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KMID : 0360220110520040454
대한안과학회지
2011년 52권 4호 p.454 ~ p.461

국소적 망막신경섬유층결손안에서 빛간섭단층촬영의 가음성 결과와 관련된 요인


False Negative Findings of Optical Coherence Tomography in Eyes with Localized Nerve Fiber Layer Defects

강성민 ( Kang Sung-Min ) - 한양대학교 의과대학 안과학교실

엄기방 ( Uhm Ki-Bang ) - 한양대학교 의과대학 안과학교실

Abstract

목적 : 망막신경섬유층촬영에서 국소적 망막신경섬유층결손이 있는 환자가 빛간섭단층촬영(optical coherence tomography, OCT)으로 검출되지 않는 것과 관련된 요인을 알아보고자 하였다.

대상과 방법 : 국소적 망막신경섬유층결손이 있는 시야결손전녹내장 24명과 시야결손녹내장 173명을 대상으로 하였고, OCT로 검출 여부에 따라 두 군으로 나누었다. 성별, 연령, 굴절이상, 당뇨병, 고혈압, 중심각막두께, 녹내장 유형, MD, PSD, 평균망막신경섬유층두 께, 유두면적, 사진의 결손과 관련된 변수(위치, 수, 폭)를 비교하였다.

결과 : 사진의 망막신경섬유층결손 197안 중 51안(25.9%)이 OCT에서는 검출되지 않았다. 사진의 결손과 OCT결손의 폭과 위치는 유의 한 상관관계가 있었다(상관계수 각각 0.98, 0.64). 로지스틱 회귀분석에서 OCT의 가음성과 관련된 요인은 평균망막신경섬유층두께(odds ratio=1.106, 95% 신뢰구간=1.057-1.156, p<0.001), 결손폭(odds ratio=0.929, 95% 신뢰구간=0.884-0.977, p=0.004)이었다.

결론 : 망막신경섬유층의 두께가 두꺼울수록, 결손폭이 좁을수록 OCT로 검출되지 않을 확률이 높았다.
Purpose: To identify the risk factors associated with false negative findings of optical coherence tomography (Stratus OCT) in patients with photographic localized retinal nerve fiber layer (RNFL) defects.

Methods: Twenty-four patients with preperimetric glaucoma and 173 patients with perimetric glaucoma, all with localized RNFL defects were included in the present study. The patients were divided into 2 groups according to the presence or absence of detection of photographic defects by OCT. Gender, age, refractive error, diabetes, hypertension, central corneal thickness, type of glaucoma, mean deviation, pattern standard deviation, average RNFL thickness, disc area, and photographic RNFL defect related variables (location, number, and angular width) were compared between the 2 groups. Each variable was initially evaluated by univariate analysis and significant variables (p < 0.1) were included in the logistic regression analysis.

Results: Photographic RNFL defects were not detected by OCT in 51 (25.9%) of the 197 eyes. The angular locations and widths of RNFL defects by OCT were significantly correlated with those of RNFL defects by red-free RNFL photographs (Pearson correlation coefficient R = 0.98 and 0.64, respectively). Logistic regression analysis revealed the risk factors for false negative findings of OCT included average RNFL thickness (odds ratio = 1.106, 95% confidence interval [CI] = 1.057-1.156, p < 0.001) and angular width of defect (odds ratio = 0.929, 95% CI = 0.884-0.977, p = 0.004).

Conclusions: This present study suggests that false negative findings of OCT in patients with photographic localized RNFL defects were associated with thicker RNFL thickness and smaller angular width of RNFL defect.
KeyWords

Glaucoma, Optical coherence tomography, Retinal nerve fiber layer defect, Risk factor
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