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백내장 수술 전후 황반부 신경절세포-내망상층과 망막신경섬유층 측정치의 변화

Comparison of Ganglion Cell-Inner Plexiform Layer and Retinal Nerve Fiber Layer after Cataract Surgery

이평|진경현|한영수
대한안과학회 (The Korean Ophthalmological Society)|2015.04|대한안과학회지 (Journal of The Korean Ophthalmological Society)|제56권 제4호|pp. 485-493|DOI http://dx.doi.org/10.3341/jkos.2015.56.4.485

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키워드

Optical coherence tomographyCataract surgeryGanglion cell-inner plexiform layerGlaucoma diagnosis
주제분류안과학

초록

목적: 백내장 수술 전후 빛간섭단층촬영에서 나타나는 황반부 신경절세포-내망상층과 망막신경섬유층의 측정치의 변화를 비교하고자 하였다. 대상과 방법: 백내장 환자 32명, 46안을 대상으로 수술 전, 수술 후 5주째에 스펙트럼 영역 빛간섭단층촬영을 이용하여 황반부 신경절세포-내망상층(GCIPL)과 망막신경섬유층(RNFL)의 두께를 반복 측정하여 수술 전후의 수치를 비교하였다. 결과: 백내장 수술 후 황반부 신경절세포-내망상층(GCIPL)과 망막신경섬유층(RNFL)의 두께는 모든 부분에서 유의하게 증가하였다(p ＜0.001). RNFL평균 두께의 증가량(14.16%)은 GCIPL의 증가량(7.36%)보다 유의하게 높게 나타났다(p＜0.001). GCIPL과 RNFL 두께및 GCIPL 신호강도 변화는 모든 백내장 유형에서 유의하게 증가하였으며, RNFL의 신호강도 변화는 후낭형 백내장에서 유의하게증가하였다(p＜0.05). 결론: 황반부 신경절세포-내망상층과 망막신경섬유층의 두께의 측정치는 백내장에 유의 있게 영향을 받으며 백내장 수술 후에 증가한다. 황반부 신경절세포-내망상층두께는 백내장에 영향을 덜 받으므로 백내장과 동반한 녹내장에서보다 더 의미 있는 지표일 수있다.

Abstract

Purpose: To observe the change in the measured thickness of ganglion cell-inner plexiform layer (GCIPL) and retinal nerve fiberlayer (RNFL) thickness before and after cataract surgery. Methods: Forty-six eyes of 32 patients, scheduled to have cataract surgery, were imaged with spectral-domain optical coherencetomography (OCT) (Cirrus HD OCT) before and 5 weeks after the surgery to measure GCIPL and RNFL thickness repeatly. Results: All GCIPL and RNFL thickness parameters were significantly higher postoperatively compared with preoperative measurements(p < 0.001). RNFL thickness changed more than GCIPL; the increased amount of mean RNFL thickness (14.16%) washigher than GCIPL thickness (7.36%; p < 0.001). GCIPL and RNFL thicknesses and, GCIPL signal strength changes were significantlyincreased in all types of cataracts (p < 0.05). RNFL signal strength change was significantly increased in posterior subcapsularcataracts (p < 0.05). Conclusions: Cataracts may affect GCIPL and RNFL thicknesses. After cataract surgery, GCIPL thickness, similar to the RNFLthickness, was increased significantly. As GCIPL thickness may be less affected by cataracts than RNFL thickness, GCIPLthickness may be a more meaningful indicator for the diagnosis of glaucoma with cataract.

참고문헌 (24)

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