녹내장 정도에 따라 망막전막이 망막신경섬유층, 신경절세포층, 황반부 두께에 미치는 영향
Effect of ERM on RNFL, GCIPL and Macular Thickness According to the Severity of Glaucoma
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초록
목적: 파장가변 빛간섭단층촬영을 이용하여 망막전막이 녹내장 환자의 시신경유두 주위 망막신경섬유층 두께(peripapillary retinal nerve fiber layer thickness, pRNFLT)와 황반부 신경절세포 및 내망상층 두께(macular ganglion cell-inner plexiform layer thickness, mGCIPLT), 황반부 두께(macular thickness, MT)에 미치는 영향을 알아보고, 녹내장 중등도에 따라 차이가 있는지 확인해보고자 한다. 대상과 방법: 녹내장 환자 중 망막전막을 진단받은 105명 중 105안을 망막전막이 없는 녹내장 환자와 연령, 성별, 백내장수술 여부, 안축장 길이, 시야검사의 mean deviation을 기준으로 일대일 매칭하였다. 두 군을 대상으로 pRNFLT, mGCIPLT 그리고 MT 차이를확인하였으며, 녹내장 중등도에 따라 세 그룹으로 나누어 비교하였다. 결과: 망막전막이 있는 녹내장군은 전체 환자군에서 평균, 이측, 7-11시 pRNFLT 영역에서 망막전막이 없는 군에 비해 두껍게 측정되었다. 모든 녹내장 중등도에서 망막전막이 있는 군이 없는 군에 비해 mGCIPLT, MT가 모든 영역에서 두껍게 측정되었다. 중기 녹내장군에서 초기 녹내장군보다 pRNFLT의 7시, 11시 영역에서 두 군 사이의 두께 차이가 유의하게 컸다(각각 p=0.043, p=0.012). 결론: 망막전막은 pRNFLT, mGCIPLT, MT에 영향을 주며, 녹내장의 중등도에 따라 망막전막이 pRNFLT에 미치는 영향의 정도는 다르다.
Abstract
Purpose: To investigate the effect of an epiretinal membrane (ERM) on peripapillary retinal nerve fiber layer thickness (pRNFLT), macular ganglion cell-inner plexiform layer thickness (mGCIPLT) and macular thickness (MT) in relation to glaucoma severity using swept-source optical coherence tomography (SS-OCT). Methods: In total, 105 eyes of 105 glaucoma patients with ERM were matched at a 1:1 ratio with glaucoma patients without ERM according to age, sex, cataract surgery, axial length and mean deviation based on visual field tests. The differences in pRNFLT, mGCIPLT and MT between the two groups were assessed using SS-OCT. Furthermore, the patients were divided into three glaucoma-severity groups, and the differences in pRNFLT, mGCIPLT and MT were compared between glaucoma patients with and without ERM in each group. Results: In all patients, including those with early, moderate, and advanced glaucoma, those with ERM had greater average, temporal quadrant, and 7, 8, 9, 10, and 11 o’clock pRNFLT values compared to those without ERM. Additionally, mGCIPLT and MT were thicker in glaucoma patients with ERM in all groups. The difference in pRNFLT at the 7 and 11 o’clock positions between glaucoma patients with and without ERM was significantly more pronounced in the moderate glaucoma group than in the early glaucoma group (p = 0.043 and p = 0.012, respectively). Conclusions: ERM has notable effects on the pRNFLT, mGCIPLT and MT. Furthermore, the magnitude of its effect on pRNFLT varies with glaucoma severity.
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