평면부 유리체절제술과 실리콘기름충전술을 시행한 눈에서 망막층 두께의 변화 분석
Analysis of the Changes in Retinal Thickness in Eyes Undergoing Vitrectomy with Silicone Oil Tamponade
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목적: 열공망막박리 및 안내이물 환자에서 유리체절제술과 실리콘기름충전술을 시행한 후 성공적으로 망막 재유착을 보인 환자에서 망막층 두께의 변화를 알아보고자 하였다. 대상과 방법: 유리체절제술과 실리콘기름 충전을 시행한 환자 28명 28안(열공망막박리 24안, 안내이물 4안)을 대상으로 후향적 연구를 진행하였다. 파장가변 빛간섭단층촬영기의 삼차원 광각모드를 사용하여 실리콘기름 충전 도중 및 제거 후 시점에서 망막전층, 망막신경섬유층 및 신경절세포-내망상층의 두께를 황반부 Early Treatment Diabetic Retinopathy Study subfield에서 측정했고, 정상 반대안과 차이를 비교 분석하였다. 결과: 실리콘기름 충전 기간 동안 망막전층 두께 감소에 비하여 망막신경섬유층과 신경절세포-내망상층의 경우 실리콘기름 유지 기간이 길어질수록 평균 두께 감소가 두드러졌다. 망막전층, 망막신경섬유층 및 신경절세포-내망상층의 두께는 실리콘기름 충전 중에 측정한 값보다 제거 후 및 정상 반대안을 측정한 값이 유의하게 크게 측정되었다. 결론: 실리콘기름 안구 내 충전술은 망막층 두께 변화를 유발할 수 있다. 실리콘기름의 안구 내 충전 기간이 길어질수록 내망막층의두께 감소를 더 유발할 수 있다.
Abstract
Purpose: To investigate changes in the retinal layer thickness in rhegmatogenous retinal detachment (RRD) and intraocular foreign body (IOFB) patients undergoing successful pars plana vitrectomy (PPV) with silicone oil tamponade. Methods: This retrospective study included 28 eyes of 28 patients (RRD: 24 patients; IOFB: 4 patients) that were successfully repaired with PPV with silicone oil tamponade. The thickness measurements of the total retina, retinal nerve fiber layer (RNFL), and ganglion cell-inner plexiform layer (GC-IPL) were performed with swept-source optical coherence tomography in nine Early Treatment Diabetic Retinopathy Study subfields, using the wide three-dimensional mode before and after silicone oil tamponade removal. The measurements were compared and differences were analyzed with respect to normal fellow eyes. Results: The RNFL and GC-IPL thickness measurements decreased remarkably as the silicone oil tamponade period progressed, compared with the thickness of the total retinal layer. The average thicknesses of the total retina, RNFL, and GC-IPL were significantly greater in eyes in which the silicone oil had been removed than in those in which the silicone oil remained. Conclusions: Silicone oil tamponade can change the thickness of the retina layer. The longer the silicone oil is tamponaded, the more significant the reduction in thickness of the inner retinal layer.
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