초기 정상안압녹내장과 초기 원발개방각녹내장의 망막신경섬유층 두께 비교
Comparison of Retinal Nerve Fiber Layer Thickness in Early Normal-Tension Glaucoma and Early Primary Open-Angle Glaucoma
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초록
목적: 초기 정상안압녹내장과 초기 원발개방각녹내장에서 빛간섭단층촬영기(OCT)로 측정한 망막신경섬유층(RNFL) 두께를 비교 분석하고자 하였다. 대상과 방법: 2007년 6월부터 2008년 6월까지 본원 안과에 내원한 환자 중 대조군 34안, 초기 정상안압녹내장군 61안, 초기 원발개방각녹내장군 21안에 대하여 시야검사와 OCT 검사를 시행하여 RNFL 두께 감소와 시야결손 정도와의 상관관계를 분석하고, ROC 곡선아래면적을 평가하였다. 결과: 초기 정상안압녹내장군과 초기 원발개방각녹내장군 모두에서 대조군에 비해 모든 사분면(이측 사분면 제외)의 RNFL 두께가감소하였으며(p<0.05), 초기 원발개방각녹내장군에서 초기 정상안압녹내장군보다 평균과 상측 사분면의 RNFL 두께가 더 얇아져 있었다(p<0.05). 초기 정상안압녹내장군과 초기 원발개방각녹내장군 모두에서 시야결손 지표인 PSD와 평균, 상측 사분면의 RNFL 두께는음의 상관관계를 보였으며(p<0.05), ROC 곡선아래면적은 평균과 하측 사분면순으로 넓었다. 결론: 초기 정상안압녹내장은 유사한 시야결손을 보이는 초기 원발개방각녹내장보다 망막신경섬유층의 결손이 심하지 않을 수 있기에주의를 요한다.
Abstract
Purpose: To investigate the comparison of retinal nerve fiber layer (RNFL) thickness parameters measured by optical coherence tomography (Stratus OCT 3000TM) and visual field indices in early normal-tension glaucoma (NTG) and early primary open-angle glaucoma (POAG). Methods: Sixty-one early normal-tension glaucomatous eyes, 21 early primary open-angle glaucomatous eyes and 34 healthy control eyes were enrolled in this cross-sectional study. Each subject received a visual field test (Humphrey C30-2) and the fast RNFL thickness algorithm test by OCT. The correlations between RNFL thickness and visual field indices were analyzed. The sensitivity and specificity for the detection of early glaucoma were determined with the area under the receiver operating characteristics curve (AUROC). Results: All RNFL thickness values except for the temporal quadrant RNFL thickness were significantly decreased in the early NTG and POAG groups (p<0.05). In early POAG, the average and superior quadrant RNFL thicknesses were significantly thinner than in the early NTG group. Significant correlations were observed between the PSD and the average and superior quadrant RNFL thicknesses in the early NTG and POAG groups (p<0.05). The average RNFL thickness for early glaucoma had the widest AUROC among all of the parameters. Conclusions: In the early NTG group with visual field defects similar to those of early POAG, RNFL defects measured by OCT were less severe, particularly in the average and superior quadrant RNFLs.
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