국소 망막신경섬유층결손을 진단하는 데 있어 빛간섭단층촬영기의 테이블지표의 유용성에 대한 연구
Usefulness of Table Parameters of Stratus OCT in Detection of Localized Retinal Nerve Fiber Layer Defects
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목적: 녹내장 환자의 국소 망막신경섬유층 결손을 발견하는 데 있어 빛간섭단층촬영기(Stratus OCT)의 테이블지표의 유용성을 알아보고자 하였다. 대상과 방법: 무적색광 안저사진에서 국소 망막신경섬유층 결손이 상이측 또는 하이측에 한 개만 관찰된 86명의 녹내장 환자를 대상으로Stratus OCT의 Fast RNFL scan을 촬영하였다. 망막신경섬유층 두께 평균분석에서 시분역 평균과 11개 테이블지표 각각의 민감도를비교하였다. 또한 상하측별 특이지표군(민감도가 높은 테이블지표)의 조합들의 민감도를 계산하여 시분역 평균의 민감도와 비교하였다. 결과: Stratus OCT의 상측 테이블지표 중 Smax, Savg, Smax/Tavg의 민감도가 가장 높았고(각각 36.7%), 하측 테이블지표 중 Iavg,Imax, Imax/Smax의 민감도가 가장 높았지만(각각 63.8%, 59.4%, 50.7%), 시분역 평균(상이측 60%, 하이측 84.1%)보다는 모두 통계적으로 유의하게 낮았다. 결론: 녹내장 환자의 국소 망막신경섬유층 결손을 발견하는 데 있어 Stratus OCT의 테이블지표의 민감도는 낮은 민감도를 보여주어임상적 유용성은 크지 않을 것으로 생각된다.
Abstract
Purpose: To evaluate the usefulness of table parameters of Stratus optical coherence tomography (OCT) in order to detect localized retinal nerve fiber layer (RNFL) defects. Methods: The present study included 86 glaucoma patients with only localized, wedge-shaped RNFL defects, as determined by red-free RNFL photographs. All subjects were tested fast RNFL scans, using of Stratus OCT. The sensitivity of the clock hour parameter and 11 table parameters of RNFL thickness average analysis were compared. Results: The best parameters in the superior table parameter of the Stratus OCT were Smax, Savg, and Smax/Tavg (sensitivity = 36.7%, 36.7%, 36.7%, respectively). The best parameters in the inferior table parameter of the Stratus OCT were Iavg, Imax, and Imax/Smax (sensitivity = 63.8%, 59.4%, and 50.7%, respectively). However, all were significantly lower than the sensitivity of the clock hour parameter (superior RNFL defect: 60%; inferior RNFL defect: 84.1%). Conclusions: The usefulness of the table parameters of the Stratus OCT used to detect localized RNFL defects in glaucoma patients is considered low because of its low sensitivity.
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