녹내장환자에서 양안 이스터만 시야검사 결과와삶의 질과의 연관성
Assessment of the Vision-Specific Quality of Life Using Binocular Esterman Visual Field in Glaucoma Patients
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목적: 양안 Esterman 시야검사를 이용하여 녹내장 환자에서 시야결손의 정도 및 위치와 환자의 주관적 삶의 질과 연관성을 알아보고자하였다. 대상과 방법: 개방각녹내장을 진단받은 환자 중 양안 모두 시야결손이 있으면서 적어도 한 눈은 중기 이상의 녹내장성 시야결손을 보이는 60명을 대상으로 단안 Humphrey 시야검사 및 양안 이스터만 시야검사와 한국판 시기능 설문지(25-item National Eye Institute Visual function Questionnaire)를 시행하였다. 양안 Esterman 시야검사는 상, 하측 중심시야 10도 이내, 상, 하측 중심시야 30도 이내, 상, 하측 주변부 시야결손으로 분류하여 각 점수와 설문지의 세부항목과 연관성을 비교하였다(spearman correlation). 또한 단안Humphrey 시야검사의 mean deviation 값을 각각 조사하여 양안 Esterman 시야검사와의 연관성을 분석하였다. 결과: 양안 Esterman 시야검사의 전체 점수와 설문지의 전체 점수는 연관성을 보였다(p=0.03). 하측 주변부 시야결손은 설문지 12개세부항목 중 가장 많은 8개 항목에서 연관성을 보였다(p＜0.05). 특히 세부항목 중 ‘전반적인 시력’ 항목과 연관성을 보인 곳은 하측10도 이내 시야결손이었고(p=0.011), ‘운전’ 항목과 연관성을 보인 곳은 상측 주변부 시야결손이었다(p=0.038). Humphrey 시야검사에서 측정한 나쁜 눈의 MD 수치는 설문지 전체 점수와 유의한 연관성을 보였다(p=0.008). 결론: 녹내장 환자의 삶의 질과 시기능을 평가하는데 양안 Esterman 시야검사가 간편하고 유용하게 사용될 수 있다.
Abstract
Purpose: To investigate the correlation of binocular visual field (VF) with vision-specific quality of life in glaucoma patients. Methods: Sixty patients who were diagnosed as open-angle glaucoma were recruited for the present study. The patients had at least moderate VF defect in 1 eye. VF testing was performed using the unilateral Humphrey Field Analyzer (HFA)and binocular Esterman VF test which was divided into 6 clusters: upper and lower center 10’, upper and lower center 30’, and upper and lower periphery. The 25-item National Eye Institute Visual Function Questionnaire (VFQ) was used to evaluate patients’ vision-specific quality of life. We analyzed the correlation between the efficiency score of each cluster from binocular Esterman VF test, mean deviation of HFA, and the scores of VFQ (Spearman correlation). Results: The correlation between the composition score of VFQ and total score of binocular Esterman visual field test was significant. The highest correlation was observed in the lower periphery cluster (all p < 0.05). For general vision, the lower center 10’ visual field was strongly correlated (p = 0.011), and for driving, the upper peripheral visual field was the strongest correlated (p = 0.038). The level of mean deviation in the worse eye showed significant correlation with composition score of questionnaire (p = 0.008), otherwise the level of mean deviation in the better eye did not show any significant correlation (p > 0.05). Conclusions: Binocular Esterman VF test is an easy and effective way to evaluate the vision-specific quality of life in glaucoma patients.
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