스마트폰 안저사진 영상 분석을 이용한 미숙아망막병증의 혈관 구불거림 정량화
Quantification of Vascular Tortuosity by Analyzing Smartphone Fundus Photographs in Patients with Retinopathy of Prematurity
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목적: 스마트폰으로 촬영한 안저사진으로부터 미숙아망막병증의 망막동맥 구불거림을 측정함으로써 추가 징후를 정량화하고 유용성을 평가하고자 하였다. 대상과 방법: 미숙아 58명 116안을 대상으로 스마트폰으로 안저촬영을 시행하였으며, 안저사진에서 망막동맥의 구불거림을 Image J 프로그램으로 계측하였다. 그 결과값을 굴곡지수(tortuosity index)로 정하였고, 레이저 치료를 시행했던 군과 정상군으로 나누어 두 군의 굴곡지수를 비교하였다. 또한, 치료군에서 치료 전과 치료 후의 굴곡지수를 비교하였다. 굴곡지수의 진단력은 receiver operating characteristic (ROC) 곡선으로 분석하였다. 결과: 총 50명 98안의 안저사진을 분석하였으며, 치료군은 20명 38안, 대조군은 30명 60안이었다. 굴곡지수는 치료군의 치료 전 사진에서 1.231 ± 0.156, 대조군에서 1.062 ± 0.019로, 치료 전이 유의하게 높았으며, 치료 후에는 1.100 ± 0.093으로 치료 전에 비해 유의하게 감소하였다. ROC 곡선 아래 영역은 0.926이었으며, cut-off value가 1.095일 때 민감도는 85.1%, 특이도는 95.5%였다. 결론: 스마트폰으로 촬영한 미숙아망막병증의 안저사진으로부터 동맥 굴곡도 측정을 통해 추가 징후를 정량화할 수 있었으며, 이는 미숙아망막병증의 선별검사 및 추적 관찰, 치료 시기 판단에 보조적인 도움을 줄 것으로 생각한다.
Abstract
Purpose: To determine the usefulness of measuring the tortuosity of retinal arteries using smartphone fundus photographs to quantify plus disease in retinopathy of prematurity (ROP) patients. Methods: Digital fundus photographs were taken with a smartphone of 116 eyes involving 58 premature infants. The tortuosity of retinal arteries named as the tortuosity index (TI) was measured with Image J software. Patients were classified into the treated and control groups and the TIs of the two groups were compared. A receiver operating characteristic curve was constructed and areas under the curve (AUC) were calculated to quantify the diagnostic utility of TI. Results: Fundus photographs of 98 eyes of 50 premature infants were analyzed; 38 eyes of 20 infants were the treated group and 60 eyes of 30 infants were the control group. The TI was 1.231 ± 0.156 in the treated group before treatment, which was significantly larger than 1.062 ± 0.019 in the control group. After treatment of the treated group, the TI was 1.100 ± 0.093, which was significantly smaller than before treatment. The AUC was 0.926, and using a cut-off value of 1.095, the sensitivity and specificity of TIs for requiring treatment were 85.1% and 95.5%, respectively. Conclusions: The tortuosity of retinal arteries was measured by analyzing smartphone fundus photographs to quantify plus disease in ROP patients. This method may be helpful for screening, follow-up, and treatment decisions for ROP patients.
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