백내장 수술 후 맥락막 두께 변화와 굴절력 오차
The Variation of Choroidal Thickness and Refractive Error after Cataract Surgery
1
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
목적: 백내장 수술이 맥락막 두께에 미치는 영향을 알아보고 맥락막 두께 변화와 술 후 굴절력 오차와의 관련성에 대해 조사하고자 하였다. 대상과 방법: 2012년 3월부터 2014년 2월까지 수정체유화술 및 인공수정체삽입술을 받은 47명 47안을 후향적으로 조사하였다. 술 전 또는 술 후 1개월, 3개월, 6개월에 시행한 스펙트럼영역 빛간섭단층촬영 사진을 이용하여 중심와아래 맥락막 두께를 측정하였다. 또한 목표굴절력과 술 후 1개월, 3개월, 6개월에 측정한 구면렌즈대응치와의 차이, 매 방문 시에 안압, 중심황반두께 등도 조사하였다. 결과: 중심와아래 맥락막 두께는 술 전보다 술 후 1개월에 평균 5.9 ± 13.3 μm, 술 후 3개월에 평균 7.6 ± 18.1 μm만큼 유의하게 증가하였으나(p=0.004 and p=0.006, respectively), 술 후 6개월에는 유의한 차이를 보이지 않았다(p=0.104). 중심와아래 맥락막두께의 변화량은 술 후 구면렌즈대응치와 술 전 목표굴절력과의 차이값과 술 후 1개월, 술 후 6개월에는 유의한 상관관계를 보이지 않았으나, 술 후 3개월에는 유의한 양의 상관관계를 보였다(r=0.310, p=0.034). 중심와아래 맥락막 두께의 변화량은 안압 변화량, 중심황반두께 변화량과는 유의한 상관관계를 보이지 않았다. 결론: 백내장 수술은 술 후 3개월까지 중심와아래 맥락막 두께를 증가시켰다. 중심와아래 맥락막 두께의 변화는 술 후 굴절력에 영향을 미칠 수 있을 것이다.
Abstract
Purpose: To evaluate the effect of cataract surgery on subfoveal choroidal thickness (SCT) and investigate the relationship between the variation of SCT and refractive error. Methods: We retrospectively reviewed the medical records of 47 patients (47 eyes) who underwent uneventful phacoemulsification cataract surgery from March 2012 to February 2014. SCTs were measured using spectral-domain optical coherence tomography performed before surgery and at 1 month, 3 months and 6 months postoperatively. We investigated the differences in target refraction (TR) and postoperative spherical equivalent (SE), intraocular pressure (IOP) and central macular thickness (CMT) at all follow-ups. Results: Compared with preoperative measurements, SCT showed a significant increase of 5.9 ± 13.3 μm at postoperative 1 month and 7.6 ± 18.1 μm at postoperative 3 months (p = 0.004 and p = 0.006, respectively), but no significant differences at postoperative 6 months (p = 0.104). The correlation between the variation of SCT and the differences in postoperative SE and TR were not significant at 1 month and 6 months, but were positively significant at 3 months (r = 0.310, p = 0.034). The variation of SCT showed no significant correlations with the postoperative change in IOP and CMT. Conclusions: SCT significantly increased up to 3 months after cataract surgery. The variation of SCT may affect the postoperative refractive error.
참고문헌 (26)
- Grossniklaus HE., "Choroidal neovascularization", Am J Ophthalmol, 137, pp.496~503 (2004)
- Iida T., "Persistent and bilateral choroidal vascular abnormalities in central serous chorioretinopathy", Retina, 19, pp.508~512 (1999)
- Torres VL., "Optical coherence tomography enhanced depth imaging of choroidal tumors", Am J Ophthalmol, 151, pp.586.e2~593.e2 (2011)
- Ho M., "Choroidal thickness measurement in myopic eyes by enhanced depth optical coherence tomography", Ophthalmology, 120, pp.1909~1914 (2013)
- Ciardella AP., "Polypoidal choroidal vasculopathy", Surv Ophthalmol, 49, pp.25~37 (2004)
- Spaide RF., "Enhanced depth imaging spectral-domain optical coherence tomography", Am J Ophthalmol, 146, pp.496~500 (2008)
- Margolis R., "A pilot study of enhanced depth imaging optical coherence tomography of the choroid in normal eyes", Am J Ophthalmol, 147, pp.811~815 (2009)
- Olsen T, "Calculation of intraocular lens power : a review", Acta Ophthalmol Scand, 85, pp.472~485 (2007)
- Falcão MS., "Choroidal and macular thickness changes induced by cataract surgery", Clin Ophthalmol, 8, pp.55~60 (2014)
- Pierru A., "Measurement of subfoveal choroidal thickness after cataract surgery in enhanced depth imaging optical coherence tomography", Invest Ophthalmol Vis Sci, 55, pp.4967~4974 (2014)
- Ohsugi H., "Changes in choroidal thickness after cataract surgery", J Cataract Refract Surg, 40, pp.184~191 (2014)
- Noda Y., "Long-term increase in subfoveal choroidal thickness after surgery for senile cataracts", Am J Ophthalmol, 158, pp.455.e1~459.e1 (2014)
- Chakraborty R., "Diurnal variations in axial length, choroidal thickness, intraocular pressure, and ocular biometrics", Invest Ophthalmol Vis Sci, 52, pp.5121~5129 (2011)
- Oh JH., "Biometric characteristics of eyes with central serous chorioretinopathy", Invest Ophthalmol Vis Sci, 55, pp.1502~1508 (2014)
- Miyake K., "Prostaglandins and cystoid macular edema", Surv Ophthalmol, 47(Suppl 1), pp.S203~S218 (2002)
- Xu H., "Cataract surgery induces retinal pro-inflammatory gene expression and protein secretion", Invest Ophthalmol Vis Sci, 52, pp.249~255 (2011)
- Bilak S., "Biometric and intraocular pressure change after cataract surgery", Optom Vis Sci, 92, pp.464~470 (2015)
- von Jagow B., "Macular thickness after uneventful cataract surgery determined by optical coherence tomography", Graefes Arch Clin Exp Ophthalmol, 245, pp.1765~1771 (2007)
- Sourdille P., "Optical coherence tomography of macular thickness after cataract surgery", J Cataract Refract Surg, 25, pp.256~261 (1999)
- Jahn CE, "Reduced intraocular pressure after phacoemulsification and posterior chamber intraocular lens implantation", J Cataract Refract Surg, 23, pp.1260~1264 (1997)
- Saeedi O., "Change in choroidal thickness and axial length with change in intraocular pressure after trabeculectomy", Br J Ophthalmol, 98, pp.976~979 (2014)
- Bayhan HA., "Long-term increase in subfoveal choroidal thickness after surgery for senile cataracts", Am J Ophthalmol, 159, pp.406~407 (2015)
- Usui S., "Circadian changes in subfoveal choroidal thickness and the relationship with circulatory factors in healthy subjects", Invest Ophthalmol Vis Sci, 53, pp.2300~2307 (2012)
- Falavarjani KG., "OCT and cataract", Ophthalmology, 117, pp.849~ (2010)
- van Velthoven ME., "Influence of cataract on optical coherence tomography image quality and retinal thickness", Br J Ophthalmol, 90, pp.1259~1262 (2006)
- 나정화, "Factors Associated with the Signal Strengths Obtained by Spectral Domain Optical Coherence Tomography", Korean Journal of Ophthalmology, 26(3), pp.169~173 (2012), 대한안과학회[DOI]