빛간섭단층촬영으로 발견하지 못한 국소적 망막신경섬유층 결손들의 분석 (Analysis of Localized Retinal Nerve Fiber Layer Defects not Detected by Optical Coherence Tomography)

서지정보

· 발행기관 : 대한안과학회
· 수록지 정보 : 대한안과학회지 / 50권 / 4호 / 558 ~ 564페이지
· 저자명 : 한영상, 제승연, 이주은, 이지은, 구기홍, 김수진

초록

목적: 범위가 좁은 국소적 망막신경섬유층(RNFL) 결손 중 망막신경섬유층사진에서는 발견되지만 빛간섭단층촬영(OCT)에서는 발견되지않는 경우들에 대해 분석해 보고자 하였다.
대상과 방법: 망막신경섬유층사진에서는 결손을 보이지만 OCT의 RNFL thickness average analysis에서는 발견되지 않았던 14눈(17곳)을 대상으로 하여, OCT scan image 및 analysis image와 비교분석하였다.
결과: 10° 이하 범위의 망막신경섬유층 결손은 71.4%에서 OCT scan image부터 망막신경섬유층의 감소 부위가 보이지 않았다. 11∼30° 범위의 결손은 모두 scan image에서는 망막신경섬유층의 감소 부위가 확인되었으나, 자동화된 컴퓨터 알고리즘에 의해 두께를측정하는 과정인 analysis image에서는 감소 부위를 나타내지 못하였다.
결론: 국소적 망막신경섬유층 결손이 OCT로 발견하기 어려운 경우는 20° 이하가 대부분이었으며, 10° 보다 좁은 경우는 OCT scan자체의 한계가, 11∼30° 범위의 결손은 RNFL thickness analysis 단계의 문제가 영향을 줄 것으로 생각된다.

영어초록

Purpose: To analyze localized RNFL defect cases that were identified in retinal nerve fiber layer (RNFL) fundus photographsbut not in optical coherence tomography (OCT).
Methods: Analysis of OCT scans and images was performed for 14 eyes (17 locations) that showed localized RNFL defects inRNFL fundus photographs but not in RNFL thickness average analysis.
Results: With respect to the range of RNFL defects, 41.2% were less than 10°, 47.0% were 11 to 20°, and 11.8% were 21 to 30°.
In 71.4% of the RNFL cases the defects were less than 10°and the decrease of RNFL thickness was not readily observable onthe OCT scan images. In all cases of RNFL defects in the 11 to 30°range the decrease in RNFL thickness could be assessedon the OCT scan images. Nonetheless, the decrease of RNFL thickness could not be seen on the OCT analysis images in whichthe results of the RNFL thickness made through an automated computer algorithm were displayed.
Conclusions: The range of localized RNFL defects that were difficult to detect with OCT consisted of those cases that werealmost less than 20°. The limitations of the OCT scan itself in patients with RNFL with an angular width defect less than 10°andthe problems of RNFL thickness analysis processing in patients with an angular width of 11 to 30°may decrease the sensitivityof OCT in diagnosing RNFL defects.

참고자료

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