스펙트럼영역 빛간섭단층촬영 유의지도에서 자동으로 구한 국소적 망막신경섬유층결손면적
Usefulness of Automated Measurements of Localized Retinal Nerve Fiber Layer Defects Area Using Significance Map
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목적: 자동으로 구한 국소적 망막신경섬유층결손면적의 유용성을 알아보았다. 대상과 방법: 국소적 망막신경섬유층결손이 있는 51명과 정상인 53명을 대상으로 스펙트럼영역 빛간섭단층촬영의 유의지도에서 결손면적(p˂1%, p˂5%)을 Image J로 수작업으로, Matlab을 이용하여 자동으로 측정하였다. 사진과 지도에서 결손면적, 망막신경섬유층두께,시신경유두 측정치, 황반부내망막두께의 AUC (area under the receiver operating characteristic curve)를 구하였다. 결과: 유의지도에서 수기와 자동으로 구한 결손면적 간에는 상관관계가 높았다(p˂1% r=0.904, p˂5% r=0.890). 유의지도에서 수기와자동으로 구한 결손면적(p˂5%)의 AUC (각각 0.987, 0.966)는 유의한 차이가 없었다. 후자의 AUC는 하사분면 망막신경섬유층두께(0.936)보다 조금 컸으나 유의한 차이는 없었고, 하반부 신경절세포 + 내망상층두께(0.894), 수직유두함몰비(0.869)보다 컸으며 유의하였다(p˂0.05). 결론: 유의지도에서 결손면적의 자동 측정은 황반부내망막과 시신경유두의 측정치보다 결손의 검출력이 우월하였다.
Abstract
Purpose: To evaluate the usefulness of automated measurements of the localized retinal nerve fiber layer (RNFL) defects area in patients with glaucoma. Methods: Fifty one patients with localized RNFL defects in RNFL red-free photographs and 53 healthy subjects were included. All participants were imaged with 3D spectral-domain optical coherence tomography (OCT). The area of defects was measured with the RNFL significance map (red = p < 1% and yellow = p < 5%) using Image J manually and Matlab software automatically. The area under the receiver operating characteristic curve (AUC) was calculated for the RNFL defect area of the RNFL photograph and RNFL maps, circumpapillary RNFL thickness, optic disc parameter, and macular inner retina thickness. Results: High correlation was observed between manually and automatically measured defect areas in the significance map (red area r = 0.904, red and yellow area r = 0.890). The AUC for manually and automatically measured defects area (0.987, 0.966; p < 5%, p = 0.31, respectively) in the significance map was comparable. The latter demonstrated slightly higher but insignificant difference in AUC for inferior quadrant circumpapillary RNFL thickness (0.936; p = 0.22) and was significantly higher than the inferior ganglion cell layer plus inner plexiform layer thickness (0.894) and vertical cup to disc ratio (0.869) (p = 0.018, p = 0.008, respectively). Conclusions: The automated measurements of the RNFL defect area in the significance map performed adequately in detecting localized RNFL defects and had a better performance than macular inner retina and optic nerve parameters.
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