단안 삼출성 나이관련황반변성 환자의 무증상 반대안의 외망막층 두께 변화
Change of Outer Retinal Thickness in Fellow Eyes of Patients with Unilateral Age-related Macular Degeneration
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목적: 단안 삼출성 나이관련황반변성 환자의 무증상 반대안과 정상안 대조군의 외망막층의 두께 변화를 비교하고자 하였다. 대상과 방법: 결절맥락막혈관병증을 포함한 단안 삼출성 나이관련황반변성 환자 60명과 정상안 대조군 60명의 의무기록을 후향적으로 조사하였다. 환자군의 무증상 반대안과 정상안 대조군에서 Spectralis 빛간섭단층촬영을 시행하여 중심와에서 전체 망막 두께 및 망막색소상피층, 원추세포외절끝, 광수용체내외절경계, 외경계막 사이의 두께를 각각 측정하였다. 결과: 망막색소상피층과 원추세포외절끝 사이의 두께는 단안 삼출성 나이관련황반변성 환자의 무증상 반대안에서 32.4 ± 3.0 μm, 대조군에서 35.3 ± 3.5 μm로 유의한 차이를 보였다(p<0.001). 전체 망막두께 및 원추세포외절끝과 광수용체내외절경계 사이의 두께, 광수용체내외절경계와 외경계막 사이 두께는 두 군 간 유의한 차이를 보이지 않았다(p=0.126, 0.615, 0.874). 환자군 중 신생혈관성나이관련황반변성 및 결절맥락막혈관병증 환자들 사이의 무증상 반대안에서 측정한 총 망막두께 및 각 외망막층 사이 두께는 모두 유의한 차이가 없었다. 결론: 단안 삼출성 나이관련황반변성 환자의 무증상 반대안은 정상안에 비해 망막색소상피층과 원추세포외절끝 사이의 두께가 더 얇았다. 망막색소상피층과 원추세포외절끝 간의 두께가 더 얇을수록 나이관련황반변성이 발생할 위험성이 더 높을 가능성이 있다고 본다.
Abstract
Purpose: To compare the outer retinal thickness in normal fellow eyes of patients with unilateral age-related macular degeneration (AMD) and normal control eyes. Methods: We retrospectively reviewed the medical records of 60 patients with unilateral exudative AMD including polypoidal choroidal vasculopathy and 60 normal controls. Spectralis optical coherence tomography was performed in the normal fellow eyes of patients with unilateral AMD and in the normal group. The thicknesses between the retinal pigment epithelium (RPE) line and the cone outer segment tips (COST) line, between the COST line and the photoreceptor inner segment/outer segment (IS/OS) line, and between the IS/OS line and the external limiting membrane (ELM) line were measured at the fovea in both groups. Results: The thickness between the RPE and COST lines was 32.4 ± 3.0 μm in normal fellow eyes of patients with unilateral AMD and 35.3 ± 3.5 μm in the normal group (p < 0.001). Total retinal thickness, thicknesses between the COST and the IS/OS lines and the IS/OS and the ELM lines in fellow eyes were not significantly different from those of normal eyes (p = 0.126, 0.615, 0.874). There was no significant difference in total retinal thickness or each outer retinal thickness measured in normal fellow eyes between patients with neovascular AMD and polypoidal choroidal vasculopathy. Conclusions: The thickness between the RPE and the COST lines was thinner in the fellow eyes of patients with unilateral AMD than in the normal eyes. We suggest that less thickness between the RPE and COST lines might indicate a greater risk of AMD.
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