2형 당뇨병 환자에서 황반부 미세혈관과 신경섬유층 및 신경절세포-속얼기층 두께의 변화
Microvasculature and Nerve Fiber Layer-Ganglion Cell Inner Plexiform Layer Thickness in Type 2 Diabetes
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목적: 당뇨망막병증이 발견되지 않은 2형 당뇨병 환자에서 파장가변광원 optical coherence tomography (OCT, swept source OCT [SS-OCT])와 optical coherence tomography angiography (OCTA, swept source OCTA [SS-OCTA])를 이용하여 황반의 신경섬유층(nerve fiber layer, NFL) 및 신경절세포-속얼기층(ganglion cell-inner plexiform layer, GCIPL)의 두께와 황반부의 표층망막혈관밀도 및 심층망막혈관밀도, 맥락막모세혈관밀도 변화를 확인하고자 한다. 대상과 방법: 2형 당뇨병으로 진단받은 환자 중 당뇨망막병증이 발견되지 않은 64안을 대상으로 하였으며, 당뇨병이 없는 54안을대조군으로 하여 비교하였다. 모든 환자에서 SS-OCT와 SS-OCTA를 이용하여 검사를 시행하였다. 결과: 황반의 표층 및 심층 망막혈관의 혈관밀도는 환자군과 대조군 사이에서 차이를 보이지 않았다. 하지만 NFL-GCIPL 두께는 환자군에서 대조군에 비해 통계적으로 의미 있는 감소를 나타냈으며 당뇨병의 이환 기간이 길수록 두께가 얇아져 있음을 확인하였다. 결론: 본 연구의 결과에서 2형 당뇨병 환자에서 당뇨망막병증 발생의 초기 변화에서 신경변성이 일어남을 추측할 수 있다.
Abstract
Purpose: To investigate thickness of the nerve fiber layer-ganglion cell inner plexiform layer (NFL-GCIPL) complex and vessel density of the superficial and deep retinal vessels and choriocapillaris using swept source optical coherence tomography (SS-OCT) and angiography (OCTA) in type 2 diabetic patients without diabetic retinopathy (DR). Methods: Sixty-four eyes of type 2 diabetic patients without DR were included. A control group of 54 eyes without diabetes was also recruited. All patients underwent multimodal imaging evaluation using SS-OCT and OCTA. Results: Vessel density of the superficial and deep retinal vessels was not different between the study and control groups. A significant decrease in NFL-GCIPL complex thickness was observed in the study group compared to the control group. NFL-GCIPL thickness of the macula decreased with increased duration of diabetes. Conclusions: These results suggest that neurodegeneration might be an early change in the development of DR.
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