파장가변 빛간섭단층촬영계와 초음파 각막두께측정계를 이용해 측정한 중심각막두께의 비교
Comparison of Central Corneal Thickness Measured by Swept-source Optical Coherence Tomography and Ultrasound Pachymetry
2
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
목적: 중심각막두께(central corneal thickness, CCT)의 측정을 위한 방법으로 기존에 널리 사용되던 초음파 각막두께측정계(ultrasound pachymetry [USP])와 최근 사용되고 있는 IOL master 700을 이용하여 그 검사 결과를 비교하고 상관관계를 분석하고자 하였다. 대상과 방법: 본원에서 녹내장으로 경과관찰 중인 환자 12명 24안과 정상 환자 42명 83안을 대상으로 검사를 시행하였다. 동일한 환자에서 IOL master 700으로 CCT를 측정 후 다시 USP로 CCT를 측정하였다. 각각의 검사기기로 측정된 중심각막두께 측정치를 paired t-test를 이용하여 비교하였다. Bland-Altman plots를 이용하여 검사기기 간의 일치도를 분석하였고, Pearson correlation test를 통해 검사기기 간의 상관관계에 대하여 알아보았다. 정상환자 일부를 대상으로 간격을 두고 IOL master 700으로 2번 측정하여 재현성을 알아보았다. 결과: IOL master 700으로 두 번 측정한 중심각막두께의 분석 결과 ICC 값은 0.997, 변동계수는 6.78%, test-retest variability는 2.7 ± 1.7 μm로 높은 재현성과 반복성을 보였다. USP와 IOL master 700으로 측정한 CCT는 각각 554.4 ± 37.4 μm, 551.1 ± 37.1 μm로 통계학적으로 유의하게 IOL master 700으로 측정한 CCT가 얇게 나타났다(p<0.001). Bland-Altman plots에서 95% 신뢰구간 내에 산점도가 분포함을 확인하였으나 일치도가 높지 않음을 보였다. Pearson correlation test를 통해 두 검사기기의 측정값이 통계적으로 높은 양의 상관관계를 보임을 알 수 있었다(Pearson correlation, r=0.977, p<0.0001). 결론: 본 연구 결과 IOL master 700으로 측정한 CCT는 높은 재현성을 보였으며 USP와 비교하여 통계적으로 유의하게 얇게 측정되었다. 두 검사는 높은 양의 상관관계를 보였으나 높은 일치도를 나타내지는 않았다.
Abstract
Purpose: To analyze and compare ultrasound pachymetry (USP) with a more recently adopted device, the intra ocular lens (IOL) master 700, which are both used to measure central corneal thickness. Methods: The central corneal thickness was measured in 24 eyes of 12 glaucoma patients and in 83 eyes of 42 normal patients. First, the IOL master 700 was used to measure the central corneal thickness, followed by measurements taken using USP later. The results were analyzed using a paired t-test. We analyzed the agreement and the correlations between the two test devices by using Bland-Altman plots and the Pearson correlation test. To evaluate the reproducibility, measurements with the IOL master 700 were taken twice for a few normal patients within a small time interval. Results: Via the IOL master 700, the thickness of the central cornea showed a high reproducibility and repeatability, demonstrating 2.7 ± 1.7 μm for the test-retest variability, 6.78% for the coefficient of variation, and 0.997 for the intraclass correlation value. The mean measurements using USP and the IOL master 700 are 554.4 ± 37.4 μm and 551.1 ± 37.1 μm, respectively, showing that the IOL master 700 measured significantly smaller values than USP with a p-value < 0.001. The deviations between the two methods are scattered throughout the 95% confidence interval. According to the Pearson correlation test, the measured values of the two test devices were found to have a highly positive correlation (r = 0.977, p < 0.0001). Conclusions: This study demonstrated that the central corneal thickness (CCT) measured via the IOL master was significantly thinner than that of USP, and the two test devices had a high correlation and good agreement. The CCT value measured via the IOL master 700 also exhibited high reproducibility.
