<31352D30392D303128C0E5BFB5BCAE2DB1E8C3BBC8AF E687770>

Size: px

Start display at page:

Download "<31352D30392D303128C0E5BFB5BCAE2DB1E8C3BBC8AF E687770>"

아령 지
4 years ago
Views:

1 대한안과학회지 2016 년제 57 권제 2 호 J Korean Ophthalmol Soc 2016;57(2): ISSN (Print) ISSN (Online) Original Article 스펙트럼영역빛간섭단층촬영을이용한한국인의연령과성별에따른황반부층별두께연구 Analysis of Macular Layer Thickness Measured Using Spectral Domain Optical Coherence Tomography in Korean Subjects 김청환 1 진선영 1 이영훈 1 장영석 1,2 Chung Hwan Kim, MD 1, Sun Young Jin, MD 1, Young Hoon Lee, MD 1, Young Suk Chang, MD 1,2 건양대학교의과대학안과학교실 1, 건양대학교명곡의과학연구소 2 Department of Ophthalmology, Konyang University College of Medicine 1, Daejeon, Korea Myunggok Medical Research Institute, Konyang University 2, Daejeon, Korea Purpose: To analyze macular layer thickness using spectral domain optical coherence tomography (SD-OCT) in normal subjects. Methods: One hundred normal eyes were enrolled in this study. Macular thickness was measured via enhanced depth imaging using Heidelberg Spectralis OCT, using calipers within the program. Results: Central subfield thickness was ± 2.11 μm in the retinal nerve fiber layer, ± 4.16 μm in the ganglion cell layer, ± 3.20 μm in the plexiform layer, ± 4.66 μm in the nuclear layer, 23.27± 6.83 μm in the plexiform layer, ± 9.59 μm in the nuclear layer, ± 1.83 μm in the retinal pigment epithelium layer, ± μm in the retinal layer, and ± 2.81 μm in the photoreceptors layer. No significant differences were observed in the spherical equivalent according to age. Despite no significant differences being present, the macular central subfield thickness was th in women than in men. Conclusions: In the present study, differences in macular layer thickness were found according to age and gender which should be considered when macular diseases are evaluated. J Korean Ophthalmol Soc 2016;57(2): Keywords: Korean normal subjects, Macular layer thickness, Spectral domain optical coherence tomography 황반부두께의측정과분석은여러원인들로인한황반부종, 망막이영양증, 황반변성, 황반원공등다양한안과 Received: Revised: Accepted: Address reprint requests to Young Suk Chang, MD Department of Ophthalmology, Konyang University Hospital, #158 Gwanjeodong-ro, Seo-gu, Daejeon 35365, Korea Tel: , Fax: happycys@kyuh.ac.kr * This work was supported by Konyang University Myunggok Research Fund of 질환의진단및치료에매우유용하게사용되고있다. 이러한망막의두께를측정하기위해안저검사를통한주관적방법, 병리조직학적방법, 초음파, 망막두께분석기 (retinal thickness analyzer), 빛간섭단층촬영기 (optical coherence tomography, OCT) 등임상에서다양한방법들이적용되어왔다. 1 이중빛간섭단층촬영은망막두께를객관적으로평가할수있는검사로서지난십여년동안급속도로발전하여기존에는초당 400회의스캔을하여약 8-10 µm의축해상도 (axial resolution) 를가진시간영역빛간섭단층촬영기 (time domain optical coherence tomography, TD-OCT) 가널리이 c2016 The Korean Ophthalmological Society This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. 264

