단안 부등시성 약시의 약시 치료 전후 다국소시유발전위 검사결과
The Change of Multifocal Visual Evoked Potential in Unilateral Anisometropic Amblyopia before and after Occlusion Treatment
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목적: 단안 부등시성 약시환자에서 진단 시와 시력호전 후 다국소시유발전위의 변화를 알아보고자 하였다. 대상과 방법: 단안 부등시성 약시로 6개월 이상 추적관찰한 환자를 대상으로 진단 시와 약시안의 시력호전 후 시행된 4 채널 기록다국소시유발전위(multifocal visual evoked potential, mfVEP)를 동심원 형태의 6개 구역(ring)과 4개의 구획(sector)으로 나누어 약시안과 정상안에서의 변화를 분석하였다. 결과: 진폭을 구역으로 나누어 분석한 결과, 약시안에 진단 시 각 ring 사이에 유의한 차이가 없었으나 시력호전 후 ring 1 (p=0.00)이ring 2-6보다 유의하게 높게 나타났다. 정상안은 진단 시와 시력호전 후 지속적으로 ring 1이 ring 2-6보다 높았다. 또한 진단 시와시력호전 후 각 ring에서의 변화를 보면 약시안의 ring 1 (p=0.005)과 ring 3 (p=0.007)에서 유의한 상승을 보였다. 진폭의 구획이나잠복기는 유의한 변화가 없었다. 결론: 단안 부등시성 약시환자에서 다국소시유발전위도 중심시야(ring 1) 진폭값 변화는 시력개선의 경과관찰에 있어 유용한 지표가되리라 생각한다.
Abstract
Purpose: To evaluate the change in multifocal visual evoked potential (mfVEP) in unilateral anisometropic amblyopia before and after occlusion treatment. Methods: The mfVEP was performed using RETIscanⓇ (Roland,Brandenburg, Germany) for patients with unilateral anisometropic amblyopia before and after occlusion treatment. Amplitude and latency values of mfVEP were analyzed according to the field divided by 6 rings or 4 sectors. Results: The each amplitude of values of all 6 rings were not significantly different before treatment (p = 0.077) in amblyopic eyes. However, the value of ring 1 (p = 0.00) was significantly higher than the value of other rings after treatment. In fellow eyes, the values of ring 1 was consistently significantly higher than the value of other rings before (p = 0.014) and after (p = 0.049) occlusion treatment. Additionally, the amplitudes of ring 1 (p = 0.005) and ring 3 (p = 0.007) were significantly increased in amblyopic eyes after occlusion treatment. In fellow eyes, the values of all rings did not change significantly. The analysis of amplitudes with 4 sectors revealed no significant result. The analysis of latencies with 6 rings and 4 sectors revealed no significant result. Conclusions: The change in amplitude on the central field (ring 1) in amblyopic eyes can be a useful objective monitoring method observing the improvement progress in visual acuity.
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