다섯 종류의 빛간섭단층촬영기로 측정한 망막신경섬유층 두께 비교
A Comparison of Retinal Nerve Fiber Layer Thickness Measured Using Five Different Optical Coherence Tomography Devices
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목적: 다섯 종류의 빛간섭단층촬영기를 이용하여 측정한 시신경유두주위 망막신경섬유층 두께를 비교하고자 한다. 대상과 방법: 정상인 32명의 32안을 대상으로 Cirrus HD-OCT (Carl Zeiss Meditec, Dublin, CA, USA), Spectralis OCT (Heidelberg engineering, Heidelberg, Germany), Topcon DRI OCT (Topcon Inc., Tokyo, Japan), RS-3000 Advance OCT (NIDEK, Aichi, Japan), RTVue-100 (Optovue Inc., Fremont, CA, USA)을 이용하여 시신경유두주위 전체 평균 및 사분면(위쪽, 코쪽, 아래쪽, 귀쪽) 망막신경섬유층 두께를 측정하였다. 각 장비로 측정한 망막신경섬유층 두께를 반복측정분산분석으로 비교하고, Bland-Altman 분석을 통해 일치도를 분석하였다. 결과: 전체 평균 망막신경섬유층 두께는 Topcon DRI OCT로 측정한 값이 평균 107.5 ± 9.0 μm로 가장 컸고, RTVue-100으로 측정한 값이 104.9 ± 8.4 μm, RS-3000 Advance OCT로 측정한 값이 104.4 ± 9.4 μm, Spectralis OCT로 측정한 값이 102.5 ± 8.9 μm였고, Cirrus HD-OCT로 측정한 값이 97.7 ± 8.7 μm로 가장 작았다(p＜0.01). 사분면 망막신경섬유층 두께도 전체 평균 두께와 비슷한 양상을 보였다(p＜0.01). 검사 장비 간 전체 평균 망막신경섬유층 두께 값의 차이는 0.5에서 9.9 μm였고, Bland-Altman 분석을 통해 산출한 장비 간 전체 망막신경섬유층 두께 일치도 범위(limit of agreement)는 6.8에서 19.6 μm로 나타났다. 결론: 다섯 종류의 빛간섭단층촬영 장비로 측정한 시신경유두주위 망막신경섬유층 두께는 서로 다른 값을 보였고 일치도 범위도 넓었다. 따라서 서로 다른 장비로 측정한 망막신경섬유층 두께 값을 분석할 때 주의해야 할 것이다.
Abstract
Purpose: To compare circumpapillary retinal nerve fiber layer (RNFL) thicknesses as measured using five different optical coherence tomography (OCT) devices. Methods: RNFL thickness was measured in 32 healthy eyes of 32 subjects using a Cirrus HD-OCT (Carl Zeiss Meditec, Dublin, CA, USA), Spectralis OCT (Heidelberg Engineering, Heidelberg, Germany), Topcon DRI OCT (Topcon, Tokyo, Japan), RS-3000 Advance OCT (NIDEK, Aichi, Japan), and RTVue-100 (Optovue, Fremont, CA, USA). Global and quadrant (superior, nasal, inferior, and temporal) RNFL thicknesses were compared using repeated measures analysis of variance, and the agreement among devices was determined using Bland-Altman analyses. Results: The global RNFL thickness was greatest when measured using the Topcon DRI OCT, with a mean value of 107.5 μm. The mean global RNFL thicknesses measured using the RTVue-100, RS-3000 Advance OCT, and Spectralis OCT were 104.9 ± 8.4, 104.4 ± 9.4, 102.5 ± 8.9 μm, respectively. The Cirrus HD-OCT presented the thinnest RNFL measurement, with a mean value of 97.7 ± 8.7 μm (p < 0.01). A similar pattern was found for the quadrant RNFL thicknesses (p < 0.01). Differences in the global RNFL thicknesses among the devices ranged from 0.5 to 9.9 μm. The limits of agreement of the global RNFL thicknesses evaluated by Bland-Altman analyses ranged from 6.8 to 19.6 μm. Conclusions: RNFL thicknesses measured using five different OCT devices were not interchangeable and there was a wide limit of agreement. When interpreting RNFL thickness values determined by different devices, caution is advised.
참고문헌 (12)
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