초광각 주사레이저검안경 영상에 나타나는 망막 외 병변의 특성
The Characteristics of Non-Retinal Lesions in the Ultra-Wide Field Scanning Laser Ophthalmoscope Image
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목적: 초광각 주사레이저검안경을 이용한 안저 영상에서 생기는 망막 외 병변에 의한 음영의 종류 및 특징을 알아보고자 하였다. 대상과 방법: Optomap 200Tx (Optos PLC, Dunfermline, Scotland, UK)를 이용한 컬러 안저 영상 중 망막 외 병변에 의한 음영을보이는 139안을 대상으로 후향적으로 분석하였다. 망막 외의 전안부 또는 유리체의 병변에 의하여 발생하는 고반사 또는 저반사의음영을 망막 외 병변이라 정의하였다. 녹색 및 적색 레이저광 영상과 자가형광안저 영상에서 나타나는 망막 외 병변의 유형을 조사하고 특징을 분석하였다. 결과: 모든 영상의 망막 외 병변은 망막 외 병변의 원인이 되는 병변 위치에 따라 두 군으로 나누었다. 전안부 망막 외 병변으로는각막혼탁, 백내장 등이 있었고 후안부 망막 외 병변으로는 성상유리체증, 후유리체박리, 유리체혼탁, 유리체출혈이 있었다. 앞쪽 망막외 병변은 녹색과 적색 레이저광 모두에서 저반사도로 보이는 경우가 많았다(p-value＜0.001). 뒤쪽 망막 외 병변은 녹색에서는 과반사도로, 적색에서는 저반사도로 보이는 경우가 많았다(p-value＜0.001). 결론: 초광각 주사레이저검안경을 이용한 안저 영상에는 망막 외의 다양한 종류의 전안부 및 후안부 병변에 의한 음영이 포함되어있었다. 이들 음영은 그 기원에 따라 반사도의 차이를 보였다. 이들 특징을 이해하는 것은 안저 영상을 해석하는 데 도움이 될 것이다.
Abstract
Purpose: To evaluate various types and; characteristics of non-retinal lesions associated with ultra-wide field scanning laser ophthalmoscope images. Methods: This retrospective study included 139 eyes of 139 patients with non-retinal lesions observed on color images obtained using Optomap 200Tx (Optos PLC, Dunfermline, Scotland, UK). The non-retinal lesion is a hyperreflective or hyporeflective shadow due to anterior segment of the eye or vitreous except the retina. Types and characteristics of red laser separation, green laser separation and autofluorescence images of non-retinal lesions were evaluated. Results: All non-retinal lesions in images were categorized into 2 groups according to the location of non-retinal lesions. The anterior non-retinal lesions group included corneal opacity, cataract and posterior capsular opacity. The posterior non-retinal lesions group included asteroid hyalosis, posterior vitreous detachment, vitreous opacity and vitreous hemorrhage. Anterior non-retinal lesions were more often hyporeflective in red and green laser separation images (p < 0.001). Posterior non-retinal lesions were more often hyperreflective in green laser separation images and hyporeflective in red laser separation images (p < 0.001). Conclusions: Ultra-wide field scanning laser ophthalmoscope images can frequently have various shadows from anterior or posterior lesions of the eye. These shadows show a difference in reflectivity depending on their origins. To understand the difference helps in the interpretation of the fundus images.
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