열공망막박리 환자의 수술 후 시야 및 망막신경섬유층 변화 비교
Comparison of Postoperative Visual Field and Nerve Fiber Layer Change in Rhegmatogenous Retinal Detachment
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목적: 열공망막박리로 수술적 치료를 시행 받은 환자에서 술 후 시야 및 망막신경섬유층 변화를 알아보고자 하였다. 대상과 방법: 황반을 포함한 열공망막박리 환자에서 성공적으로 망막이 유착된 28명을 대상으로 하였다. 수술 후 3개월에 시야검사및 망막신경섬유층 두께측정을 시행하여 정상반대안과 비교하였고 또한 공막돌륭술과 유리체절제술의 두 군으로 나누어 각 군 간의차이를 비교 분석하였다. 결과: 망막박리 술 후 PSD와 MD는 정상안에 비하여 높았고(p=0.002, p＜0.001) 망막신경섬유층 두께는 낮았다(p＜0.001). 이 중 공막돌륭술군과 유리체절제술군에서 교정시력은 통계적인 차이가 없었으나 시야검사상 반대안과의 PSD와 MD차이는 각각 4.0 ± 4.0,0.7 ± 1.5 (p=0.006)와 6.5 ± 4.6, 1.9 ± 1.9 (p=0.001)로 유리체절제술군에서 높았으며 반대안과의 망막신경섬유층의 두께차이 또한8.2 ± 10.3 μm, 1.8 ± 2.7 μm (p=0.015)로 유의하게 유리체절제술군에서 높았다. 결론: 열공망막박리 환자 수술 후 시야손상 및 망막신경섬유층의 두께감소가 있었으며 공막돌륭술에 비해 유리체절제술에서 더 심하였다.
Abstract
Purpose: To compare the visual field and retinal nerve fiber layer of scleral buckling (SB) and primary pars plana vitrectomy (PPV) for treatment of simple rhegmatogenous retinal detachment (RRD). Methods: We studied 20 eyes with RRD that were underwent successful surgical reattachment. Visual field test and retinal nerve fiber layer (RNFL) thickness measurements were performed in patients, and outcomes were compared not only between the operated eye and fellow eye, but also between SB and PPV 3 months postoperatively. Results: After the operation, PSD and MD were higher in the operated eye than in the fellow eye (p = 0.002, p < 0.001, respectively). RNFL thickness was lower in the operated eye than in the fellow eye (p < 0.001). No significant differences in BCVA were detected between SB and PPV. However, the respective differences between the operated eye and fellow eye regarding pattern standard deviation (4.0 ± 4.0, 0.7 ± 1.5), mean deviation (6.5 ± 4.6, 1.9 ± 1.9), and RNFL (8.2 ± 10.3 μm,1.8 ± 2.7 μm) were significantly higher in PPV than in SB. Conclusions: Both visual field defect and retinal nerve fiber damage are significantly larger in PPV than in SB.
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