단안 망막분지정맥폐쇄 환자에서 반대눈과 대조군 눈의 망막내층의 두께 비교
Comparison of Inner Retinal Thickness between the Fellow Eyes of Unilateral Branch Retinal Vein Occlusion and Normal Control
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목적: 단안 망막분지정맥폐쇄환자에서 망막분지정맥폐쇄가 발생한 눈의 반대눈의 망막신경섬유층의 두께와 망막내층의 두께가 감소되어 있는지 알아보고자 하였다. 대상과 방법: 단안 망막분지정맥폐쇄로 진단 받은 환자(59명, 59안)와 동일 기간 내에 동일 병원에서 검진 목적으로 녹내장검사를 시행 받았던 환자(48명, 48안)를 대조군으로 하여 후향적으로 비교하였다. 스펙트럼영역 빛간섭단층촬영기를 이용하여 각 군의 평균망막신경섬유층 두께, 12시각 망막신경섬유층 두께, 4사분면 망막신경섬유층 두께 및 평균 신경절세포복합체의 두께, 최소 신경절세포복합체의 두께, 상측, 상비측, 상이측, 하측, 하비측, 하이측 신경절세포복합체의 두께를 각각 측정하여 비교분석하였다. 결과: 단안 망막분지정맥폐쇄가 있는 환자와 대조군과 비교하였을 때 고혈압은 단안 망막분지정맥폐쇄가 있는 환자에서 대조군보다 유의하게 많았고, 망막신경섬유층의 두께는 단안 망막분지정맥폐쇄가 있는 환자의 반대눈의 7시와 11시 방향에서 대조군과 비교하여 의미 있는 차이를 보였지만(p-value=0.005, 0.017) 나머지 부분은 의미 있는 차이를 보이지 않았고 신경절세포복합체의 두께는 통계적으로 두 군 간의 차이를 보이지 않았다. 결론: 망막분지정맥폐쇄 환자들의 반대안에서 대조군에 비해 시신경의 상이측, 하이측에 해당하는 7시, 11시 방향의 망막신경섬유층의 두께가 얇았다. 따라서 단안에 국한된 망막정맥폐쇄 환자에서도 반대안의 녹내장성 변화가 있는지 주의 깊은 관찰이 필요할 것으로 생각된다.
Abstract
Purpose: The purpose of this study was to compare inner retinal thickness and retinal nerve fiber layer (RNFL) thickness between fellow eyes with unilateral branch retinal vein occlusion (BRVO) and normal control eyes. Methods: Retrospective cross-sectional study including 59 patients diagnosed with unilateral BRVO and 51 control subjects. Using spectral domain optical coherence tomography, we investigated the average, 4 quadrant, and 12 clock-hour RNFL thicknesses and the average, minimum, superior, superonasal, superotemporal, inferior, inferonasal, and inferotemporal thicknesses of the ganglion cell-inner plexiform layer (GCIPL) layer. Results: Patients with unilateral BRVO had a higher incidence of hypertension. In the fellow eyes of the unilateral BRVO patients, 7 and 11 o’clock RNFL thicknesses were significantly thinner than for the control eyes. There was no significant difference in the GCIPL thickness between the two groups. Conclusions: The RNFL thickness of the fellow eyes of the unilateral BRVO patients showed significant decreases in the 7 and 11 o’clock sectors (p=0.005, 0.017, respectively), whereas there was no significant difference in the GCIPL thickness between the two groups. In the RNFL thickness analysis, the 7 and 11 o’clock sectors were found to be dominant locations of decreased RNFL thickness for the open angle glaucoma. Further, glaucomatous change should be carefully monitored in the fellow eyes of unilateral BRVO patients.
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- 이영록, "녹내장 진단에서 스펙트럼 영역 빛간섭단층촬영기로 측정한 황반과 망막신경섬유층 두께의 유용성", 대한안과학회지, 51(9), pp.1250~1257 (2010), 대한안과학회