2 - 김청환외 : 정상인의황반부각층별평균두께 - 용되었으나최근에는푸리에변환 (Fourier transform) 을통해영상을얻어속도가더빠르고해상도가더좋은스펙트럼영역빛간섭단층촬영기 (Spectral domain optical coherence tomography, SD-OCT) 가개발되어보편화되고있다. 최근개발된스펙트럼영역빛간섭단층촬영 (SD-OCT) 은시세포내분절과외분절의접합부 (Inner segment/outer segment junction) 뿐만아니라망막층별로두께측정을할수있게만들어주었고, 이를바탕으로황반의구조를연구하는데큰도움이되고있다. 2 또한스펙트럼영역빛간섭단층촬영기는기존의시간영역빛간섭단층촬영기가측정하지못하였던맥락막의두께를측정할수있으며시간영역빛간섭단층촬영기에비하여황반두께의측정에있어재현성이더뛰어난결과를보이고있다. 스펙트럼영역빛간섭단층촬영기로망막 10개층의두께를객관적으로측정하는것은망막질환의위험성을예견하고경과를관찰하며치료의효과를판정할수있는근거가되어임상적으로매우중요하고, 망막의층을구분하고그형태를관찰하는일은망막질환의연구및진단에있어필수적인요소가되었다. 스펙트럼영역빛간섭단층촬영기로정상황반의두께, 형태, 연령에따른변화등은보고된바가있지만 1,3 아직황반부층별각각에대한정상두께는아직국내에보고된바가없다. 따라서한국정상인에실시한검사측정치를제시함으로써임상에서광범위하거나국소적인망막질환의진단에도움을주고또한연구에있어서기초자료로사용하고자한다. 대상과방법 대상군은 2015년 3월에서 7월까지 20대부터 60대지원자남녀각각 5명, 총 50명, 100안을대상으로하였다. 지원자에대한연구는헬싱키선언을준수하여시행되었고, 건양대학교병원임상시험심사위원회의심의및승인 (No ) 을받았다. 대상자의연령은 20세부터 69세사이로선정하였고, 대상군은최대교정시력 1.0 이상, 굴절력구면대응치 (spherical equivalent) ±6디옵터이하, 정상안압, 정상안저소견및세극등현미경과안저검사상이상이없는경우를연구대상으로하였다. 다음과같은이상소견이관찰되는경우대상에서제외하였다. 굴절교정수술을받은병력이있는경우, 망막두께에영향을줄수있는당뇨, 고혈압, 신경학적질환의병력이있는경우, 세극등현미경, 또는자동시야검사에서비정상소견을보이는경우연구대상에서제외하였고, 한눈이라도안과적이상이관찰된경우연구대상에서제외하였다. 대상자모두 Heidelberg Spectralis (Spectralis; Heidelberg Figure 1. ETDRS subfields within standard 1-, 3-, and 6-mm diameter concentric circles at the right used for reporting retinal thickness (central circle: F, ring: SI+NI+II+TI, ring: SO+NO+IO+TO). ETDRS = Early Treatment of Diabetic Retinopathy Study; F = fovea; SI = superior ; NI = nasal ; II = inferior ; TI = temporal ; SO = superior ; NO = nasal ; IO = inferior ; TO = temporal. Engineering, Heidelberg, Germany) OCT 로 Enhanced depth image를얻었고, Heidelberg eye Software (version , Heidelberg Engineering, Heidelberg, Germany) 에서제공하는영상분할과황반두께지도기능을이용하여측정하였다. 황반두께지도는 early treatment of diabetic retinopathy study (ETDRS) 9개구역의개념을이용하여중심와에서 6 mm 직경이내의황반부각층의두께를나타내준다. ETDRS subfield는중심오목을기준으로하는 1 mm, 3 mm, 6 mm 직경의 3개의동심원을만들고중심원 (central circle), 안쪽원 ( ring), 바깥쪽원 ( ring) 으로구분한후안쪽원과바깥쪽원구역은각각상측, 비측, 하측, 이측의 4분역으로다시나누어져총 9개의구역으로구성되어있다 (Fig. 1). 본연구에서는망막 9개의층별에따라 ETDRS subfield 의각구역별로계산된수치인평균두께값을이용 (Heidelberg Eye software manual) 하였고, 환자의연령, 성별에따른결과를분석하고자하였다. 통계분석은 SPSS 15.0 (SPSS Inc., Chicago, IL, USA) 을이용하여대상군내의성별, 연령에따른차이는 Independent sample t-test와 Partial correlation analysis 를이용하여비교하였다. p-value 가 0.05 미만인경우에만통계적으로유의한것으로판정하였다. 265

