스펙트럼 빛간섭단층촬영을 이용한 단안성 약시 환자의 유두주위망막신경섬유층, 황반, 황반신경절세포층 두께 분석
The Analysis of Peripapillary RNFL, Macula and Macular Ganglion Cell Layer Thickness in Patients with Monocular Amblyopia Using SD-OCT
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목적: 단안성 약시 환자에서 스펙트럼 빛간섭단층촬영을 이용하여 약시안과 정상안의 유두주위망막신경섬유층, 황반, 황반신경절세포층의 두께를 각각 비교하고자 하였다. 대상과 방법: 사시약시 환자 17명과 정상대조군 17명, 부등시약시 환자 23명과 정상대조군 23명, 총 80명 160안의 유두주위망막신경섬유층, 황반, 황반신경절세포층의 두께를 스펙트럼 빛간섭단층촬영을 이용하여 측정한 후 양안의 차이를 분석하였다. 또한 약시 치료가 시행된 약시 환자군에서 치료 전후에 각층의 두께 변화가 있는지 알아보았다. 결과: 전체 40명의 약시 환자에서 약시안의 유두주위망막신경섬유층, 황반신경절세포층의 평균 두께는 정상안보다 두꺼웠지만 황반 두께는 차이가 없었다(p＜0.001, p＜0.001, p=0.835). 약시군별로는 부등시약시군 23명에서 약시안의 유두주위망막신경섬유층, 황반신경절세포층 평균 두께가 정상안보다 두꺼웠지만 황반 두께는 차이가 없었다(p=0.008, p＜0.001, p=0.986). 사시약시군 17명에서 약시안의 유두주위망막신경섬유층의 평균두께만이 정상안보다 두꺼웠으며, 황반 및 황반신경절세포층의 두께는 차이가 없었다(p=0.016, p=0.752, p=0.241). 사시약시군과 부등시약시군 각각의 정상대조군에서는 각 층의 양안 두께 차이는 없었다. 약시 치료가 시행된 환자에서 치료 전 양안 두께 차이는 치료 후에도 지속되었다. 결론: 단안성 약시 환자에서 약시안의 유두주위망막신경섬유층, 황반신경절세포층의 평균 두께는 정상안보다 두꺼웠지만 황반은 두께 차이가 없었다. 이러한 두께 차이는 약시를 치료한 후에도 지속되었다.
Abstract
Purpose: To determine whether retinal nerve fiber layer (RNFL), macula and macular ganglion cell layer (mGCL)-inner plexiform layer (IPL) thickness differ in the amblyopic and normal fellow eyes of unilateral amblyopic patients using spectral domain optical coherence tomography (SD-OCT). Methods: 80 patients with 160 eyes were included in this study; the distribution of patients was 17 patients with strabismic amblyopia, 17 patients with strabismic non-amblyopia, 23 patients with anisometropic amblyopia, and 23 patients with anisometropic non-amblyopia. Macular, RNFL, and mGCL-IPL thickness were obtained by SD-OCT, and the interocular thickness differences of each group were analyzed. After treatment, the changes of OCT parameters were evaluated in amblyopic patients. Results: Average macular, average RNFL, and average mGCL-IPL thickness of amblyopic eyes were thicker than for normal fellow eyes in amblyopic patients (40 patients total; p < 0.001, p < 0.001, p = 0.002, respectively). In 23 patients with anisometropic amblyopia, average macular, average RNFL, and average mGCL-IPL thickness of amblyopic eyes were thicker than the normal fellow eye (p = 0.008, p < 0.001, p = 0.002). In the 17 patients with strabismic amblyopia, average macular and average RNFL thickness of amblyopic eyes were thicker than the normal fellow eye (p = 0.016, p < 0.006, respectively). No interocular thickness differences were observed in the control groups. Interocular differences between amblyopic and normal eyes remained unchanged after the amblyopic eyes were treated. Conclusions: Average RNFL and average mGCL-IPL thickness of amblyopic eyes were thicker than normal fellow eyes, but no differences were observed for macular in amblyopic patients. There was no change in the OCT parameter in amblyopic eyes after treatment.
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