시신경병증 환자군에서 빛간섭단층촬영기로 측정한 망막신경섬유층 두께와 시력과의 관계
Correlation between Visual Acuity and Retinal Nerve Fiber Layer Thickness in Optic Neuropathies
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목적: 시신경염, 허혈시신경병증, 외상성시신경병증 환자들에서 스펙트럼영역 빛간섭단층촬영기로 측정한 망막신경섬유층 두께와 시력과의 관계를 알아보았다. 대상과 방법: 시신경염, 허혈시신경병증, 외상성시신경병증 환자들 중에서 발병 이후 최소 6개월 이상 경과한 38명을 선정하여 횡단적 단면 연구를 진행하였다. 각 사분면의 망막신경섬유층 두께와 logMAR 최대교정시력과의 관계에 대한 회귀분석을 실시하였다. 결과: 환자들의 최대교정시력과 시신경유두 주위 각각의 사분면에서의 망막신경섬유층 두께는 유의한 상관관계를 보였다. 시신경염에서 위쪽 사분면 망막신경섬유층 두께는 허혈시신경병증과 외상성시신경병증에 비해(p=0.009, 0.003) 통계적으로 유의하게 두꺼웠다. 시신경염 환자의 아래쪽 사분면 망막신경섬유층 두께는 외상성시신경병증에 비해 통계적으로 유의하게 두꺼운 차이를 보였다(p=0.012). 결론: 시신경병증 환자군에서 최대교정시력과 스펙트럼영역 빛간섭단층촬영으로 측정한 망막신경섬유층 두께는 유의한 상관관계를 보였다. 관계식을 이용하면 시신경병증 발병 이후 시력을 예측할 수 있고 시력이상으로 내원했으나 꾀병이 있는 환자를 감별하는 데에도 도움이 될 것으로 생각된다.
Abstract
Purpose: To assess the correlation between retinal nerve fiber layer (RNFL) thickness measured by optical coherence tomography (OCT, Cirrus HD-OCT®) and visual acuity in optic neuritis, ischemic optic neuropathy and traumatic optic neuropathy. Methods: Thirty-eight patients were recruited. RNFL thickness and visual acuity in optic neuritis, ischemic optic neuropathy and traumatic optic neuropathy were measured at least 6 months after the event. The correlation between log MAR best-corrected visual acuity (BCVA) and retinal nerve fiber thickness in each quadrant was analyzed. Results: log MAR BCVA and RNFL thickness of each quadrant in optic neuropathy exhibited a statistically significant correlation. In optic neuritis, RNFL thickness of the superior quadrant was significantly thicker than in ischemic optic neuropathy and traumatic optic neuropathy (p = 0.009, 0.003). In addition, RNFL thickness of the inferior quadrant in optic neuritis was significantly thicker than in traumatic optic neuropathy (p = 0.012). Conclusions: There was a statistically significant correlation between log MAR BCVA and RNFL thickness by OCT in patients with optic neuropathies. The RNFL thickness may predict visual acuity after an optic neuropathy attack and help to differentiate malingering patients with impaired vision loss.
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