3 - 대한안과학회지 2016 년제 57 권제 2 호 - 결 과 대상군은 20 대부터 60 대까지연령대별로남녀각각 5 명 Table 1. Demographics of patients Characteristic Subjects Patients (n) 50 (male/female) 25/25 Eyes (right/left) 50/ ± Spherical equivalent (diopter) ± 1.75 s are presented as mean ± SD unless otherwise indicated. 씩총 50명, 100안이었다. 대상군의평균연령은 ± (22-66) 세였으며, 평균굴절대응치는 ± 1.75디옵터였다 (Table 1). 망막신경섬유층 (retinal nerve fiber layer, RNFL) 에서중심황반두께 (central subfield thickness) 는 ± 2.11 μm, 평균상부내측두께 (average superior thickness) 는 ± 2.97 μm, 평균비측내측두께 (average nasal thickness) 는 ± 3.99 μm, 평균하부내측두께 (average inferior thickness) 는 ± 6.91 μm, 평균이측내측두께 (average temporal thickness) 는 ± 2.50 μm, 평균상부외측두께 (average superior thickness) 는 Table 2. Macular subfield thicknesses at retinal nerve fiber layer Superior Superior Male Mean SD Mean SD Mean SD Mean SD Mean SD Total Mean SD Female Mean SD Mean SD Mean SD Mean SD Mean SD Total Mean SD Overall Mean SD Mean SD Mean SD Mean SD Mean SD Total Mean SD

4 - 김청환외 : 정상인의황반부각층별평균두께 - Table 3. Macular subfield thicknesses at ganglion cell layer Superior Superior Male Mean SD Mean SD Mean SD Mean SD Mean SD Total Mean SD Female Mean SD Mean SD Mean SD Mean SD Mean SD Total Mean SD Overall Mean SD Mean SD Mean SD Mean SD Mean SD Total Mean SD ± 4.14 μm, 평균비측외측두께 (average nasal thickness) 는 ± 4.53 μm, 평균하부외측두께 (average inferior thickness) 는 ± 9.60 μm, 평균이측외측두께 (average temporal thickness) 는 ± μm 였다 (Table 2). 신경절세포층 (ganglion cell layer, GGCL) 에서중심황반두께는 ± 4.16 μm, 평균상부내측두께는 ± 4.56 μm, 평균비측내측두께는 ± 5.21 μm, 평균하부내측두께는 ± 4.61 μm, 평균이측내측두께는 ± 6.63 μm, 평균상부외측두께는 ± 2.85 μm, 평균비측외측두께는 ± 3.58 μm, 평균하부외측두께는 ± 2.76 μm, 평균이측외측두께는 ± 3.52 μm였다 (Table 3). 내망상층 ( plexiform layer, IPL) 에서중심황반두께는 ± 3.20 μm, 평균상부내측두께는 ± 2.82 μm, 평균비측내측두께는 ± 3.09 μm, 평균하부내측두께는 ± 2.89 μm, 평균이측내측두께는 ± 3.58 μm, 평균상부외측두께는 ± 2.13 μm, 평균비측외측두께는 ± 2.83 μm, 평균하부외측두께 ± 2.50 μm, 평균이측외측두께는 ± 2.53 μm였다 (Table 4). 내핵층 ( nuclear layer, INL) 에서중심황반두께는 267

5 - 대한안과학회지 2016 년제 57 권제 2 호 - Table 4. Macular subfield thicknesses at plexiform layer Superior Superior Male Mean SD Mean SD Mean SD Mean SD Mean SD Total Mean SD Female Mean SD Mean SD Mean SD Mean SD Mean SD Total Mean SD Overall Mean SD Mean SD Mean SD Mean SD Mean SD Total Mean SD ± 4.66 μm, 평균상부내측두께는 ± 4.04 μm, 평균비측내측두께는 ± 3.63 μm, 평균하부내측두께는 ± 3.91 μm, 평균이측내측두께는 ± 4.87 μm, 평균상부외측두께는 ± 2.24 μm, 평균비측외측두께 ) 는 ± 2.43 μm, 평균하부외측두께는 ± 2.20 μm, 평균이측외측두께는 ± 2.36 μm였다 (Table 5). 외망상층 ( plexiform layer, OPL) 에서중심황반두께는 23.27± 6.83 μm, 평균상부내측두께는 ± μm, 평균비측내측두께는 ± 5.99 μm, 평균하부내측 두께는 ± μm, 평균이측내측두께는 ± 7.31 μm, 평균상부외측두께는 ± 3.36 μm, 평균비측외측두께는 ± 2.61 μm, 평균하부외측두께는 ± 3.48 μm, 평균이측외측두께는 ± 3.52 μm였다 (Table 6). 외핵층 ( nuclear layer, ONL) 에서중심황반두께는 ± 9.59 μm, 평균상부내측두께는 ± μm, 평균비측내측두께는 ± 8.66 μm, 평균하부내측두께는 ± μm, 평균이측내측두께는 ± μm, 268

