녹내장 진단에서 스펙트럼 영역 빛간섭단층촬영기로 측정한 황반과 망막신경섬유층 두께의 유용성
Glaucoma Diagnostic Performance of Macular and Retinal Nerve Fiber Layer by Spectral-Domain Optical Coherence Tomography
2
조회
0
다운로드
4
인용
0
참고문헌
키워드
초록
목적: 스펙트럼 영역 빛간섭단층촬영기로 측정한 황반 두께와 시신경유두 주위 망막신경섬유층 두께의 녹내장 진단력을 비교하고자하였다. 대상과 방법: 정상 96안, 초기 녹내장 63안, 진행된 녹내장 37안을 대상으로 스펙트럼 영역 빛간섭단층촬영기로 측정한 황반과 망막신경섬유층 두께의 녹내장을 감별하는 Areas Under the Receiver Operating Characteristics curves (AUCs)를 측정하였고 표준 분류를사용하여 민감도 및 특이도를 알아보았다. 결과: AUC로 측정한 평균 망막신경섬유층 두께는 황반 두께보다 우수한 녹내장 진단력을 보였다(0.914, 0.775, p＜0.001). 초기 녹내장안의 AUC는 각각 0.670, 0.870 (p＜0.001), 진행된 녹내장안은 각각 0.954, 0.990으로(p=0.03), 양군 모두 평균 망막신경섬유층두께가 높았다. 황반 두께는 하외측에서 가장 민감도가 높았다(58%). 결론: Cirrus 스펙트럼 영역 빛간섭단층촬영기로 측정한 황반 두께는 망막신경섬유층 두께에 비해 녹내장 진단력이 우수하지 않았으나함께 사용하여 환자의 상태를 이해하는 데 도움을 줄 것으로 기대한다.
Abstract
Purpose: To compare the performance of glaucoma diagnosis according to the macular and peripapillary retinal nerve fiber layer (RNFL) thicknesses, as determined by spectral domain optical coherence tomography (OCT). Methods: Ninety-six normal, 63 early glaucoma and 37 moderate to advanced glaucomatous eyes were imaged by Cirrus OCT. The areas under the receiver operating characteristics curves (AUCs) of macular and RNFL thicknesses were calculated for discrimination of normal and glaucomatous eyes. The sensitivity and specificity of normative classification of each parameter were assessed. Results: The glaucoma diagnostic capability determined by AUC was greater when based on the peripapillary RNFL than the macular thickness (0.914, 0.775, p<0.001). Both the early and the moderate-to-advanced group showed higher AUCs in peripapillary RNFL thickness (early glaucoma group; 0.870, 0.670, p<0.001, moderate to advanced glaucoma group; 0.990,0.954, p=0.03). The inferior outer sector of macular thickness showed highest sensitivity among the parameters (58%). Conclusions: Although Cirrus OCT applied to determine macular thickness did not outperform that applied to determine peripapillary RNFL thickness in glaucoma diagnosis, applying Cirrus OCT to determine both thicknesses in diagnosis may help in understanding a patient’s status.
