거짓비늘증후군에서 발생하는 다양한 종류의 녹내장: 저안압녹내장
Diverse Types of Glaucoma in Patients with Pseudoexfoliation Syndrome: Normal Pressure Glaucoma
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초록
목적: 거짓비늘증후군에서 발생하는 다양한 종류의 녹내장에 대하여 알아보고 정상 안압 환자에서 보이는 녹내장성 변화를 분석하고자하였다. 대상과 방법: 본원에서 거짓비늘증후군을 진단받은 40명을 대상으로 환자들의 안압, 시신경 소견, 시야 검사, 빛간섭단층촬영을 통하여녹내장의 종류를 분류하고, 이 중 정상 안압을 보이는 환자를 대상으로 녹내장군와 비녹내장군을 구분하여 임상적으로 비교하였다. 결과: 거짓비늘증후군이 동반된 48안에서 고안압녹내장 21안, 정상안압녹내장 5안, 정상안 19안으로 나타났고, 거짓비늘증후군이 동반되지 않은 32안에서 각각 2안, 8안, 20안으로 나타났다. 전체 환자를 대상으로 하였을 때 거짓비늘증후군은 녹내장성 변화에 통계적으로 유의하게 영향을 주는 것으로 나타났으나(OR=2.544, p=0.045), 정상 안압을 보이는 환자 중에서 거짓비늘증후군은 녹내장성 변화에 영향을 미치지 않는 것으로 나타났다(p=0.519). 결론: 거짓비늘증후군 환자에서 저안압녹내장을 포함한 다양한 종류의 녹내장이 발생할 수 있으므로 거짓비늘증후군 환자를 볼 때저안압녹내장의 발생 가능성에 대해서도 주의 깊게 살펴보아야 할 것이다.
Abstract
Purpose: To evaluate the types of glaucoma in patients with pseudoexfoliation syndrome (PXS) and analyze the glaucomatous changes in patients with normal intraocular pressure (IOP). Methods: A retrospective chart analysis of patients diagnosed with PXS was performed. The types of glaucoma were classified based on the IOP, optic disc examination, visual field test results, and optical coherence tomography (OCT) results. Other than those with pseudoexfoliative glaucoma (PXG), the normal IOP patients with PXS were divided into glaucomatous and non-glaucomatous groups. Later, the glaucomatous group was clinically compared to the non-glaucomatous group. Results: The records of 40 patients with PXS were evaluated. Among the 48 PXS eyes, high pressure glaucoma was found in 21 eyes (43.75%), low pressure glaucoma in 5 eyes (10.42%), and non-glaucoma in 19 eyes (39.58%). However,in the 32 fellow eyes without PXS, 2 eyes (6.25%), 8 eyes (25%), and 20 eyes (62.5%) showed the above diseases,respectively. In result, PXS affected the glaucomatous change (odds ratio = 2.544, p = 0.045). By contrast, in PXS patients with normal IOP, PXS did not affect the glaucomatous change (p = 0.519). Conclusions: Diverse types of glaucoma including low pressure glaucoma may exist in patients with PXS. Considering the possibility of low pressure glaucoma in patients with PXS is necessary.
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