스펙트럼 도메인 빛간섭단층촬영에서 발생하는 오류
Artifacts Associated with Spectral-Domain Optical Coherence Tomography
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목적: 스펙트럼 도메인 빛간섭단층촬영에서 발생하는 오류의 빈도 및 황반두께 측정에 미치는 영향을 알아보고자 하였다. 대상과 방법: 267명 267안을 대상으로 Spectralis HRA+OCT를 이용해 검사를 시행하고 이를 후향적으로 분석하였다. 정상안과 망막질환이 있는 안에서 각각 전체 볼륨스캔과 중심부 1 mm 영역내에서 관찰되는 오류에 대해서 조사하였고 망막질환의 분류에 따른 오류의빈도를 비교하였다. 결과: 전체 볼륨스캔의 79.4%에서, 중심부 1 mm 영역 내에서는 26.6%에서 적어도 하나 이상의 오류가 관찰되었다. 내망막 경계설정오류는 망막전막(36.1%), 외망막 경계설정 오류는 습성나이관련황반변성(40.0%)에서 가장 높은 빈도를 보였다. 중심부 1 mm 영역 내에서는 임상적으로 유의한 오류가 6.4%에서 관찰되었으며 습성나이관련황반변성에서 43.3%로 가장 흔했다. 결론: SD OCT 볼륨스캔에서 오류는 흔히 발생하며, 중심부 1 mm 영역 내에서는 상대적으로 오류의 발생빈도가 낮았으나 임상적으로유의한 오류가 발생할 수 있고 이는 망막두께 측정에 영향을 줄 수 있으므로 세심한 주의가 필요하다.
Abstract
Purpose: To report frequencies of image artifacts associated with spectral-domain optical coherence tomography (SD-OCT) and to evaluate the impact of artifacts on foveal thickness measurements. Methods: This retrospective study included 267 eyes of 267 patients who underwent OCT volume scanning using Spectralis HRA+OCT (Heidelberg Engineering, Heidelberg, Germany). Macular volume scans of normal and diseased eyes were systematically evaluated for image artifacts within each scan overall and within the center 1-mm area. The frequency of each artifact type was compared for scans stratified by diagnosis category. Results: Among the volume scans, 79.4% had at least 1 artifact overall, and 26.6% had at least 1 artifact in the center 1-mm area. The highest percentage of inner retina misidentification occurred in the epiretinal membrane (36.1%), whereas the highest percentage of outer retina misidentification occurred in neovascular age-related macular degeneration (wet AMD, 40.0%). Clinically significant artifacts involving the center 1-mm area were observed in 6.4% of volume scans and were most common in wet AMD (43.3%). Conclusions: Image artifacts in SD-OCT volume scanning are common, but relatively less common in the center 1-mm area of scans. Clinicians should carefully review scans for artifacts when using SD-OCT images and retinal thickness measurements because clinically significant artifacts may affect retinal thickness measurements.
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