국소적 망막신경섬유층결손안에서 빛간섭단층촬영의 가음성 결과와 관련된 요인
False Negative Findings of Optical Coherence Tomography in Eyes with Localized Nerve Fiber Layer Defects
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목적: 망막신경섬유층촬영에서 국소적 망막신경섬유층결손이 있는 환자가 빛간섭단층촬영(optical coherence tomography, OCT)으로 검출되지 않는 것과 관련된 요인을 알아보고자 하였다. 대상과 방법: 국소적 망막신경섬유층결손이 있는 시야결손전녹내장 24명과 시야결손녹내장 173명을 대상으로 하였고, OCT로 검출 여부에 따라 두 군으로 나누었다. 성별, 연령, 굴절이상, 당뇨병, 고혈압, 중심각막두께, 녹내장 유형, MD, PSD, 평균망막신경섬유층두 께, 유두면적, 사진의 결손과 관련된 변수(위치, 수, 폭)를 비교하였다. 결과: 사진의 망막신경섬유층결손 197안 중 51안(25.9%)이 OCT에서는 검출되지 않았다. 사진의 결손과 OCT결손의 폭과 위치는 유의 한 상관관계가 있었다(상관계수 각각 0.98, 0.64). 로지스틱 회귀분석에서 OCT의 가음성과 관련된 요인은 평균망막신경섬유층두께(odds ratio=1.106, 95% 신뢰구간=1.057-1.156, p＜0.001), 결손폭(odds ratio=0.929, 95% 신뢰구간=0.884-0.977, p=0.004)이었다. 결론: 망막신경섬유층의 두께가 두꺼울수록, 결손폭이 좁을수록 OCT로 검출되지 않을 확률이 높았다.
Abstract
Purpose: To identify the risk factors associated with false negative findings of optical coherence tomography (Stratus OCT) in patients with photographic localized retinal nerve fiber layer (RNFL) defects. Methods: Twenty-four patients with preperimetric glaucoma and 173 patients with perimetric glaucoma, all with localized RNFL defects were included in the present study. The patients were divided into 2 groups according to the presence or absence of detection of photographic defects by OCT. Gender, age, refractive error, diabetes, hypertension, central corneal thickness, type of glaucoma, mean deviation, pattern standard deviation, average RNFL thickness, disc area, and photographic RNFL defect related variables (location, number, and angular width) were compared between the 2 groups. Each variable was initially evaluated by univariate analysis and significant variables (p < 0.1) were included in the logistic regression analysis. Results: Photographic RNFL defects were not detected by OCT in 51 (25.9%) of the 197 eyes. The angular locations and widths of RNFL defects by OCT were significantly correlated with those of RNFL defects by red-free RNFL photographs (Pearson correlation coefficient R = 0.98 and 0.64, respectively). Logistic regression analysis revealed the risk factors for false negative findings of OCT included average RNFL thickness (odds ratio = 1.106, 95% confidence interval [CI] = 1.057-1.156, p < 0.001) and angular width of defect (odds ratio = 0.929, 95% CI = 0.884-0.977, p = 0.004). Conclusions: This present study suggests that false negative findings of OCT in patients with photographic localized RNFL defects were associated with thicker RNFL thickness and smaller angular width of RNFL defect.
