주사레이저검안경의 레트로모드를 이용한 낭포황반부종의 영상화
Cystoid Macular Edema Detected by Scanning Laser Ophthalmoscopy in Retro-Mode
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목적: 새로운 주사레이저검안경의 Retromode를 이용하여 낭포황반부종을 영상화하고 기존의 영상법들과 비교해보려 한다. 대상과 방법: 낭포황반부종 환자 20명 21안의 의무기록을 후향적으로 분석하였다. 환자들은 안저사진, 형광안저촬영과 주사레이저검안경, 스펙트럼 영역 빛간섭단층촬영을 시행받았다. 주사레이저검안경은 기기내에 내장된 Retromode를 이용하여 촬영하였다. 결과: 기존의 안저사진은 낭포황반부종 상태를 보기가 어려운 반면 주사레이저검안경의 Retromode는 낭포황반부종을 입체적으로 확인할 수 있었다. 각각의 작은 낭포를 더 잘 보여주었으며 낭포의 면적을 구할 수 있었다. Retromode에서 보이는 가장 넓은 낭포의넓이와 OCT에서 보이는 그 낭포의 높이는 상호 연관성을 보였으며(R=0.606, p=0.004) Retromode에서 보이는 낭포황반부종의 전체넓이와 OCT에서 측정된 황반중심두께는 역시 상호 연관성을 보였다(R=0.493, p=0.023). 결론: 기존의 영상법에 비해 새로운 주사레이저검안경의 Retromode는 낭포황반부종에서 보이는 낭포들의 관찰을 용이하게 하며 낭포황반부종의 범위 및 정도를 파악하는 데 도움을 줄 수 있다.
Abstract
Purpose: To investigate the visualization of cystoid macular edema (CME) using noninvasive retromode imaging by a new scanning laser ophthalmoscope (SLO) and compare to previous imaging modalities. Methods: The authors of the present study retrospectively reviewed the medical records of 21 eyes of 20 patients with CME due to various etiologies. All eyes were examined with fundus camera, fluorescein angiography (TRC-50EX, Topcon,Tokyo, Japan), SLO (F-10, Nidek, Gamagori, Japan), and spectral-domain optical coherence tomography (OCT) (3D OCT-1000, Topcon, Tokyo, Japan). In the present study the SLO was used in the retro-mode with an infrared laser. Results: Previous fundus photography could not detect CME adequately although SLO retro-mode could show numerous oval or polygonal cystoid spaces more readily. Furthermore, each individual small cystoid space could be detected and the area of each cystoid space could be measured. The area of the largest cystoid space showed a correlation with its height,as measured with OCT (R = 0.606, p = 0.004). The area of the whole foveal cystoid space showed a correlation with central macular thickness, as measured with OCT (R = 0.493, p = 0.023). Conclusions: A new commercially available SLO (F-10) in the retro-mode can allow us to detect each cystoid space noninvasively and to measure the extent of CME.
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