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특발성 망막전막에서 유리체절제술 전후 미세시야계를 이용한 구조와 기능의 상관관계 분석

Morphologic and Functional Evaluation before and after Vitrectomy in Idiopathic Epiretinal Membrane Patients Using Microperimetry

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목적: 특발성 망막전막으로 유리체절제술과 막제거술을 시행한 환자에서 빛간섭단층촬영과 미세시야계 검사를 사용하여 시세포 접합부 구조와 망막민감도의 관계를 알아보고자 한다. 대상과 방법: 특발성 망막전막에 대한 수술을 받은 환자 20명 20안을 대상으로 술 전과 술 후 빛간섭단층촬영과 미세시야계 검사를시행하였다. 시세포 접합부의 구조, 시력, 망막민감도, 주시안정도를 측정하였으며 각 인자간에 유의한 관련이 있는지 알아보았다. 결과: 수술 후 망막민감도는 유의하게 증가하였으며(p˂0.001), 시세포 접합부 결손범위는 변화가 없었다. 술 전 시세포 접합부 결손범위는 술 전, 후 망막민감도와 유의한 상관관계를 보였으나(p=0.035, p=0.006), 주시안정도와는 유의한 상관관계를 보이지 않았다. 결론: 망막민감도는 시세포 접합부 결손 범위와 유의한 상관관계를 보였으며, 구조변화에 따른 망막의 기능을 객관적으로 정량화할수 있을 것으로 생각한다.

Abstract

Purpose: To investigate the relationship between photoreceptor inner/outer segment (IS/OS) integrity and macular sensitivity after epiretinal membrane (ERM) surgery using spectral-domain optical coherence tomography combined with microperimetry. Methods: 20 eyes of 20 patients with idiopathic ERM who underwent pars plana vitrectomy for ERM removal were prospectively reviewed. The IS/OS defect diameter, BCVA, macular sensitivity, and fixation stability were measured using spectral-domain optical coherence tomography combined with microperimetry. The correlation of these factors was analyzed. Results: The macular sensitivity improved after successful ERM surgery (p < 0.001), but the IS/OS defect diameter has not improved. The preoperative and postoperative macular sensitivity were negatively correlated with preoperative IS/OS defect diameter (p = 0.035, p = 0.006). The fixation stability was not correlated with preoperative IS/OS defect diameter. Conclusions: Macular sensitivity showed significant correlation with IS/OS defect diameter. Macular sensitivity is vital functional parameter allows subjective quantification of the retinal function and reflects morphologic changes.

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