당뇨황반부종에서 시간과 스펙트럼 도메인 빛간섭단층촬영으로 측정한 황반두께의 반복성과 일치도
Repeatability and Agreement of Macular Thickness Measurement Using Time and Spectral Domain OCT in Diabetic Macular Edema
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목적: 당뇨황반부종 환자에서 time domain (TD) OCT와 spectral domain (SD) OCT로 황반두께와 총황반부피를 측정해 반복성과 일치도를 비교해 보고자 하였다. 대상과 방법: 당뇨황반부종 42명, 42안을 대상으로 TD OCT와 SD OCT로 3회 연속 황반두께와 총황반부피를 측정하여 비교하였다. 개체내 표준편차, 변동계수, 급내상관계수로 반복성을, Bland Altman plot으로 일치도를 평가하였다. 또한 Pearson 상관계수를 통해두 OCT 사이의 상관관계를 알아보았다. 결과: TD OCT와 SD OCT로 측정한 중심와두께, 총황반부피의 개체내 표준편차는 각각 29.67 μm/16.44 μm, 1.26 mm3/0.23 mm3로SD OCT에서 유의하게 낮았다. 변동계수와 급내상관계수는 TD OCT에서 각각 2.92%, 0.92이었고, SD OCT에서 각각 1.39%, 0.95이었다. 중심와두께와 총황반부피의 95% 일치도 범위는 각각 88.9 μm, 2.4 mm3이었다. 두 OCT 사이의 모든 황반두께와 총황반부피는통계적으로 유의한 상관관계를 보였다(p=0.88-0.99). 결론: 당뇨황반부종에서 두 OCT로 측정한 황반두께 및 황반부피는 높은 신뢰성을 보이나 SD OCT에서 더 높은 반복성을 보였다. 두OCT로 측정한 황반두께 및 황반부피는 낮은 일치도를 보여 상호 교환적이지 않았으나 두 OCT간 유의한 상관관계를 보였다.
Abstract
Purpose: To evaluate the repeatability of macular thickness measurements using time domain (TD) OCT and spectral domain (SD) OCT in diabetic macular edema. Methods: In 42 eyes of 42 patients with diabetic macular edema, three consecutive macular measurements were performed with TD OCT and SD OCT, and measurements for macular thickness and total macular volume obtained by the two OCTs were compared. The within-subject standard deviation (Sw), coefficient of variation (CVw), and intraclass correlation coefficient (ICC)were calculated to assess repeatability, with agreement between measurements assessed with Bland Altman plots. The correlations were also evaluated via the Pearson’s correlation coefficient. Results: The Sw of TD OCT and SD OCT for foveal thickness, total macular volume were 29.67 μm/16.44 μm, 1.26 mm3/0.23 mm3, respectively, and were significantly lower in SD OCT. The ranges of the respective CVw and ICC values were 1.10-2.78%,0.78~0.96 for TD OCT, and 0.29~0.94%, 0.92~0.99 for SD OCT. The SD OCT showed better repeatability for macular thickness measurements (all p≤0.001). The 95% limits of agreement for foveal and total macular volume were 88.9 μm, 2.4 mm3,respectively. The Pearson’s correlation coefficients of macular thickness and total macular volume between the two OCT methods were statistically significant (p=0.88-0.99). Conclusions: Although both OCTs proved reliable for macular thickness measurements in diabetic macular edema, SD OCT shows better repeatability than TD OCT. Although macular thickness measurements obtained from the two OCTs cannot be used interchangeably, there were statistically significant correlations between measurements obtained using the two OCTs.
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