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근시안에서 나이에 따른 시신경유두주위 망막신경섬유층 두께 분포의 변화

Changes of Peripapillary Retinal Nerve Fiber Layer Thickness Profile According to Aging in Myopic Eyes

유영철|배은진
대한안과학회 (The Korean Ophthalmological Society)|2013.07|대한안과학회지 (Journal of The Korean Ophthalmological Society)|제54권 제7호|pp. 1066-1073

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참고문헌

키워드

AgingMyopiaGlaucomaRetinal nerve fiber layer (RNFL)Stratus OCT
주제분류안과학

초록

목적: 근시안에서 나이에 따른 시신경유두주위 망막신경섬유층 두께 분포의 변화를 빛간섭단층촬영을 통해 알아보고자 한다. 대상과 방법: 근시가 있는 긴 안구길이(≥24.5 mm)의 정상안 64명을 20-39세, 40-59세의 두 군으로 구분한 뒤, 각 군 환자의 우안을안구길이 차가 0.5 mm 미만이 되도록 일대일로 대응해 최종 42명을 연구 대상으로 하였다. 빛간섭단층촬영기로 망막신경섬유층 두께를 측정하여 상하측 최대두께를 보이는 지점의 각도, 평균분석지표 및 위양성률을 두 군 사이에 비교하였다. 결과: 망막신경섬유층의 두께분포는 두 군 모두 두 개의 봉우리 모양을 보였고, 젊은 근시안에서는 안구길이 증가에 따라 두 봉우리의이측 이동을 보였으나, 중장년 근시안에서는 보이지 않았다. 1, 7, 8시 시분역에서 중장년 근시안의 망막신경섬유층 두께가 젊은 근시안보다 유의하게 낮았다(p≤0.02). 정상인의 5% 미만에 해당하는 망막신경섬유층두께 이상의 위양성률은 두 군간 유의한 차이가 없었다. 결론: 안구길이 증가에 따른 망막신경섬유층 두께 분포 변화는 중장년 근시안에서 젊은 근시안보다 상대적으로 덜 관찰되었다. 근시안에서 빛간섭단층촬영기를 이용한 녹내장 진단시 이러한 결과가 고려되어야겠다.

Abstract

Purpose: To evaluate the effects of age on the distributional variability of peripapillary retinal nerve fiber layer (RFNL)thickness measured by optical coherence tomography (OCT) in myopia. Methods: Only the right eye of 64 myopic patients with long axial length (≥24.5 mm) was included in the present study. The patients were divided into 2 age groups, 20 to 39 years of age and 40 to 59 years of age. Eventually, 42 subjects were selected and matched based on the difference of axial length not exceeding 0.5 mm between subjects in each group. The RFNL thickness was measured using Stratus OCT and average thickness, angular locations of double humps, and false-positive rate were compared. Results: In both groups, the distribution of RNFL thickness in a double hump pattern was observed, which had a deviation to the temporal side only in the younger myopic eye group, but not in the middle-aged group. The middle-aged group had significantly thinner RNFL in 1, 7, and 8 clock-hour sectors compared to the younger myopic eyes (p ≤ 0.02). Probability of abnormal OCT parameters at the 5% level of the 2 groups with the built-in RNFL normative database was not significantly different. Conclusions: The variability of RFNL thickness distribution related to axial length was less observed in the middle-aged group than the younger-aged group. These results should be considered in glaucoma diagnosis when using OCT.

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