스펙트럼 영역 빛간섭단층촬영의 진단 능력: 시야결손 전 녹내장과 큰 시신경유두함몰군 간 비교
Diagnostic Ability of Spectral Domain OCT: Comparision between Preperimetric Glaucoma and Large Physiologic Cupping
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
목적: Spectral domain optical coherence tomography (SD-OCT) 지표의 시야결손 전 녹내장 진단 능력을 평가하고자 실제 임상환경을 고려하여 큰 생리적 시신경유두함몰이 있는 정상인을 함께 비교하였다. 대상과 방법: 시야결손 전 녹내장 환자 47안, 큰 생리적 시신경유두함몰이 있는 정상인 66안, 큰 시신경유두함몰이 없는 정상인 55안을 대상으로 SD-OCT 지표를 비교하였다. 시야결손 전 녹내장은 표준자동시야검사에서 정상을 보이나 수직 시신경유두비의 비대칭, 테 얇아짐, 패임, 함몰, 망막신경섬유층 손상 등의 녹내장성 시신경 변화를 보이는 초기녹내장으로 정의하였다. 결과: 큰 시신경유두함몰이 없는 정상인과 비교하였을 때 시신경유두 지표 중 가장 우수한 수직 시신경유두함몰비(0.89)가 retinal nerve fiber layer (RNFL) 지표 중 가장 우수한 하측 RNFL 지표(0.72)와 ganglion cell inner plexiform layer (GCIPL) 지표 중 가장 우수한 상이측, 하이측 GCIPL 지표(0.70)보다 통계적으로 우수한 진단 능력을 보였다(p=0.005, 0.002). 큰 생리적 시신경유두함몰이 있는정상인과 비교하였을 때 시신경유두 지표 중에서는 평균 시신경유두함몰비(0.70), RNFL 지표 중에서는 하측 RNFL 두께(0.72), GCIPL 지표 중에서는 하측 GCIPL (0.67)이 가장 우수하였고, 세 지표는 통계적으로 차이가 없으며(p＞0.05) 앞의 경우보다 판별능력이 전반적으로 낮았다. 결론: 큰 생리적 시신경유두함몰이 있는 정상인으로부터 SD-OCT의 시야결손 전 녹내장 진단 능력은 시신경유두, RNFL, GCIPL 지표모두 비슷하였고 큰 시신경유두함몰이 없는 정상인과 비교하였을 때보다 전반적으로 낮은 진단 능력을 보인다.
Abstract
Purpose: To assess the distinction ability for differentiating glaucoma patients based on optic disc, retinal nerve fiber layer (RNFL) and ganglion cell‐inner plexiform layer (GCIPL) measured using spectral domain optical coherence tomography (SDOCT). Additionally, the diagnostic ability of these parameters was evaluated by comparing preperimetic glaucoma patients who frequently visited the clinic and normal patients with and without a large physiologic cup/disc (C/D) ratio. Methods: Using SD-OCT, the optic disc, RNFL and GCIPL of preperimetic glaucoma patients were compared with normal people with and without a large C/D ratio from March, 2011 to December, 2014 at Department of Ophthalmology, Inha University Hospital. Preperimetic glaucoma was defined using the normal standard automated perimetry for glaucomatous optic nerve changes such as asymmetry of vertical C/D ratio, rim thinning, notching, excavation and RNFL defect. Results: When comparing preperimetic glaucoma patients to normal people without large disc cupping, the most reliable parameter for optic disc parameters, vertical C/D ratio (0.89), showed more reliable diagnostic ability than the most reliable parameter for retinal nerve fiber, inferior RNFL thickness (0.79) and superonasal and inferonasal GCIPL thickness were the most reliable GCIPL parameters (p = 0.005 and 0.002, respectively). When comparing preperimetic glaucoma patients to normal people having a large physiologic disc cupping, average C/D ratio among optic nerve parameters, inferior RNFL thickness among RNFL thickness parameters and inferior GCIPL thickness among GCIPL parameters showed highly reliable diagnostic abilities. These 3 parameters were not statistically different (all p > 0.05) and had lower distinction ability than reported in previous studies. Conclusions: Diagnostic abilities of SD-OCT for distinguishing preperimetric glaucoma from normal people having large physiologic disc cupping were similar for optic disc, RNFL and GCIPL and showed low diagnostic ability than compared to normal people without large disc cupping.