6 - 김청환외 : 정상인의황반부각층별평균두께 - Table 5. Macular subfield thicknesses at nuclear layer Superior Superior Male Mean SD Mean SD Mean SD Mean SD Mean SD Total Mean SD Female Mean SD Mean SD Mean SD Mean SD Mean SD Total Mean SD Overall Mean SD Mean SD Mean SD Mean SD Mean SD Total Mean SD 평균상부외측두께는 ± 6.22 μm, 평균비측외측두께는 ± 6.24 μm, 평균하부외측두께 ± 6.65 μm, 평균이측외측두께는 ± 7.44 μm였다 (Table 7). 망막색소상피층 (retinal pigment epithelium layer, RPEL) 에서중심황반두께는 ± 1.83 μm, 평균상부내측두께는 ± 1.34 μm, 평균비측내측두께는 ± 1.26 μm, 평균하부내측두께는 ± 1.34 μm, 평균이측내측두께는 ± 1.54 μm, 평균상부외측두께는 ± 1.00 μm, 평균비측외측두께는 ± 1.07 μm, 평균하부외측두께 는 ± 1.04 μm, 평균이측외측두께는 ± 1.20 μm 였다 (Table 8). 내망막층 ( retinal layer, IRL) 에서중심황반두께는 ± μm, 평균상부내측두께는 ± μm, 평균비측내측두께는 ± μm, 평균하부내측두께는 ± μm, 평균이측내측두께는 ± μm, 평균상부외측두께는 ± μm, 평균비측외측두께는 ± μm, 평균하부외측두께는 ± μm, 평균이측외측두께는 ±

7 - 대한안과학회지 2016 년제 57 권제 2 호 - Table 6. Macular subfield thicknesses at plexiform layer Superior Superior Male Mean SD Mean SD Mean SD Mean SD Mean SD Total Mean SD Female Mean SD Mean SD Mean SD Mean SD Mean SD Total Mean SD Overall Mean SD Mean SD Mean SD Mean SD Mean SD Total Mean SD μm였다 (Table 9). 광수용체층 (photoreceptors layer, PRL) 에서중심황반두께는 ± 2.81 μm, 평균상부내측두께는 ± 2.71 μm, 평균비측내측두께는 ± 2.69 μm, 평균하부내측두께는 ± 2.49 μm, 평균이측내측두께는 ± 2.76 μm, 평균상부외측두께는 ± 2.53 μm, 평균비측외측두께는 ± 2.43 μm, 평균하부외측두께는 ± 2.23 μm, 평균이측외측두께는 ± 2.47 μm였다 (Table 10). 고찰 황반부의상태를간접적으로나타내는황반부두께는시력과유의한상관관계를가지기때문에황반부두께의평가는여러황반질환의진단및경과관찰에있어매우유용한방법중하나이다. 4 또한시신경유두주위망막신경섬유층두께의분석은녹내장의조기진단및치료효과의측정에있어매우중요하다. 이러한망막의두께를측정하고정확히평가하기위해서는정상망막두께의범위를알고이에영향을주는인자에대한이해가필요하다. 270

8 - 김청환외 : 정상인의황반부각층별평균두께 - Table 7. Macular subfield thicknesses at nuclear layer Superior Superior Male Mean SD Mean SD Mean SD Mean SD Mean SD Total Mean SD Female Mean SD Mean SD Mean SD Mean SD Mean SD Total Mean SD Overall Mean SD Mean SD Mean SD Mean SD Mean SD Total Mean SD OCT를이용한다른연구에서중심황반두께는연령이증가함에따라감소한다는보고가있으나유의한차이가없다는보고도있다 Kang et al 11 은 OCT III (OCT model 3000, Zeiss-Humphrey, Dublin, CA, USA) 를이용하여 112안의정상한국인을분석한결과중심와를제외한영역에서연령이증가함에따라황반두께는감소한다고하였다. Kim et al 12 은정시안 162안을대상으로 Cirrus HD-OCT (Carl Zeiss Meditec Inc., Dublin, CA, USA) 를이용하여 ETDRS의 9개 subfield 방법으로측정하였는데중 심와를중심으로직경 1 mm 이내인중심원 (central circle) 에서의평균황반두께는연령에따른차이가없다고하였다. 본연구에서는황반부모든층에서연령에따른유의한차이가없었다. 하지만연령이다른여러사람을분석한것이므로, 연령에따른황반두께변화추세를알려면한개인을장기간지속적, 반복적으로측정하여분석하는연구가필요하다. 또한성별에따른황반두께에관한연구에서는남성이여성보다황반두께가더두껍다는결과가대부분을차지 271

