한국인 정상안압녹내장 환자에서 안구반응분석기의 진단적 유용성
Diagnostic Availability of Ocular Response Analyzer in Korean Patients with Normal Tension Glaucoma
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목적: 한국인 정상안압녹내장 환자에서 안구반응분석기(Ocular Response Analyzer, ORA)로 측정된 계측치들의 임상적 유용성을 알아본다. 대상과 방법: 전체 200명 200안 중 정상군 100안, 정상안압녹내장군 100안을 대상으로 골드만압평안압, 중심각막두께, corneal hysteresis(CH), corneal resistance factos (CRF), Goldmann-correlated IOP (IOPg), corneal-compensated IOP (IOPcc)를 측정 분석하였다. 결과: CH와 CRF는 정상안압녹내장군에서 유의하게 낮았으며(p<0.001), IOPcc는 높았다(p=0.004). IO Pg는 골드만압평안압과 좋은일치도를 보였고(ICC=0.811), IOPcc는 중심각막두께와 상관관계를 보이지 않았다. 정상안압녹내장에 대한 진단적 기준치로서IOPcc-IOPg의 절단값은 -0.05 mmHg였다. 결론: ORA로 측정된 IOPg는 골드만압평안압과 유사하고, CH, CRF, IOPcc는 정상군과 정상안압녹내장 환자에서 유의하게 달랐다. IOPcc와 IOPg의 차이값은 정상안압녹내장의 진단에 도움이 될 수 있을 것으로 생각한다.
Abstract
Purpose: To compare the parameters measured with the ocular response analyzer (ORA; Reichert Inc., Depew, NY, USA) betweennormal control subjects and patients with normal tension glaucoma (NTG) and to investigate clinical usefulness of ORA. Methods: Intraocular pressure (IOP) and central corneal thickness (CCT) were measured using the Goldmann applanation tonometer(GAT) in 100 eyes of 100 normal subjects and 100 eyes of 100 NTG patients. Four types of ORA parameters, cornealhysteresis (CH), corneal resistance factor (CRF), Goldmann-correlated IOP (IOPg), and corneal-compensated IOP (IOPcc)were also measured. Results: The mean CH values were 11.2 mm Hg and 10.3 mm Hg and the mean CRF values were 10.8 mm Hg and 9.9 mm Hgin the normal subjects group and the NTG group, respectively. Mean CH and CRF were significantly lower in NTG patients (p <0.001) and the IOPcc were higher than normal subjects (p = 0.004). IOPg was in agreement with the GAT IOP (ICC = 0.811) andIOPcc was not correlated with CCT. The cut-off value of ‘IOPcc - IOPg’ as the diagnostic standard parameter was -0.05 mm Hg(sensitivity; 76%, specificity; 55%). Conclusions: IOPg measurements were similar to GAT IOP, and other ORA parameters (CH, CRF, IOPcc) were significantly differentbetween normal subjects and NTG patients. Consequently, the difference of IOPcc and IOPg could be a useful parameterin NTG diagnosis.
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