녹내장 환자에서 안압의 하루 변동 반복성에 대한 고찰
Repeatability of Intraocular Pressure Patterns in Glaucomatous Patients
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목적: 녹내장 환자에서 안압의 하루 변동이 반복성을 띄는지 알아보았다. 대상과 방법: 녹내장 환자 18명을 대상으로 48시간 동안 2시 혹은 4시를 제외하고 2시간 간격으로 Goldmann 안압계로 안압 측정 후안압의 하루 변동이 반복성을 띄는지 분석하였다. 결과: 측정 1일째와 2일째 모두 양안에서 4시 및 6시의 안압이 가장 높았다. 대상 환자수가 다른 2시와 4시의 결과를 제외하고 나머지시간대의 결과만을 분석 시 우안 일치도는 6시, 18시에서 매우 좋음, 8시, 20시, 22시, 24시에서 좋음을 보였으며 좌안 일치도는 6시,22시에서 매우 좋음, 12시, 18시, 20시, 24시에서 좋음을 보였다. 2시에 안압을 측정한 5명의 결과를 제외하면 일치도는 우안은 6시,18시에서 매우 좋음, 4시에서 좋음을 보였고, 좌안은 4시, 6시, 22시에서 매우 좋음을 보였다. 결론: 안압은 새벽에 최고치를 보였다는 점에서 하루 변동이 반복되는 경향성을 가진다고 생각하나, 측정 1일째와 측정 2일째의 시간대별 반복성 비교에서 일치도가 나쁨을 보인 시간대가 많다는 점을 고려할 때 안압의 하루 변동에 반복성을 입증하기는 어려울 것으로판단된다.
Abstract
Purpose: To investigate the repeatability of 24-hour intraocular pressure (IOP) patterns in glaucomatous patients. Methods: The author reviewed bilateral IOP data of 18 glaucoma patients who were admitted for 2 days. IOP data were collected in both eyes every 2 hours using Goldmann applanation tonometry during a 48-hour admission except at 02:00o’clock (13 patients) and 04:00 o’clock (5 patients). The intraclass correlation coefficient was used to analyze the agreement of IOP patterns between the first and the second 24 hours. Results: IOP reached its peak between 04:00 o’clock and 06:00 o’clock in both eyes and on both days. On evaluation, the IOP data excluding the results of 02:00 o’clock and 04:00 o’clock, agreement of IOP values of 18 patients was good to excellent at 06:00, 18:00, 20:00, and 24:00 o’clock in both eyes. Agreement of IOP values at 08:00 and 12:00 o’clock was good in the right eye and the left eye, respectively. The agreement of IOP values of 13 patients who underwent IOP assessment at 04:00 o’clock and not at 02:00 o’clock, was good to excellent only at 04:00 and 06:00 o’clock in both eyes. Otherwise, agreement was poor or not significant except at 18:00 and 22:00 o’clock which showed good agreement in the right eye and the left eye, respectively. Conclusions: Presumable, a circadian IOP pattern exists, because in the present study, IOP reached its peak in the early morning on both days. However, to stipulate IOP patterns were repeatable appears to be difficult since there were numerous time points with poor agreement.
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