9 - 대한안과학회지 2016 년제 57 권제 2 호 - Table 8. Macular subfield thicknesses at retinal pigment epithelium layer Superior Superior Male Mean SD Mean SD Mean SD Mean SD Mean SD Total Mean SD Female Mean SD Mean SD Mean SD Mean SD Mean SD Total Mean SD Overall Mean SD Mean SD Mean SD Mean SD Mean SD Total Mean SD 한다. 6,13-15 하지만황반의어느부분이성별에따라차이가있는지는연구마다다른결과를보이고있다. Song et al 6 은여성이남성에비해작은중심황반두께, 평균내측황반두께, 전체황반부의평균부피를보인다고하였으나, Duan et al 14 은황반중심두께, 평균내측황반두께, 평균외측황반두께가작다고하였다. 반면에 Wong et al 13 과 Massin et al 15 은황반중심두께만이차이를보인다고보고하였다. 연구마다차이는있지만대부분의연구에서공통된결과는여성이남성에비해얇은중심황반두께를보인다는것이다. 본연구에서도중심황반의각층에서여성이남성에비해유의하지는않았으나얇은두께를보였다. 이러한성별에따른황반두께의차이를설명하기위하여남녀간의 신체질량지수 (body mass index) 12, 호르몬분비의차이 13 등다양한가설이제기되었지만추가연구가필요하며, 남성보다여성의중심황반이얇아서황반원공의빈도가높다고설명하기도한다. 16,17 Lim et al 18 은근시안을대상으로 1세대 OCT (OCT 1; Carl Zeiss Meditec Inc., Dublin, CA, USA) 를이용한연구에서근시의정도와평균황반두께간에는상관관계를보이지않는다고보고하였다. 이후에 2세대 OCT (Humphrey 2000 OCT system; Carl Zeiss Meditec Inc., Dublin, CA, USA) 와망막두께분석기를이용한연구에서도동일한결과를보고하였다. 7,19 본연구에서는연구대상자들의평균구면대응치 (spherical equivalent) 는 ± 1.75디옵터이 272

10 - 김청환외 : 정상인의황반부각층별평균두께 - Table 9. Macular subfield thicknesses at retinal layer Superior Superior Male Mean SD Mean SD Mean SD Mean SD Mean SD Total Mean SD Female Mean SD Mean SD Mean SD Mean SD Mean SD Total Mean SD Overall Mean SD Mean SD Mean SD Mean SD Mean SD Total Mean SD 고, 구면대응치의차이가크지않았으며, 근시에따른각층의두께는유의한차이를보이지않았다. 본연구에서황반부두께측정을위해사용한 ETDRS의 9개 subfield 연구는구역별평균두께만알수있기때문에황반의구체적인형태를파악할수없고, 또한 ETDRS subfield는당뇨에의한변화를평가하기위해망막의범위를나눈것이기때문에황반의형태를분석하기에는제한점이있다. 하지만본연구는이전에측정하지못하였던황반부의 9개층별두께를측정하였다는것에의의가있다고하 겠다. 황반을침범하는여러가지질환들을이해하기위해황반의형태를분석하는연구가지속되고있는데본연구에서는정상한국인의연령및성별에따른황반부각층별두께를스펙트럼영역빛간섭단층촬영기를통해알수있었다. 이런황반형태의차이는황반질환의발생에도관련이있는것으로알려져있어서앞으로황반질환의형태를평가하는데있어본연구자료가좋은참고가될수있을것이다. 273

