당뇨환자의 백내장 수술 후 중심황반두께의 변화
The Changes in Central Macular Thickness after Cataract Surgery in Patients with Diabetic Retinopathy
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초록
목적: 당뇨환자에서 당뇨망막병증의 정도에 따라 초음파유화술을 통한 백내장수술 후 중심황반두께의 변화 및 황반부종의 발생률을빛간섭단층촬영을 통해 비당뇨환자와 비교하여 알아보고자 하였다. 대상과 방법: 백내장수술을 받은 당뇨환자군 138안을 술 전 당뇨망막병증의 정도에 따라 다섯 군으로, 그리고 술 전 범망막광응고술을시행 받은 군과 받지 않은 군으로 나누어 비당뇨환자군 34안과 함께 술 전, 술 후 1주일, 1개월, 2개월, 6개월의 중심황반두께의 변화를후향적으로 분석하였다. 결과: 당뇨환자군과 비당뇨환자군에서 백내장수술 후 황반부종의 발생률은 19.6%, 2.9%였다. 당뇨환자군은 비당뇨환자군에 비해 술후 모든 경과관찰에서 중심황반두께가 통계적으로 유의하게 증가하였고(p＜0.05), 술 전 범망막광응고술을 시행 받지 않은 군은 시행받은 군에 비해 술 후 1주일째를 제외한 모든 경과관찰에서 중심황반두께가 유의하게 증가하였다(p=0.005, 0.002, 0.008). 결론: 당뇨환자에서 초음파유화술을 통한 백내장수술 후 중심황반두께 및 황반부종 발생률이 비당뇨환자에 비해 유의하게 증가하고,당뇨망막병증의 정도가 심할수록 황반부종 발생률이 증가한다.
Abstract
Purpose: To evaluate the changes in central macular thickness (CMT) and incidence of macular edema (ME) after cataract surgery in diabetic patients compared with non-diabetic patients using optical coherence tomography (OCT). Methods: The records of 138 diabetic patients and 34 non-diabetic patients who underwent cataract surgery were retrospectively reviewed. The diabetic group was divided into 5 groups according to severity of diabetic retinopathy. The diabetic group was also divided into 2 groups depending on prior panretinal photocoagulation history. The changes in CMT were examined using OCT before cataract surgery and 1 week, 1-, 2- and 6-months after surgery in diabetic and non-diabetic patients. Results: The incidence of ME in the diabetic group and non-diabetic group was 19.6% and 2.9% respectively. The increased amount of CMT (ΔCMT) was significantly greater in the diabetic group compared with the non-diabetic group during the observation period (p < 0.05). The ΔCMT of eyes without a history of panretinal photocoagulation was statistically greater compared to the eyes with a history of panretinal photocoagulation at 1-, 2- and 6-months after cataract surgery (p = 0.005, 0.002, 0.008, respectively). Conclusions: The ΔCMT and incidence of ME were significantly greater in the diabetic group compared with the non-diabetic group. Additionally, the incidence of ME was significantly greater depending on severity of diabetic retinopathy in the diabetic group.
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