스펙트럼 영역 빛간섭단층촬영을 이용한 시신경유두모양에 따른 시신경 유두주위위축 분석
Analysis of Peripapillary Atrophy According to the Optic Disc Shape Using Spectral Domain OCT
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목적: 스펙트럼 영역 빛간섭단층촬영기(SD-OCT)를 이용하여 시신경유두 모양에 따라 시신경 유두주위위축 베타영역(PPA-β)에서 구조적 변화가 있는지에 대해 분석하였다. 대상과 방법: Cirrus HD-OCT를 이용하여 시신경 유두주위위축이 있는 녹내장환자 137명 137안과 정상인 31명 31안에 대해 시신경유두 단면을 촬영하였다. 시신경유두 모양에 따라 녹내장안을 국소성군, 근시성군, 동심성군, 노년경화성군으로 나눈 후 브루크막의 모양, 망막층의 구성, 망막기울기에 대해 정상안과 비교하였다. 결과: 녹내장안은 총 137안 중 국소성 54안, 근시성 34안, 동심성 28안, 노년경화성 21안이었고 정상안은 31안이었다. 근시성군에서브루크막 결함 형태가 높은 빈도를 보였고 망막기울기는 가장 낮은 값(70.6 ± 12.0°)을 보였으며 망막층이 조기에 소실되는 등 두드러진 차이를 보였다. 동심성군에서는 곡선형 브루크막 형태가 높은 빈도를 보였다. 망막기울기는 나이가 증가함에 따라 각도가 커지고,안축장이 길어짐에 따라 각도가 작아지는 유의한 상관관계를 보였다. 결론: 시신경 유두주위위축 베타영역에서 브루크막의 모양, 망막층의 구성, 망막기울기는 시신경유두 모양에 따라 차이를 보였다.
Abstract
Purpose: To analyze the structural changes in the β-zone of peripapillary atrophy (PPA-β) using cross-sectional image of the optic disc head from spectral-domain optical coherence tomography (SD-OCT) according to the optic disc shape. Methods: One hundred thirty-seven eyes in 137 patients with glaucoma having PPA-β and 31 normal eyes (control group)were evaluated retrospectively. Cross-sectional images of the optic disc were taken using the Cirrus HD-OCT. We classified optic disc patterns into normal, focal, myopic, generalized enlargement and senile sclerotic appearance types and analyzed the shape of Bruch’s membrane (BM), composition of retinal layer and retinal slope according to the optic disc shape. Results: Among the 137 eyes with glaucoma, 54 eyes were focal disc type, 34 eyes were myopic disc type, 28 eyes were generalized enlargement disc type and 21 eyes were senile sclerotic disc type. The myopic disc group showed a noticeable difference compared to the other groups in terms of a higher percentage of BM defect type, the lowest retinal slope (70.6 ± 12.0°) and the earlier termination of retinal layers. The generalized enlargement disc group showed the highest percentage of curved BM type. Retinal slope angle increased with age and decreased with axial length. Conclusions: In the β-zone of peripapillary atrophy, there were several differences in the shape of Bruch’s membrane,composition of retinal layers and the retinal slope according to the optic disc shape.
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