연령대에 따른 망막신경섬유층결손의 양상 분석
Comparison of the Detection Rate, Location and Amount of Retinal Nerve Fiber Layer Defect
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목적: 건강검진에서 시행한 안저사진에서 발견된 망막신경섬유층결손의 빈도를 연령별로 비교하고자 하였다. 대상과 방법: 2009년 1월부터 12월까지 건강검진을 받은 22,811명을 대상으로 후향적으로 분석하였다. 연령별로 망막신경섬유층결손이 발견된 비율, 결손의 정도, 위치 및 시야검사로 녹내장이 진단되거나, 녹내장성 시신경유두로 판정된 환자의 비율을 비교하였다. 결과: 망막신경섬유층결손이 발견된 비율은 40세 미만 1.7%, 40대 1.5%, 50대 2.0%, 60세 이상 2.3%로 60세 이상에서 가장 높았다 (p=0.012). 이 중 시야검사에서 또는 녹내장성 시신경유두로 판정되어 녹내장으로 진단된 비율은 40세 미만 1.1%, 40대 0.9%, 50대 1.2%, 60세 이상 1.4%로 60세 이상에서 가장 높게 나타났지만 의미있는 차이는 나타나지 않았다(p=0.070). 결론: 망막신경섬유층결손은 60세 이상에서 가장 높은 빈도로 발견되었지만, 40세 미만에서도 40대, 50대의 수진자와 비슷한 빈도로 나타났다. 이에 따라 안저사진 촬영을 이용한 녹내장 선별 검사는 40세 이전이라도 시행하는 것이 바람직할 것이다.
Abstract
Purpose: To compare the detection rate of the patients with retinal nerve fiber layer (RNFL) defect and the amount of RNFL defect according to the patients’ age. Methods: Retrospective chart reviews of 22,811 subjects, who visited the health care center from January 2009 to December 2009 were performed. The detection rate, location and average amount of RNFL defect and the proportions of the patients who were diagnosed with glaucoma through Humphrey visual field (HVF) test or determined as a glaucomatous optic disc were compared according to the patients’ age. Results: The proportions of the patients whose RNFL defect were detected was highest in the patients 60 years old or older (2.3%) and was statistically significant (p = 0.012). However, there was no significant difference among the other age groups (under 40 years: 1.7%, 40 thru 49 years: 1.5%, 50 thru 59 years: 2.0%). The proportions of the patients who were determined as glaucoma through the HVF test or glaucomatous optic disc were also highest in the patients 60 years old or older (1.4%), however, there was no statistically significant difference (p = 0.070) among the age groups (under 40 years: 1.1%, 40 thru 49 years: 0.9%, 50 thru 59 years: 1.2%). Conclusions: The RNFL defect is likely to be detected in subjects less than 40 years of age and the detection rate is similar to subjects in their 40’s and 50’s. The use of fundus photography to detect RNFL defect in a health care center is recommended in subjects under 40 years of age.
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