표층황반원공에서 유리체절제술의 치료효과와 빛간섭단층촬영을이용한 예후인자
The Evaluation of Prognostic Factors after Vitrectomy for Lamellar Macular Hole Using Optical Coherence Tomography
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목적: 표층황반원공에서 유리체절제술을 통한 황반전막제거술 및 내경계막제거술의 치료효과와 술 전 빛간섭단층촬영상의 예후인자에 대해 알아보고자 하였다. 대상과 방법: 표층황반원공으로 유리체절제술을 통한 황반전막제거술 및 내경계막제거술과 가스충전술(2안)을 받은 26안에 대해 술전 빛간섭단층촬영상에서 예후인자로 생각되는 중심와부근 최대망막두께, 표층황반원공의 최대높이 및 최대직경, 황반층간분리의 최대높이 및 최대직경, 황반중심 기저부의 최소망막두께, 시세포 내절/외절 결손범위를 조사하고 술 후 시력과의 관계를 알아보았다. 결과: 평균관찰기간은 32.2개월이었고, 최대교정시력은 술 전 logMAR 0.47 ± 0.32에서 술 후 0.23 ± 0.23로 유의하게 호전되었다. 술 전 시력과 술 전 빛간섭단층촬영상 기저부 최소망막두께 및 시세포 내절/외절 결손범위가 술 후 시력과 유의한 상관관계를 보인반면에, 중심와부근 최대망막두께, 표층황반원공의 최대높이 및 최대직경, 황반층간분리의 최대높이 및 최대직경은 유의한 상관관계를 보이지 않았다. 결론: 표층황반원공 환자에서 술 전 빛간섭단층촬영상의 기저부 최소망막두께 및 시세포 내절/외절 결손범위는 유리체절제술을 통한황반전막제거술 및 내경계막제거술 후 시력을 예측하는 데 유용한 변수로 판단된다.
Abstract
Purpose: To evaluate the prognostic factors that predict visual outcome after vitrectomy for lamellar macular hole using opticalcoherence tomography (OCT). Methods: This study included 26 eyes that underwent pars plana vitrectomy, epiretinal membrane removal, and internal limitingmembrane peeling for lamellar macular hole. The maximum parafoveal thickness, maximum height and diameter of lamellarmacular hole, maximum height and diameter of intraretinal splitting, thinnest foveal floor thickness, and inner segment/outer segmentdisruption length on preoperative OCT image were investigated for prognostic factors that predict visual outcome. Results: The mean follow-up period was 32.2 months and the mean best corrected visual acuity improved significantly after vitrectomyfrom log MAR 0.47 ± 0.32 to log MAR 0.23 ± 0.23. The postoperative visual acuity correlated significantly with preoperativevisual acuity, thinnest foveal floor thickness and inner segment/outer segment disruption length, but not with maximumparafoveal thickness, maximum height and diameter of lamellar macular hole and maximum height and diameter of intraretinalsplitting. Conclusions: The thinnest foveal floor thickness and inner segment/outer segment disruption length on preoperative OCT imagewere significant prognostic factors.
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