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약시 환자에서 스펙트럼 빛간섭단층촬영을 이용한 망막신경섬유층의 분석

The Analysis of Retinal Nerve Fiber Layer in Amblyopia Using Spectral Domain Optical Coherence Tomography

김수진|박찬금
대한안과학회 (The Korean Ophthalmological Society)|2016.10|대한안과학회지 (Journal of The Korean Ophthalmological Society)|제57권 제10호|pp. 1631-1639

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참고문헌

키워드

AmblyopiaOptic nerve head parameterRetinal nerve fiber layer (RNFL) thickness
주제분류안과학

초록

목적: 원시성 굴절부등 단안 약시 환자들을 대상으로 스펙트럼영역 빛간섭단층촬영을 이용하여(spectrum domain optical coherence tomography, SD-OCT) 유두주위망막신경섬유층의 두께와 안축장/시신경유두면적 비, 망막면적/시신경유두테 면적 비, 시신경유두 관련 지표들을 측정하여 약시안과 정상안 사이에 구조적 차이를 분석하였다. 대상과 방법: 원시성 굴절부등 단안 약시를 진단 받은 30명의 환자를 대상으로 SD-OCT를 이용하여 유두주위망막신경섬유층의 두께와 시신경유두지표들을 측정한 후 약시안과 비약시안 간 차이를 비교 분석하였다. IOL Master®를 이용하여 안축장과 추정 망막면적을 구한 뒤 각각 시신경유두면적과 시신경유두테 면적으로 나눈 지표를 두 군 사이에 비교하였다. 결과: 유두주위망막신경섬유층은 비측 구역에서 비약시안에 비해 약시안의 두께가 유의하게 두꺼웠다(p=0.010). 시신경유두 관련 지표들 중에서는 유두용적이 약시안에서 비약시안에 비해 유의하게 작게 나타났다(p=0.021). 굴절이상에 따른 망막신경섬유층의 두께변화는 관련이 없는 것으로 나타났다. 시신경유두테 면적과 유두주위망막신경섬유층 사이에는 유의한 양적 선형관계가 관찰되었다(rho=0.426, p=0.005). 결론: 원시성 굴절부등 단안 약시 환자에서 SD-OCT 분석상 약시안의 비측 구역의 유두주위망막신경섬유층이 비약시안에 비해 두꺼워져 있는 결과가 관찰되었다. 유두용적을 제외한 시신경유두 관련 지표들은 약시안과 비약시안 사이에 유의한 차이가 없었다.

Abstract

Purpose: To determine whether retinal nerve fiber layer (RNFL) thickness and optic nerve head parameters differ in the amblyopic and normal fellow eyes of hyperopic anisometropic amblyopic patients using spectral domain optical coherence tomography (SD-OCT). Methods: This study included 30 patients with hyperopic anisometropic amblyopia; patient eyes were divided into 30 anisometropic amblyopic eyes and 30 normal fellow eyes. RNFL thickness, disc area, rim area, average cup-to-disc ratio, and cup volume were obtained using SD-OCT. Axial length was obtained using the IOL Master®, and the interocular differences between group were analyzed. Results: Nasal quadrant RNFL thickness of amblyopic eyes was significantly thicker than that of normal fellow eyes in amblyopic patients (p = 0.010). Among optic nerve parameters, cup volume of amblyopic eyes was significantly smaller than that of normal fellow eyes (p = 0.021). No significant relationship between refractive error and RNFL thickness was observed, and a significant positive linear relationship was observed between neural rim area and RNFL thickness (rho = 0.426, p = 0.005). Conclusions: SD-OCT analysis of hyperopic anisometropic amblyopic eyes demonstrated a significant increase in nasal RNFL thickness compared to fellow non-amblyopic eyes. No optic nerve head parameters except cup volume showed significant change.

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