참고문헌 (24)
- Quigley HA, "Optic nerve damage in human glaucoma. III. Quantitative correlation of nerve fiber loss and visual field defect in glaucoma, ischemic neuropathy, papilledema, and toxic neuropathy", Arch Ophthalmol, 100, pp.135~146 (1982)
- Sommer A, "Clinically detectable nerve fiber atrophy precedes the onset of glaucomatous field loss", Arch Ophthalmol, 109, pp.77~83 (1991)
- Airaksinen PJ, "Effect of retinal never fiber loss on the optic nerve head configuration in early glaucoma", Graefes Arch Clin Exp Ophthalmol, 220, pp.193~196 (1983)
- Tuulonen A, "Nerve fiber layer defects with normal visual fields,In Do normal optic disc and normal visual field indicate absence of glaucomatous abnormality", Ophthalmology, 100, pp.587~597 (1993)
- Tuulonen A, "Initial glaucomatous optic disk and retinal nerve fiber layer abnormalities and their progression", Am J Ophthalmol, 111, pp.485~490 (1991)
- Quigley HA, "Quantitative grading of nerve fiber layer photographs", Ophthalmology, 100, pp.1800~1807 (1993)
- Chen HY, "Discrimination between normal and glaucomatous eyes using Stratus optical coherence tomography in Taiwan Chinese subjects", Graefes Arch Clin Exp Ophthalmol, 243, pp.894~902 (2005)
- Medeiros FA, "Evaluation of retinal nerve fiber layer, optic nerve head, and macular thickness measurements for glaucoma detection using optical coherence tomography", Am J Ophthalmol, 139, pp.44~55 (2005)
- Wollstein G, "Comparison of three optical coherence tomography scanning areas for detection of glaucomatous damage", Am J Ophthalmol, 139, pp.39~43 (2005)
- Manassakorn A, "Comparison of retinal nerve fiber layer thickness and optic disk algorithms with optical coherence tomography to detect glaucoma", Am J Ophthalmol, 141, pp.105~115 (2006)
- 송유미, "광간섭단층촬영기를 이용한 정상안과 초기 녹내장안의 구별", 대한안과학회지, 48(12), pp.1675~1685 (2007), 대한안과학회
- Paunescu LA, "Reproducibility of nerve fiber thickness, macular thickness, and optic nerve head measurements using StratusOCT", Invest Ophthalmol Vis Sci, 45, pp.1716~1724 (2004)
- Budenz DL, "Sensitivity and specificity of the StratusOCT for perimetric glaucoma", Ophthalmology, 112, pp.3~9 (2005)
- Kim TW, "Ability of Stratus OCT to identify localized retinal nerve fiber layer defects in patients with normal standard automated perimetry results", Invest Ophthalmol Vis Sci, 48, pp.1635~1641 (2007)
- Jonas JB, "Localised wedge shaped defects of the retinal nerve fibre layer in glaucoma", Br J Ophthalmol, 78, pp.285~290 (1994)
- Airaksinen PJ, "Optic disc haemorrhagesprecede retinal nerve fibre layer defects in ocular hypertension", Acta Ophthalmol, 59, pp.627~641 (1981)
- Jeoung JW, "Diagnostic ability of opticalcoherence tomography with a normative database to detect localized retinal nerve fiber layer defects", Ophthalmology, 112, pp.2157~2163 (2005)
- Hwang JM, "Correlation between topographic profiles of localized retinal nerve fiber layer defects as determined by optical coherence tomography and red-free fundus photography", JOURNAL OF GLAUCOMA, 15, pp.223~228 (2006)
- Kanamori A, "Evaluation of the effect of aging on retinal nerve fiber layer thickness measured by optical coherencetomography", Ophthalmologica, 217, pp.273~278 (2003)
- Budenz DL, "qDeterminants of normal retinal nerve fiber layer thickness measured by Stratus OCT", Ophthalmology, 114, pp.1046~1052 (2007)
- Nagai Kusuhara A, "Association of retinal nerve fibre layer thickness measured by confocal scanning laser ophthalmoscopy and optical coherence tomography with disc size and axial length", Br J Ophthalmol, 92, pp.186~190 (2008)
- 한정일, "광간섭단층촬영기로 구한 시신경 및 망막신경섬유층 측정치들에 영향을 미치는 요인", 대한안과학회지, 48(8), pp.1073~1081 (2007), 대한안과학회
- Da Pozzo S, "The effect of ageing on retinal nerve fibre layer thickness an evaluation by scanning laser polarimetry with variable corneal compensation", Acta Ophthalmol Scand, 84, pp.375~379 (2006)
- 강성민, "한국인 정상치를 이용한 Stratus 광간섭단층촬영기의 초기 정상안압녹내장 진단 능력", 대한안과학회지, 49(5), pp.798~810 (2008), 대한안과학회