시신경염에서 초기 시신경유두부종의 정도에 따른 황반부 내측 망막두께 변화 비교
A Comparison of Retinal Thickness Changes According to Initial Optic Disc Edema in Optic Neuritis Patients
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목적: 시신경염에서 초기 시신경유두부종의 정도에 따른 황반망막신경섬유층 및 신경절세포-내망상층 두께의 초기 변화를 알아보고자 했다. 대상과 방법: 후향적 연구로, 외래를 방문한 환자에서 시신경염을 진단 받고 파장가변 빛간섭단층촬영을 시행 받은 환자들 중 초기시신경유두부종이 나타났던 18명의 의무기록을 분석하였다. 초진시 시신경유두부종의 정도는 시신경유두 중심부 두께 및 시신경유두주위 망막두께를 측정했고, 정량적인 분석을 위해 반대안과 비교하여 평가하였다. 황반망막신경섬유층 및 신경절세포-내망상층 두께의 초기 변화를 분석하였다. 황반망막신경섬유층 및 신경절세포-내망상층 두께를 측정하였고, 그 변화와 초진시 시신경유두부종 정도와 상관관계도 분석했다. 결과: 시신경염 안에서 황반 신경절세포-내망상층의 두께는 경과 관찰 1달째 유의하게 감소되어 있었다. 초진시의 시신경유두 중심부두께는 1달째 이측 황반 신경절세포-내망상층의 두께 감소와 양의 상관관계를 보였다(R=0.648, p=0.045). 초진시 비측의 시신경유두주위 망막두께가 두꺼울수록 1달째 비측(R=0.659, p=0.038)과 이측(R=0.774, p=0.009) 황반 신경절세포-내망상층의 두께 감소가 심했다. 초진시 이측의 시신경유두주위 망막두께가 두꺼울수록 1달째 비측(R=0.646, p=0.044)과 이측(R=0.760, p=0.011) 황반 신경절세포-내망상층의 두께 감소가 심했다. 결론: 시신경유두부종이 동반된 시신경염에서, 시신경유두주위와 시신경유두 중심부 두께 및 시신경유두주위 망막두께로 평가한 초기 시신경유두부종 정도가 심할수록 1달째 이측 황반 신경절세포-내망상층의 두께 감소가 심했다. 본 연구의 결과는 초진시 시신경유두부종 정도가 심할수록 황반 신경절세포-내망상층의 두께의 감소가 초기에 더 빨리 진행된다는 것을 시사한다.
Abstract
Purpose: To compare early changes in the macular retinal nerve fiber layer (mRNFL) and ganglion cell-inner plexiform layer (mGCIPL) thicknesses according to the severity of initial optic disc edema in optic neuritis patients using swept-source optical coherence tomography (SS-OCT). Methods: We retrospectively reviewed 18 eyes of patients diagnosed with naïve optic neuritis along with optic disc edema who underwent SS-OCT. The central thickness of the optic nerve head and the peripapillary retinal thickness were measured at the initial visit. To quantitate the degree of initial optic disc edema, we calculated the difference of each measurement between the affected eye and the normal fellow eye. The mRNFL and mGCIPL thicknesses were measured at the initial visit and at the 1 month follow-up. The association between changes in mRNFL and mGCIPL thicknesses at the 1 month follow-up and the severity of initial optic disc edema were evaluated. Results: In the affected eye, the mGCIPL thickness was reduced at 1 month. The central thickness of the optic nerve head at the initial visit correlated with the reduction in the temporal mGCIPL at 1 month (R = 0.648, p = 0.045). Furthermore, thicker nasal peripapillary retinal thickness at the initial visit correlated with a reduction in nasal (R = 0.659, p = 0.038) and temporal (R = 0.774, p = 0.009) mGCIPL at 1 month. Thicker temporal peripapillary retinal thickness at the initial visit correlated with reduction in the nasal (R = 0.646, p = 0.044) and temporal (R = 0.760, p = 0.011) mGCIPL at 1 month. Conclusions: In optic neuritis patients with optic disc edema, severe optic disc edema, evaluated by peripapillary retinal thickness and central thickness of the optic nerve at the initial visit was associated with a reduced temporal mGCIPL thickness at 1 month. This study suggested that initially severe optic disc edema in optic neuritis patients can predict a rapid decline in the mGCIPL.