참고문헌 (27)
- Quigley HA, "An evaluation of optic disc and nerve fiber layer examinations in monitoring progression of early glaucoma damage", Ophthalmology, 99, pp.19~28 (1992)
- Sommer A, "Clinically detectable nerve fiber atrophy precedes the onset of glaucomatous field loss", Arch Ophthalmol, 109, pp.77~83 (1991)
- Zeyen TG, "Progression of disc and field damage in early glaucoma", Arch Ophthalmol, 111, pp.62~65 (1993)
- Burgansky-Eliash Z, "Optical coherence tomography machine learning classifiers for glaucoma detection: a preliminary study", Invest Ophthalmol Vis Sci, 46, pp.4147~4152 (2005)
- Huang ML, "Development and comparison of automated classifiers for glaucoma diagnosis using Stratus optical coherence tomography", Invest Ophthalmol Vis Sci, 46, pp.4121~4129 (2005)
- Kanamori A, "Comparison of confocal scanning laser ophthalmoscopy, scanning laser polarimetry and optical coherence tomography to discriminate ocular hypertension and glaucoma at an early stage", Graefes Arch Clin Exp Ophthalmol, 244, pp.58~68 (2006)
- Lalezary M, "Baseline optical coherence tomography predicts the development of glaucomatous change in glaucoma suspects", Am J Ophthalmol, 142, pp.576~582 (2006)
- Leung CK, "Comparison of macular and peripapillary measurements for the detection of glaucoma: an optical coherence tomography study", Ophthalmology, 112, pp.391~400 (2005)
- Manassakorn A, "Comparison of retinal nerve fiber layer thickness and optic disk algorithms with optical coherence tomography to detect glaucoma", Am J Ophthalmol, 141, pp.105~115 (2006)
- Medeiros FA, "Evaluation of retinal nerve fiber layer, optic nerve head, and macular thickness measurements for glaucoma detection using optical coherence tomography", Am J Ophthalmol, 139, pp.44~55 (2005)
- Naithani P, "Evaluation of optical coherence tomography and heidelberg retinal tomography parameters in detecting early and moderate glaucoma", Invest Ophthalmol Vis Sci, 48, pp.3138~3145 (2007)
- Nouri-Mahdavi K, "Detection of early glaucoma with optical coherence tomography (StratusOCT)", J Glaucoma, 17, pp.183~188 (2008)
- Parikh RS, "Diagnostic capability of optical coherence tomography (Stratus OCT 3) in early glaucoma", Ophthalmology, 114, pp.2238~2343 (2007)
- Sihota R, "Comparing glaucomatous optic neuropathy in primary open angle and chronic primary angle closure glaucoma eyes by optical coherence tomography", Ophthalmic Physiol Opt, 25, pp.408~415 (2005)
- Ojima T, "Measurement of retinal nerve fiber layer thickness and macular volume for glaucoma detection using optical coherence tomography", Jpn J Ophthalmol, 51, pp.197~203 (2007)
- Tan O, "Mapping of macular substructures with optical coherence tomography for glaucoma diagnosis", Ophthalmology, 115, pp.949~956 (2008)
- Ishikawa H, "Macular segmentation with optical coherence tomography", Invest Ophthalmol Vis Sci, 46, pp.2012~2017 (2005)
- Zeimer R, "Quantitative detection of glaucomatous damage at the posterior pole by retinal thickness mapping. A pilot study", Ophthalmology, 105, pp.224~231 (1998)
- Greenfield DS, "Macular thickness changes in glaucomatous optic neuropathy detected using optical coherence tomography", Arch Ophthalmol, 121, pp.41~46 (2003)
- Park SB, "Comparison of glaucoma diagnostic capabilities of Cirrus HD and Stratus optical coherence tomography", Arch Ophthalmol, 127, pp.1603~1609 (2009)
- Hodapp E, "Clinical decisions in glaucoma", pp.52~61 (1993), The CV Mosby Co
- Mills RP, "Categorizing the stage of glaucoma from pre-diagnosis to end-stage disease", Am J Ophthalmol, 141, pp.24~30 (2006)
- DeLong ER, "Comparing the areas under two or more correlated receiver operating characteristic curves: a nonparametric approach", Biometrics, 44, pp.837~845 (1988)
- Wollstein G, "Comparison of three optical coherence tomography scanning areas for detection of glaucomatous damage", Am J Ophthalmol, 139, pp.39~43 (2005)
- Budenz DL, "Sensitivity and specificity of the Stratus OCT for perimetric glaucoma", Ophthalmology, 112, pp.3~9 (2005)
- Bows C, "Detecting early glaucoma by assessment of retinal nerve fiber layer thickness and visual function", Invest Ophthalmol Vis Sci, 42, pp.1993~2003 (2001)
- 한경은, "정상안압녹내장에서 서로 다른 빛간섭단층촬영기를 이용한 망막신경섬유층의 측정 비교", 대한안과학회지, 50(12), pp.1853~1859 (2009), 대한안과학회