정상인의 안구 운동 범위와 연령과의 연관성
Range of Eye Movement in a Normal Population and Its Relationship to Age
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목적: 정상인의 안구 운동 범위를 측정하고 연령이 안구 운동 범위에 미치는 영향에 대해 알아보고자 하였다. 대상과 방법: 5세부터 91세까지의 연령으로 구성된 85명을 대상으로 전향적 관찰 연구를 시행하였다. 기본주시안위에서의 사진을 얻은 뒤 이미지 분석 소프트웨어(Photoshop 6.0 [Adobe, San Jose, CA, USA])를 이용하여 처리하였다. 안구 운동 범위를 측정하기 위해 전처리된 이미지를 Image J 프로그램을 이용하여 분석하였다. 안구 운동 범위를 각막 윤부 분석법을 통해 각도로 정량화하였다. 내전, 외전, 상전, 그리고 하전에서의 안구 운동 범위를 측정하였다. 결과: 안구 운동의 정상 범위는 내전에서 44.4 ± 6.9o, 외전에서 44.8 ± 5.5o, 상전에서 27.7 ± 7.6o, 그리고 하전에서 46.7 ± 8.4o로 측정되었다. 내전, 외전 및 상전과 연령은 유의미한 음의 상관관계를 보였다(R2=0.220 in adduction, R2=0.126 in abduction, and R2=0.304 in elevation, all p<0.001). 그러나, 하전은 연령과 유의미한 상관관계를 보이지 않았다(R2=0.030, p=0.113). 결론: 모든 연령에서 수평 방향의 정상 안구 운동 범위는 대칭적인 반면, 수직 방향의 정상 안구 운동 범위는 상전이 하전보다 작았다. 연령이 증가하면서 하전 이외의 모든 방향에서는 안구 운동 범위의 감소가 나타났으나, 하전은 연령이 증가해도 감소하지 않았다. 안구 운동을 평가할 때, 운동 방향에 따른 안구 운동 범위의 차이와 연령에 따른 안구 운동 범위의 변화를 고려해야 할 것이다.
Abstract
Purpose: The purpose of this study is to measure the range of normal eye movement and to evaluate the effect of age on the range of ocular movement in a normal population. Methods: We conducted a prospective observational study of 85 subjects aged between 5 and 91 years. Photographs were taken of the cardinal position, and these images were analyzed using an image analysis software (Adobe Photoshop 6.0, Adobe, San Jose, CA, USA). To measure the range of eye movement, the preprocessed images were analyzed using the Image J program. The range of movement of the eyeball was quantitatively measured using corneal limbal analysis. Specifically, the ranges of ocular movement according to adduction, abduction, elevation, and depression were measured. Results: The normal movement ranges were 44.4 ± 6.9° in adduction, 44.8 ± 5.5° in abduction, 27.7 ± 7.6° in elevation, and 46.7 ± 8.4° in depression. Adduction, abduction, and elevation were negatively correlated with age (R2 = 0.220, R2 = 0.126, and R2 = 0.304, respectively, all p < 0.001). However, there was no significant correlation between age and depression (R2 = 0.030, p = 0.113). Conclusions: For all ages, the range of normal ocular movement in the horizontal direction was symmetric, while the range of ocular movement in elevation was smaller than that of depression. As age increased, the range of ocular movement decreased in all directions except depression, but depression did not decrease with age. When assessing eye movement, it is necessary to consider the range of ocular movements relative to both the movement direction and changes in the ocular movement range according to age.
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