참고문헌 (26)
- Sommer A., "The nerve fiber layer in the diagnosis of glaucoma", Arch Ophthalmol, 95, pp.2149~2156 (1977)
- Quigley HA., "Optic nerve damage in human glaucoma. III. Quantitative correlation of nerve fiber loss and visual field defect in glaucoma, ischemic neuropathy, papilledema, and toxic neuropathy", Arch Ophthalmol, 100, pp.135~146 (1982)
- Hayreh SS., "Pathogenesis of cupping of the optic disc", Br J Ophthalmol, 58, pp.863~876 (1974)
- Quigley HA., "The size and shape of the optic disc in normal human eyes", Arch Ophthalmol, 108, pp.51~57 (1990)
- Carpel EF., "The normal cup-disk ratio", Am J Ophthalmol, 91, pp.588~597 (1981)
- Armaly MF., "Genetic determination of cup", disc ratio of the optic nerve, 1967, pp.78, 35~43
- Armaly MF., "The cup-disc ratio. The findings of tonometry and tonography in the normal eye", Arch Ophthalmol, 82, pp.191~196 (1969)
- Varma R., "Race-, age-, gender-, and refractive error-related differences in the normal optic disc", Arch Ophthalmol, 112, pp.1068~1076 (1994)
- Garvin MK., "Automated 3-D intraretinal layer segmentation of macular spectral-domain optical coherence tomography images", IEEE Trans Med Imaging, 28, pp.1436~1447 (2009)
- Bagga H., "Detection of psychophysical and structural injury in eyes with glaucomatous optic neuropathy and normal standard automated perimetry", Arch Ophthalmol, 124, pp.169~176 (2006)
- Jonas JB., "Optic disc, cup and neuroretinal rim size, configuration and correlations in normal eyes", Invest Ophthalmol Vis Sci, 29, pp.1151~1158 (1988)
- Mwanza JC., "Profile and predictors of normal ganglion cell-inner plexiform layer thickness measured with frequency-domain optical coherence tomography", Invest Ophthalmol Vis Sci, 52, pp.7872~7879 (2011)
- Kim NR., "Spectral-domain optical coherence tomography for detection of localized retinal nerve fiber layer defects in patients with open-angle glaucoma", Arch Ophthalmol, 128, pp.1121~1128 (2010)
- Hanley JA., "A method of comparing the areas under receiver operating characteristic curves derived from the same cases", Radiology, 148, pp.839~843 (1983)
- Knight OJ., "Comparison of retinal nerve fiber layer measurements using time domain and spectral domain optical coherent tomography", Ophthalmology, 116, pp.1271~1277 (2009)
- Sung KR., "Comparison of retinal nerve fiber layer thickness measured by Cirrus HD and Stratus optical coherence tomography", Ophthalmology, 116, pp.1264~1270 (2009)
- Tan O., "Detection of macular ganglion cell loss in glaucoma by Fourier-domain optical coherence tomography", Ophthalmology, 116, pp.2305~2314.e1-2 (2009)
- Na JH., "Detection of macular ganglion cell loss in preperimetric glaucoma patients with localized retinal nerve fibre defects by spectral-domain optical coherence tomography", Clin Experiment Ophthalmol, 41, pp.870~880 (2013)
- Jeoung JW., "Comparison of Cirrus OCT and Stratus OCT on the ability to detect localized retinal nerve fiber layer defects in preperimetric glaucoma", Invest Ophthalmol Vis Sci, 51, pp.938~945 (2010)
- Hirashima T., "Frequency-doubling technology and retinal measurements with spectral-domain optical coherence tomography in preperimetric glaucoma", Graefes Arch Clin Exp Ophthalmol, 251, pp.129~137 (2013)
- Rao HL., "Effect of spectrum bias on the diagnostic accuracy of spectral-domain optical coherence tomography in glaucoma", Invest Ophthalmol Vis Sci, 53, pp.1058~1065 (2012)
- Rao HL., "Ability of different scanning protocols of spectral domain optical coherence tomography to diagnose preperimetric glaucoma", Invest Ophthalmol Vis Sci, 54, pp.7252~7257 (2013)
- Lisboa R., "Comparison of different spectral domain OCT scanning protocols for diagnosing preperimetric glaucoma", Invest Ophthalmol Vis Sci, 54, pp.3417~3425 (2013)
- Leite MT., "Comparison of the diagnostic accuracies of the Spectralis, Cirrus, and RTVue optical coherence tomography devices in glaucoma", Ophthalmology, 118, pp.1334~1339 (2011)
- Savini G., "Retinal nerve fiber layer thickness measurement by Fourier-domain optical coherence tomography : a comparison between cirrus-HD OCT and RTVue in healthy eyes", J Glaucoma, 19, pp.369~372 (2010)
- Buchser NM., "Comparison of retinal nerve fiber layer thickness measurement bias and imprecision across three spectral-domain optical coherence tomography devices", Invest Ophthalmol Vis Sci, 53, pp.3742~3747 (2012)