참고문헌 (22)
- Pau D, "Optic neuritis", Eye, 25, pp.833~842 (2011)
- Soelberg K, "Optical coherence tomography in acute optic neuritis : a population-based study", Acta Neurol Scand, 138, pp.566~573 (2018)
- Beck RW, "A randomized, controlled trial of corticosteroids in the treatment of acute optic neuritis. The Optic Neuritis Study Group", N Engl J Med, 326, pp.581~588 (1992)
- 강태신, "한국 성인의 시신경염", 대한안과학회지, 59(1), pp.81~86 (2018), 대한안과학회
- Balcer LJ, "Clinical practice. Optic neuritis", N Engl J Med, 354, pp.1273~1280 (2006)
- Costello F, "Quantifying axonal loss after optic neuritis with optical coherence tomography", Ann Neurol, 59, pp.963~969 (2006)
- Soelberg K, "A population-based prospective study of optic neuritis", Mult Scler, 23, pp.1893~1901 (2017)
- Britze J, "Retinal ganglion cell analysis in multiple sclerosis and optic neuritis : a systematic review and meta-analysis", J Neurol, 264, pp.1837~1853 (2017)
- Lee TH, "Retinal ganglion cell and axonal loss in optic neuritis : risk factors and visual functions", Eye(Lond), 31, pp.467~474 (2017)
- Droby A, "A novel automated segmentation method for retinal layers in OCT images proves retinal degeneration after optic neuritis", Br J Ophthalmol, 100, pp.484~490 (2016)
- Bech RW, "The clinical profile of optic neuritis. Experience of the optic neuritis treatment trial. Optic Neuritis Study Group", Arch Ophthalmol, 109, pp.1673~1678 (1991)
- Voss E, "Clinical approach to optic neuritis : pitfalls, red flags and differential diagnosis", Ther Adv Neurol Disord, 4, pp.123~134 (2011)
- Bertuzzi F, "Diagnostic validity of optic disc and retinal nerve fiber layer evaluations in detecting structural changes after optic neuritis", Ophthalmol, 117, pp.1256~1264 (2010)
- Gabilondo I, "Dynamics of retinal injury after acute optic neuritis", Ann Neurol, 77, pp.517~528 (2015)
- Henderson APD, "A serial study of retinal changes following optic neuritis with sample size estimates for acute neuroprotection trials", Brain, 133, pp.2592~2602 (2010)
- Huang-Link YM, "Acute optic neuritis : retinal ganglion cell loss precedes retinal nerve fiber thinning", Neurol Sci, 36, pp.617~620 (2015)
- Wang JC, "The presentation, aetiology, management and outcome of optic neuritis in an Asian population", Clin Exp Ophthalmol, 29, pp.312~315 (2001)
- Min Kyung Kim, "Analysis of Fundus Photography and Fluorescein Angiography in Nonarteritic Anterior Ischemic Optic Neuropathy and Optic Neuritis", Korean Journal of Ophthalmology, 30(4), pp.289~294 (2016), 대한안과학회
- Lochner P, "Transorbital sonography and visual outcome for the diagnosis and monitoring of optic neuritis", J Neuroimaging, 27, pp.92~96 (2017)
- Fernández-Domínguez J, "Transorbital echography for assessment of optical nerve atrophy in demyelinating diseases : a pilot study", Rev Neurol, 54, pp.587~592 (2012)
- Hickman SJ, "A serial MRI study following optic nerve mean area in acute optic neuritis", Brain, 127, pp.2498~2505 (2004)
- Costello F, "Tracking retinal nerve fiber layer loss after optic neuritis : a prospective study using optical coherence tomography", Mult Scler, 14, pp.893~905 (2008)