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특발성 망막앞막수술 후 중심황반두께 및 황반하 맥락막두께의 2년 변화

Two-year Changes in Postoperative Central Macular Thickness and Subfoveal Choroidal Thickness in Epiretinal Membrane Patients

박지혜|강현구|이규원|최우석
대한안과학회 (The Korean Ophthalmological Society)|2021.12|대한안과학회지 (Journal of The Korean Ophthalmological Society)|제62권 제12호|pp. 1607-1616

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Optical coherence tomographyIdiopathic epiretinal membraneSubfoveal choroidal thicknessCentral macular thicknessPhacovitrectomy
주제분류안과학

초록

목적: 특발성 망막앞막수술 후 중심황반두께와 황반하 맥락막두께의 2년 장기 변화를 알아보고자 한다. 대상과 방법: 유리체절제술과 백내장병합수술 후 2년 이상 경과 관찰한 특발성 망막앞막 환자 중 재발하지 않은 52안을 대상으로 빛간섭단층촬영에서 측정된 중심황반두께와 황반하 맥락막두께를 후향적으로 분석하였고, 정상 대조군과 비교하였다. 결과: 술 전 중심황반두께와 황반하 맥락막두께는 425.67 ± 84.67 μm와 257.56 ± 90.13 μm였다. 중심황반두께는 술 후 1년 372.17 ± 45.26 μm, 술 후 2년 363.15 ± 47.35 μm로 감소하였고(p<0.001), 황반하 맥락막두께도 술 후 1년 238.85 ± 84.85 μm, 술 후 2년 230.31 ± 87.95 μm로 감소하였다(p<0.001). 대조군에서 2년간의 중심황반두께는 유의한 변화는 없었고, 황반하 맥락막두께는 11.09 ± 22.36 μm 감소하였다(p=0.007). 반면 환자군은 중심황반두께와 황반하 맥락막두께가 62.52 ± 71.45 μm, 27.25 ± 41.97 μm 감소하여 대조군과 유의한 차이를 보였다(p<0.001, p=0.043). 술 전, 술 후 1년 중심황반두께가 얇을수록 각 시기의 최대교정시력이 좋았고(p=0.010, p=0.018), 술 후 2년 최대교정시력은 술 전 최대교정시력이 좋을수록, 술 전 중심황반두께가 얇을수록 좋았다(p<0.001, p<0.001). 결론: 특발성 망막앞막수술 후 2년간 경과 관찰 결과 중심황반두께와 황반하 맥락막두께는 감소하였다.

Abstract

Purpose: To evaluate changes in central macular thickness (CMT) and subfoveal choroidal thickness (SFCT) after phacovitrectomy over a 2-year period in idiopathic epiretinal membrane (ERM) patients. Methods: The records of 52 idiopathic ERM patients (52 eyes) who underwent phacovitrectomy, without recurrence of the condition over a 2-year follow-up period, were reviewed retrospectively. Changes in CMT and SFCT, as measured by optical coherence tomography, were analyzed and compared with those of a normal control group over a 2-year period. Results: The mean preoperative CMT and SFCT were 425.67 ± 84.67 and 257.56 ± 90.13 μm, respectively. Postoperative CMT was reduced significantly to 372.17 ± 45.26 μm at 1 year and 363.15 ± 47.35 μm at 2 years (p < 0.001). SFCT at 1 and 2 years postoperatively was significantly reduced to 238.85 ± 84.85 and 230.31 ± 87.95 μm, respectively (p < 0.001). In the control group, there was no significant change in CMT; however, the SFCT decreased by 11.09 ± 22.36 μm during the 2-year follow-up (p = 0.007). In contrast, in the patient group, CMT and SFCT decreased by 62.52 ± 71.45 and 27.25 ± 41.97 μm, respectively, showing a significant difference from the control group (p < 0.001 and p = 0.043, respectively). Both before surgery and at 1 year postoperatively, the thinner the CMT, the better the best-corrected visual acuity (BCVA) (p = 0.010 and p = 0.018, respectively). A better postoperative BCVA at 2 years was associated with a thinner CMT and better BCVA before surgery (p < 0.001 and p < 0.001, respectively). Conclusions: Following a phacovitrectomy procedure, ERM patients showed significant reductions in both the CMT and SFCT at the 2-year follow-up.

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