급성 망막중심동맥폐쇄에서의 스펙트럼 영역 빛간섭단층촬영상의 소견
Spectral-Domain Optical Coherence Tomography Findings in Acute Central Retinal Artery Occlusion
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목적: 급성기의 망막중심동맥폐쇄안에서의 스펙트럼 영역 빛간섭단층촬영 영상의 특징을 알아보고자 한다. 대상과 방법: 급성 망막중심동맥폐쇄환자 6명 6안을 대상으로 하였다. 빛간섭단층촬영기로 황반부의 구역별 두께 및 황반부 망막의내외층망막의 두께를 따로 측정하였다. 결과: 황반부종은 직경 3 mm 이내에서 심하였으며 중심과 부종은 없는 도넛 모양을 보였다. 비측의 부종이 이측, 하측, 상측보다 심했다. 신경섬유층과 신경절세포층의 고반사와 외망막층의 저반사가 특징적으로 보였다. 내망막층과 외망막층 모두 비슷한 정도의 부종률을 보였다. 낭포형이나 장액성 황반박리형태의 부종은 없었다. 결론: 급성기의 망막중심동맥폐쇄안에서의 스펙트럼 영역 빛간섭단층촬영에서 내망막층의 부종과증가된 고반사뿐만 아니라 외망막층의 부종도 확인할 수 있었으며 시세포의 내분절과 외분절의 접합부와 망막색소상피세포의 신호는 정상이었다.
Abstract
Purpose: To evaluate spectral-domain optical coherence tomography (SD-OCT) images of acute central retinal artery occlusion (CRAO). Methods: Six eyes of 6 patients who were diagnosed with acute CRAO were enrolled in the present study. The main SD-OCT measurements included macular thickness in the macular cube map and retinal thickness in the 5-line raster map. Results: In acute CRAO, macular thickness increased more than that in the normal fellow eye in all cases. SD-OCT images demonstrated increased reflectivity and thickness in the inner retinal layer, especially in the nerve fiber layer and ganglion cell layer. However, in the outer retinal layer, SD-OCT images disclosed decreased reflectivity and increased thickness. The central subfield thickness area image showed normal reflectivity and thickness. The horizontal cross-sectional image showed relatively the same edema ratio between the inner retinal layer and outer retinal layer thickness. There was no cystoid or serous foveal detachment-type edema. Conclusions: SD-OCT images of CRAO showed increased outer retinal layer thickness and decreased reflectance as well as increased inner retinal layer thickness and reflectance. However, inner segment and outer segment junctions of the photoreceptor and retinal pigment epithelial signal were intact.
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