참고문헌 (33)
- Chihara E, "Assessment of true intraocular pressure: the gap between theory and practical data", Surv Ophthalmol, 53, pp.203~218 (2008)
- Ou RJ, "Keratectasia after laser in situ keratomileusis (LASIK): evaluation of the calculated residual stromal bed thickness", Am J Ophthalmol, 134, pp.771~773 (2002)
- Wang Z, "Posterior corneal surface topographic changes after laser in situ keratomileusis are related to residual corneal bed thickness", Ophthalmology, 106, pp.406~409 (1999)
- Jonas JB, "Central corneal thickness correlated with glaucoma damage and rate of progression", Invest Ophthalmol Vis Sci, 46, pp.1269~1274 (2005)
- Grulkowski I, "Reproducibility of a long-range swept-source optical coherence tomography ocular biometry system and comparison with clinical biometers", Ophthalmology, 120, pp.2184~2190 (2013)
- Harper CL, "Diurnal variations in human corneal thickness", Br J Ophthalmol, 80, pp.1068~1072 (1996)
- Copt RP, "Corneal thickness in ocular hypertension, primary open-angle glaucoma, and normal tension glaucoma", Arch Ophthalmol, 117, pp.14~16 (1999)
- Ling T, "Method of evaluating ultrasonic pachometers", Am J Optom Physiol Opt, 63, pp.462~466 (1986)
- Li EY, "Agreement among 3 methods to measure corneal thickness: ultrasound pachymetry, Orbscan II, and Visante anterior segment optical coherence tomography", Ophthalmology, 114, pp.1842~1847 (2007)
- Ventura AC, "Corneal thickness and endothelial density before and after cataract surgery", Br J Ophthalmol, 85, pp.18~20 (2001)
- Savini G, "Repeatability of automatic measurements performed by a dual Scheimpflug analyzer in unoperated and post-refractive surgery eyes", J Cataract Refract Surg, 37, pp.302~309 (2011)
- Olsen T, "Calibration of axial length measurements with the Zeiss IOLMaster", J Cataract Refract Surg, 31, pp.1345~1350 (2005)
- 최재혁, "IOL Master로 측정된 생체 계수의 재현성과 정확성", 대한안과학회지, 45(10), pp.10~10 (2004), 대한안과학회
- 신정아, "접촉식 초음파와 부분결합간섭계를 이용한 생체계측시 백내장수술 후 굴절력 예측의 비교", 대한안과학회지, 54(5), pp.723~727 (2013), 대한안과학회
- Maldonado MJ, "Optical coherence tomography evaluation of the corneal cap and stromal bed features after laser in situ keratomileusis for high myopia and astigmatism", Ophthalmology, 107, pp.81~87 (2000)
- Muscat S, "Repeatability and reproducibility of corneal thickness measurements by optical coherence tomography", Invest Ophthalmol Vis Sci, 43, pp.1791~1795 (2002)
- Izatt JA, "Micrometer-scale resolution imaging of the anterior eye in vivo with optical coherence tomography", Arch Ophthalmol, 112, pp.1584~1589 (1994)
- Radhakrishnan S, "Real-time optical coherence tomography of the anterior segment at 1310 nm", Arch Ophthalmol, 119, pp.1179~1185 (2001)
- Bovelle R, "Corneal thickness measurements with the Topcon SP-2000P specular microscope and an ultrasound pachymeter", Arch Ophthalmol, 117, pp.868~870 (1999)
- Módis L Jr, "Corneal thickness measurements with contact and noncontact specular microscopic and ultrasonic pachymetry", Am J Ophthalmol, 132, pp.517~521 (2001)
- Yaylali V, "Corneal thickness measurements with the Orbscan Topography System and ultrasonic pachymetry", J Cataract Refract Surg, 23, pp.1345~1350 (1997)
- Kang PS, "Comparison of corneal thickness measurements with the orbscan and ultrasonic pachymetry", J Korean Ophthalmol Soc, 41, pp.1697~1703 (2000)
- Yeter V, "Comparison of central corneal thickness measurements by Galilei Dual-Scheimpflug analyzer(R) and ultrasound pachymeter in myopic eyes", Ophthalmic Surg Lasers Imaging, 43, pp.128~134 (2012)
- Ladi JS, "Comparison of central corneal thickness measurements with the Galilei dual Scheimpflug analyzer and ultrasound pachymetry", Indian J Ophthalmol, 58, pp.385~388 (2010)
- 이민지, "비접촉경면현미경, 이중샤임플러그 전안부사진기, 초음파각막두께측정계를 이용해 측정한 중심각막두께의 비교", 대한안과학회지, 56(10), pp.1520~1526 (2015), 대한안과학회
- Maruyama Y, "Effects of long-term topical prostaglandin therapy on central corneal thickness", J Ocul Pharmacol Ther, 30, pp.440~444 (2014)
- Sen E, "Comparison of the effects of latanoprost and bimatoprost on central corneal thickness", J Glaucoma, 17, pp.398~402 (2008)
- Grueb M, "Effect of brimonidine on corneal thickness", J Ocul Pharmacol Ther, 27, pp.503~509 (2011)
- Lee SY, "Tear lipid layer thickness change and topical anti-glaucoma medication use", Optom Vis Sci, 93, pp.1210~1217 (2016)
- Herse P, "Short-term effects of proparacaine on human corneal thickness", Acta Ophthalmol (Copenh), 70, pp.740~744 (1992)
- Nam SM, "Comparison of corneal thickness after the instillation of topical anesthetics: proparacaine versus oxybuprocaine", Cornea, 25, pp.51~54 (2006)
- Fukuda R, "Corneal thickness and volume measurements by swept source anterior segment optical coherence tomography in normal subjects", Curr Eye Res, 38, pp.531~536 (2013)
- 김임규, "중심각막두께 측정에 대한 파장가변 빛간섭단층촬영계의 유용성", 대한안과학회지, 57(10), pp.1542~1548 (2016), 대한안과학회