당뇨 환자와 정상인의 스펙트럼 영역 빛간섭단층촬영을 통한 신경절세포-내망상층 두께 차이
Difference of GCIPL Thickness of Diabetes and Normal Eyes in Spectral Domain OCT
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목적: 당뇨병 환자와 정상인에서 스펙트럼 영역 빛간섭 단층촬영(Carl Zeiss Meditec, Dublin, CA)을 통한 신경절 세포-내망상층 및망막신경섬유층 두께의 차이에 대하여 분석한다. 대상과 방법: 정상안 92안과 당뇨안 42안을 대상으로 스펙트럼 영역 빛간섭단층촬영을 시행하여 망막신경섬유층 두께와 신경절 세포-내망상층 두께의 차이를 비교 분석하였다. 결과: 정상군 92명, 당뇨망막병증이 없는 당뇨환자 22명, 당뇨망막병증이 있는 당뇨환자 26명으로 각 군을 나누어 분석한 결과 당뇨유무나 당뇨망막병증 유무는 망막신경섬유층 두께 차이에 영향을 주지 않았다. 신경절 세포-내망상층 두께는 당뇨가 있는 환자에서,그리고 당뇨망막병증이 있는 환자에서 더욱 얇아지는 경향이 있었으며 특히 위쪽 망막 구역에서 정상군 82.24 ± 7.21 μm, 당뇨망막병증이 없는 당뇨환자군 81.86 ± 9.53 μm, 당뇨망막병증이 있는 당뇨환자군 76.77 ± 14.13 μm로 유의하게 감소하였다(p=0.029). 결론: 당뇨와 당뇨망막병증에 의한 영향에 의해 망막 신경절 세포의 두께 감소가 유발되며 이러한 변화는 특히 위쪽 망막에서 먼저일어나는 것을 확인하였다.
Abstract
Purpose: To analyze the difference of the ganglion cell-inner plexiform layer (GCIPL) thickness in diabetic and normal eyes ofpatients using spectral domain optical coherence tomography (OCT) (Carl Zeiss Meditec, Dublin, CA, USA). Methods: The authors compared and analyzed the difference of the GCIPL thickness measured with spectral domain optical coherencetomography (OCT) in 42 diabetic and 92 normal subjects. Results: The study subjects were divided into 3 groups: 92 normal subjects, 22 diabetic patients without diabetic retinopathy,and 26 diabetic patients with diabetic retinopathy. Presence of diabetes mellitus (DM) or diabetic retinopathy did not influencethe retinal nerve fiber layer (RNFL) thickness. The GCIPL thickness tended to be thinner especially in the superior sector GCIPL. The GCIPL thickness of normal subjects, diabetes patients without diabetic retinopathy, and diabetic retinopathy patients was82.24 ± 7.21 μm, 81.86 ± 9.53 μm, and 76.77 ± 14.13 μm, respectively, especially in the superior sector GCIPL (p = 0.029). Conclusions: Retinal ganglion cell layer thinning was induced by diabetes and diabetic retinopathy, and originated specificallyfrom the superior part of the retina.
참고문헌 (21)
- Dyck PJ, "Fiber loss is primary and multifocal in sural nerves in diabetic polyneuropathy", Ann Neurol, 19, pp.425~439 (1986)
- Antonetti DA, "Diabetic retinopathy:seeing beyond glucose-induced microvascular disease", Diabetes, 55, pp.2401~2411 (2006)
- Barber AJ, "Neural apoptosis in the retina during experimental and human diabetes. Early onset and effect of insulin", J Clin Invest, 102, pp.783~791 (1998)
- Barber AJ, "The Ins2Akita mouse as a model of early retinal complications in diabetes", Invest Ophthalmol Vis Sci, 46, pp.2210~2218 (2005)
- Rungger-Brändle E, "Glial reactivity, an early feature of diabetic retinopathy", Invest Ophthalmol Vis Sci, 41, pp.1971~1980 (2000)
- Takahashi H, "Diabetes-associated retinal nerve fiber damage evaluated with scanning laser polarimetry", Am J Ophthalmol, 142, pp.88~94 (2006)
- Lopes de Faria JM, "Retinal nerve fibre layer loss in patients with type 1 diabetes mellitus without retinopathy", Br J Ophthalmol, 86, pp.725~728 (2002)
- Ozdek S, "Assessment of nerve fiber layer in diabetic patients with scanning laser polarimetry", Eye(Lond), 16, pp.761~765 (2002)
- Sugimoto M, "Detection of early diabetic change with optical coherence tomography in type 2 diabetes mellitus patients without retinopathy", Ophthalmologica, 219, pp.379~385 (2005)
- Lonneville YH, "The effect of blood glucose regulation on retinal nerve fiber layer thickness in diabetic patients", Ophthalmologica, 217, pp.347~350 (2003)
- Zhang L, "Retrograde axonal transport impairment of large- and medium-sized retinal ganglion cells in diabetic rat", Curr Eye Res, 20, pp.131~136 (2000)
- Lieth E, "Retinal neurodegeneration:early pathology in diabetes", Clin Experiment Ophthalmol, 28, pp.3~8 (2000)
- van Dijk HW, "Decreased retinal ganglion cell layer thickness in patients with type 1 diabetes", Invest Ophthalmol Vis Sci, 51, pp.3660~3665 (2010)
- Garvin MK, "Automated 3-D intraretinal layer segmentation of macular spectral-domain optical coherence tomography images", IEEE Trans Med Imaging, 28, pp.1436~1447 (2009)
- "Photocoagulation for diabetic macular edema. Early Treatment Diabetic Retinopathy Study report number 1. Early Treatment Diabetic Retinopathy Study research group", Arch Ophthalmol, 103, pp.1796~1806 (1985)
- Park HY, "Early diabetic changes in the nerve fibre layer at the macula detected by spectral domain optical coherence tomography", Br J Ophthalmol, 95, pp.1223~1228 (2011)
- Mizutani M, "Müller cell changes in human diabetic retinopathy", Diabetes, 47, pp.445~449 (1998)
- Rungger-Brändle E, "Glial reactivity, an early feature of diabetic retinopathy", Invest Ophthalmol Vis Sci, 41, pp.1971~1980 (2000)
- Chung HS, "Regional differences in retinal vascular reactivity", Invest Ophthalmol Vis Sci, 40, pp.2448~2453 (1999)
- Jonas JB, "Parapapillary retinal vessel diameter in normal and glaucoma eyes. II. Correlations", Invest Ophthalmol Vis Sci, 30, pp.1604~1611 (1989)
- Kern TS, "Vascular lesions in diabetes are distributed non-uniformly within the retina", Exp Eye Res, 60, pp.545~549 (1995)