비삼출성 나이관련황반변성 환자와 정상인의 망막신경섬유층 두께 비교
Comparison of Retinal Nerve Fiber Layers in Patients with Non-Neovascular Age-Related Macular Degeneration and Normal Controls
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목적: 삼출성 나이관련황반변성에서는 외망막층의 손상으로 인해 녹내장에서와 같이 신경절세포층 및 망막신경섬유층 두께가 감소한다. 본 연구에서는 비삼출성 나이관련황반변성 환자에서 망막신경섬유층 두께의 변화에 대해 알아보고자 하였다. 대상과 방법: 비삼출성 나이관련황반변성 중 Age-Related Eye Disease Study (AREDS) AMD Category 3a에 속하는 31안, Category4a에 속하는 중심와를 침범한 지도모양위축 11안, 정상인 31안을 대상으로 하였다. 빛간섭단층촬영을 시행하여 각 영역(전반적, 이측,상이측, 상비측, 상측, 비측, 하비측, 하이측, 하측)의 시신경주변 망막신경섬유층 두께를 측정하였다. 결과: 세 군 간 평균 나이와 평균 안압의 유의한 차이는 없었다. AMD Category 3a군과 Category 4a 군의 전체구역에서의 망막신경섬유층 두께 평균은 각각 99.5 ± 14.0 μm, 99.3 ± 9.4 μm로 정상 대조군 99.4 ± 9.6 μm와 통계적으로 유의한 차이가 없었다. 그 외에이측, 상이측, 상비측, 상측, 비측, 하비측, 하이측, 하측 모든 부위에서도 정상 대조군과 유의한 차이를 보이지 않았다. 결론: 비삼출성 나이관련황반변성 환자군과 정상 대조군 사이에 망막신경섬유층 두께의 유의한 차이는 없었다. 따라서 비삼출성 나이관련황반변성에서는 외망막층에서 시작된 병변이 진행되어도 내망막층은 잘 보존된다는 것을 알 수 있다.
Abstract
Purpose: In neovascular age-related macular degeneration (AMD), it is reported that retinal nerve fiber layer (RNFL) thicknessbecomes gradually thinner due to degeneration of the outer retinal layer. To our knowledge, there is no previous report regardingRNFL thickness in patients with non-neovascular AMD. Therefore, in this study, we compared RNFL thickness in patients withnon-neovascular AMD and normal controls. Methods: Thirty-one eyes with AMD category 3a (AREDS research group), 11 eyes suffering foveal geographic atrophy AMDcategory 4a, and 31 age-matched normal eyes were evaluated. In every group, regional RNFL thickness (General, Temporal,Superotemporal, Superonasal, Superior, Nasal, Inferonasal, Inferotemporal, and Inferior) was measured using spectral domainoptical coherence tomography (SD-OCT). Results: There were no significant differences in age or intraocular pressure among the 3 groups. The mean best corrected visualacuity (BCVA) (log MAR) of the category 4a group was significantly decreased compared to those of the other 2 groups. Themean RNFL thickness in total area in the category 3a group, category 4a group, and normal control group was 99.5 ± 14.0 μm,99.3 ± 9.4 μm, and 99.4 ± 9.6 μm, respectively. The difference was not statistically significant. No other regional mean values ofRNFL thickness in the three groups were significantly different. Conclusions: There was no significant difference in RNFL thickness between non-neovascular patients and the control group.
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