373~378 (2008)
