Dynamic Contour Tonometry 및 골드만 압평 안압계와 심각막두께의 관계
Comparison of Dynamic Contour Tonometry and Goldmann Applanation Tonometry in Relation to Central Corneal Thickness
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
목적: Dynamic contour tonometry (DCT)로 측정한 안압과 골드만 압평 안압계(Goldmann applanation tonometer, GAT)로 측정한안압의 중심각막두께(central corneal thickness, CCT)와의 상관관계에 대해 알아보고, 각각을 비교해 보고자 하였다. 대상과 방법: 녹내장 및 녹내장 의증 환자 91명 178안을 대상으로 DCT와 GAT를 이용하여 측정한 안압을 비교하고, 초음파 각막 두께측정계를 이용하여 측정한 CCT와의 상관관계를 비교하였다. 분석 시 CCT에 따라 얇은 군(CCT＜525 μm, n=59), 중간 군(525≤CCT ＜561 μm, n=59), 두꺼운 군(CCT≥561 μm, n=60)으로 나누어 각 군에서의 안압과 CCT 간의 상관관계를 분석하였다. 결과: 모든 환자를 대상으로 분석 시 GAT로 측정한 안압은 CCT와 유의한 양의 상관관계를 나타냈으나 DCT로 측정한 안압은 유의한상관관계를 보이지 않았다(p＜0.001 for GAT; p=0.108 for DCT). CCT에 따라 세 군으로 나누어 분석하였을 때에는 GAT 안압은 얇은군에서만 CCT와 유의한 상관관계가 나타났으며(p=0.027), DCT 안압은 모든 군에서 유의하지 않았다. 결론: GAT 안압은 CCT의 영향을 받으며, 특히 CCT가 얇은 경우에 CCT와 유의한 상관관계를 보였다. DCT는 CCT의 영향을 받지않았다. 따라서 CCT가 얇은 환자에서는 GAT보다 DCT로 안압을 측정하는 것이 더 정확할 것이다.
Abstract
Purpose: In this study we compared the intraocular pressures (IOPs) measured using dynamic contour tonometry (DCT) and Goldmann applanation tonometry (GAT) and investigated the correlation between central corneal thickness (CCT) and IOP. Methods: In a prospective study, 178 eyes of 91 subjects with glaucoma and glaucoma suspect were enrolled. IOP was measured using DCT and GAT and CCT was measured using ultrasound pachymetry. Each eye was classified into 1 of 3 groups according to their CCT: low CCT (Group A; CCT < 525 μm), normal CCT (Group B; 525 ≤ CCT < 561 μm), and high CCT (Group C; CCT ≥ 561 μm). In each group, we investigated the correlation between CCT and IOP measurement using GAT and DCT. Results: A significant correlation was found between CCT and IOP measured using GAT (p < 0.001), but not between CCT and IOP measured using DCT (p = 0.108) in all patients. Subgroup analysis showed that CCT affected IOP measured with GAT only in Group A (p = 0.027) and IOP measured with DCT was not affected by CCT in all 3 groups. Conclusions: IOP measured using GAT and DCT were significantly affected by CCT, especially when the CCT was low. CCT may have no effect on DCT thus, IOP measured using DCT is more reliable than GAT in patients with thin corneas.
참고문헌 (33)
- Epstein DL., "A long-term clinical trial of timolol therapy versus no treatment in the management of glaucoma suspects", Ophthalmology, 96, pp.1460~1467 (1989)
- Kass MA., "Topical timolol administration reduces the incidence of glaucomatous damage in ocular hypertensive individuals. A randomized, double-masked, long-term clinical trial", Arch Ophthalmol, 107, pp.1590~1598 (1989)
- Schulzer M., "A comparison of treated and untreated glaucoma suspects", Ophthalmology, 98, pp.301~307 (1991)
- Goldmann H., "Applanation tonometry", Ophthalmologica, 134, pp.221~242 (1957)
- Ehlers N., "Applanation tonometry and central corneal thickness", Acta Ophthalmol(Copenh), 53, pp.34~43 (1975)
- Doughty MJ., "Human corneal thickness and its impact on intraocular pressure measures : a review and meta-analysis approach", Surv Ophthalmol, 44, pp.367~408 (2000)
- Doughty MJ., "Effect of central corneal thickness on Goldmann applanation tonometry measures-a different result with different pachymeters", Graefes Arch Clin Exp Ophthalmol, 245, pp.1603~1610 (2007)
- Kanngiesser HE., "Dynamic contour tonometry : presentation of a new tonometer", J Glaucoma, 14, pp.344~350 (2005)
- Siganos DS., "Assessment of the Pascal dynamic contour tonometer in monitoring intraocular pressure in unoperated eyes and eyes after LASIK", J Cataract Refract Surg, 30, pp.746~751 (2004)
- Kaufmann C., "Intraocular pressure measurements using dynamic contour tonometry after laser in situ keratomileusis", Invest Ophthalmol Vis Sci, 44, pp.3790~3794 (2003)
