당뇨황반부종 호전 후 황반부 신경절세포-내망상층 두께와 시력과의 관계
Correlation between Macular GCIPL Thickness and Visual Acuity after Resolution of Diabetic Macular Edema
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목적: 호전된 당뇨황반부종 환자에서 빛간섭단층촬영기를 이용하여 황반부 신경절세포-내망상층과 시신경 유두주위 망막신경섬유층의 두께를 측정하고, 시력과의 관련성을 평가해 보고자 하였다. 대상과 방법: 당뇨황반부종으로 치료 받은 후 중심황반두께가 정상화된 환자 20안을 대상으로 하였으며, 당뇨황반부종이 없는 당뇨망막병증 환자 20안을 대조군으로 하여 비교하였다. 빛간섭단층촬영을 이용하여 황반부 신경절세포-내망상층과 시신경 유두주위 망막신경섬유층, 중심 황반의 두께를 측정하였으며, 각각의 두께와 시력과의 상관 관계를 조사하였다. 결과: 당뇨황반부종이 있던 군과 당뇨황반부종이 없는 군에서의 중심황반두께는 차이를 보이지 않았으나, 시신경 유두주위 망막신경섬유층의 두께는 당뇨황반부종이 있던 군이 더 두꺼웠으며, 황반부 신경절세포-내망상층 두께는 당뇨황반부종이 있던 군이 더 얇았다. 당뇨황반부종이 있던 군에서 최종 시력은 신경절세포-내망상층 두께와는 상관관계가 있는 반면에, 시신경 유두주위 망막신경섬유층 두께나 중심황반 두께와는 상관관계가 없었다. 결론: 당뇨황반부종 치료 후에 신경절세포-내망상층 두께는 당뇨황반부종이 있던 군에서 당뇨황반부종이 없는 군에 비해 얇았고, 최종 시력과도 연관성이 있었다. 이런 결과는 당뇨황반부종에서 발생하는 망막내층의 손상이 치료 이후에도 지속되는 시력 저하의 원인이 될 수 있음을 뜻한다.
Abstract
Purpose: To evaluate the peripapillary retinal nerve fiber layer (pRNFL) thickness and macular ganglion cell-inner plexiform layer (mGCIPL) thickness in eyes with resolved diabetic macular edema (DME). Methods: Twenty eyes of diabetic retinopathy patients with resolved DME (DME group) after treatment, and 20 eyes of diabetic retinopathy patients without DME (no-DME group) were included in this study. The pRNFL thickness, mGCIPL thickness and central macular thickness (CMT) were measured using spectral-domain optical coherence tomography (SD-OCT). Analyses were performed to determine the correlation between the different thicknesses and the visual function. Results: No significant difference in mean CMT was observed between the DME and no-DME groups. Average pRNFL thickness in the DME group was thicker than in the no-DME group (p = 0.003). Average mGCIPL thickness in the DME group was thinner than in the no-DME group (p = 0.030). Final visual acuity was significantly correlated with average mGCIPL thickness and minimum mGCIPL thickness, but not pRNFL thickness and CMT in the DME group. Conclusions: mGCIPL thickness decreased in the DME group compared with the no-DME group and was correlated with the visual acuity. These results suggested that inner retinal injury in patients with DME might lead to poor visual outcome after treatment.
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