- 최현준, "굴절교정수술 환자에서 Dynamic Contour Tonometer를 이용한 안압 측정", 대한안과학회지, 49(4), pp.577~582 (2008), 대한안과학회
- Han KE., "Comparison of intraocular pressures after myopic laser-assisted subepithelial keratectomy : tonometry-pachymetry, Goldmann applanation tonometry, dynamic contour tonometry, and noncontact tonometry", J Cataract Refract Surg, 39, pp.888~897 (2013)
- Schneider E., "Intraocular pressure measurement-comparison of dynamic contour tonometry and goldmann applanation tonometry", J Glaucoma, 15, pp.2~6 (2006)
- Carbonaro F., "Comparison of three methods of intraocular pressure measurement and their relation to central corneal thickness", Eye(Lond), 24, pp.1165~1170 (2010)
- Regev G., "Goldmann applanation tonometry and dynamic contour tonometry are not correlated with central corneal thickness in primary open angle glaucoma", J Glaucoma, 20, pp.282~286 (2011)
- Grieshaber MC., "Effect of central corneal thickness on dynamic contour tonometry and Goldmann applanation tonometry in primary open-angle glaucoma", Arch Ophthalmol, 125, pp.740~744 (2007)
- Francis BA., "Effects of corneal thickness, corneal curvature, and intraocular pressure level on Goldmann applanation tonometry and dynamic contour tonometry", Ophthalmology, 114, pp.20~26 (2007)
- Doyle A., "Comparison of dynamic contour tonometry with goldman applanation tonometry over a wide range of central corneal thickness", J Glaucoma, 14, pp.288~292 (2005)
- 서장원, "Dynamic Contour Tonometry와 골드만 압평 안압계의 비교", 대한안과학회지, 50(2), pp.242~246 (2009), 대한안과학회
- 이주은, "Comparison Between Dynamic Contour Tonometry and Goldmann Applanation Tonometry", Korean Journal of Ophthalmology, 23(1), pp.27~31 (2009), 대한안과학회
- Kass MA., "Standardizing the measurement of intraocular pressure for clinical research. Guidelines from the Eye Care Technology Forum", Ophthalmology, 103, pp.183~185 (1996)
- Altman DG., "Measurement in medicine : the analysis of method comparison studies", The Statistician, 32, pp.307~317 (1983)
- 곽주영, "초음파와 두 가지 부분결합간섭계를 이용한 안구의 생체 계측 비교", 대한안과학회지, 52(2), pp.169~174 (2011), 대한안과학회
- Allingham RR., "Shields' textbook of glaucoma", pp.30~32 (2010), Lippincott Williams & Wilkins
- Shih CY., "Clinical significance of central corneal thickness in the management of glaucoma", Arch Ophthalmol, 122, pp.1270~1275 (2004)
- Faucher A., "Accuracy of Goldmann tonometry after refractive surgery", J Cataract Refract Surg, 23, pp.832~838 (1997)
- Mardelli PG., "The effect of excimer laser photorefractive keratectomy on intraocular pressure measurements using the Goldmann applanation tonometer", Ophthalmology, 104, pp.945~948 (1997)
- Boehm AG., "Dynamic contour tonometry in comparison to intracameral IOP measurements", Invest Ophthalmol Vis Sci, 49, pp.2472~2477 (2008)
- Tzamalis A., "Association of ocular hypotensive medication types with dynamic contour tonometry and Goldmann applanation tonometry measurements in a glaucoma and ocular hypertensive population", J Ocul Pharmacol Ther, 29, pp.41~47 (2013)
- Hwang YH., "Central corneal thickness in a Korean population : the Namil Study", Invest Ophthalmol Vis Sci, 53, pp.6851~6855 (2012)
- Hager A., "The influence of corneal hysteresis and corneal resistance factor on the measurement of intraocular pressure", Ophthalmologe, 104, pp.484~489 (2007)
- Oh JH., "The effect of contact lens-induced corneal edema on Goldmann applanation tonometry and dynamic contour tonometry", Graefes Arch Clin Exp Ophthalmol, 247, pp.371~375 (2009)
- Yoo C., "Goldmann applanation tonometry and dynamic contour tonometry in eyes with elevated intraocular pressure(IOP) : comparison in the same eyes after subsequent medical normalization of IOP", Graefes Arch Clin Exp Ophthalmol, 248, pp.1611~1616 (2010)