11 - 대한안과학회지 2016 년제 57 권제 2 호 - Table 10. Macular subfield thicknesses at photoreceptors layer Superior Superior Male Mean SD Mean SD Mean SD Mean SD Mean SD Total Mean SD Female Mean SD Mean SD Mean SD Mean SD Mean SD Total Mean SD Overall Mean SD Mean SD Mean SD Mean SD Mean SD Total Mean SD REFERENCES 1) Lee YJ. Analysis of factors associated with variability in measures obtained by spectral domain optical coherence tomography. J Korean Ophthalmol Soc 2012;53: ) Ko TH, Fujimoto JG, Schuman JS, et al. Comparison of ultrahighand standard-resolution optical coherence tomography for imaging macular pathology. Ophthalmology 2005;112:1922.e ) Chae MB, Kim JS. shape according to age and gender using spectral domain optical coherence tomography. J Korean Ophthalmol Soc 2014;55: ) Nussenblatt RB, Kaufman SC, Palestine AG, et al. Macular thickening and visual acuity. Measurement in patients with cystoid macular edema. Ophthalmology 1987;94: ) Ko BW, Shin YW, Lee JM, et al. Comparison of macular thickness measurements between fourier-domain and time-domain optical coherence tomography in normal eyes and eyes with macular diseases. J Korean Ophthalmol Soc 2009;50: ) Song WK, Lee SC, Lee ES, et al. Macular thickness variations with sex, age, and axial length in healthy subjects: a spectral domain-optical coherence tomography study. Invest Ophthalmol Vis Sci 2010;51:

12 - 김청환외 : 정상인의황반부각층별평균두께 - 7) Zou H, Zhang X, Xu X, Yu S. Quantitative in vivo retinal thickness measurement in chinese healthy subjects with retinal thickness analyzer. Invest Ophthalmol Vis Sci 2006;47: ) Kanai K, Abe T, Murayama K, Yoneya S. Retinal thickness and changes with age. Nihon Ganka Gakkai Zasshi 2002;106: ) Neuville JM, Bronson-Castain K, Bearse MA Jr, et al. OCT reveals regional differences in macular thickness with age. Optom Vis Sci 2009;86:E ) Guedes V, Schuman JS, Hertzmark E, et al. Optical coherence tomography measurement of macular and nerve fiber layer thickness in normal and glaucomatous human eyes. Ophthalmology 2003; 110: ) Kang JH, Kim SA, Song WG, Yoon HS. Macular thickness changes with age in normal subjects measured by optical coherence tomography. J Korean Ophthalmol Soc 2004;45: ) Kim SH, Choi KS, Lee SJ. Macular thickness changes with age and gender in emmetropia using spectral domain optical coherence tomography. J Korean Ophthalmol Soc 2011;52: ) Wong AC, Chan CW, Hui SP. Relationship of gender, body mass index, and axial length with central retinal thickness using optical coherence tomography. Eye (Lond) 2005;19: ) Duan XR, Liang YB, Friedman DS, et al. Normal macular thickness measurements using optical coherence tomography in healthy eyes of adult Chinese persons: the Handan Eye Study. Ophthalmology 2010;117: ) Massin P, Erginay A, Haouchine B, et al. Retinal thickness in healthy and diabetic subjects measured using optical coherence tomography mapping software. Eur J Ophthalmol 2002;12: ) Evans JR, Schwartz SD, McHugh JD, et al. Systemic risk factors for idiopathic macular holes: a case-control study. Eye (Lond) 1998;12(Pt 2): ) Risk factors for idiopathic macular holes. The Eye Disease Case-Control Study Group. Am J Ophthalmol 1994;118: ) Lim MC, Hoh ST, Foster PJ, et al. Use of optical coherence tomography to assess variations in macular retinal thickness in myopia. Invest Ophthalmol Vis Sci 2005;46: ) Wakitani Y, Sasoh M, Sugimoto M, et al. Macular thickness measurements in healthy subjects with different axial lengths using optical coherence tomography. Retina 2003;23: = 국문초록 = 스펙트럼영역빛간섭단층촬영을이용한한국인의연령과성별에따른황반부층별두께연구 목적 : 황반부두께의측정과분석으로임상에서광범위하거나국소적인망막질환의진단에도움을주고또한연구에있어서기초자료로사용하고자한다. 대상과방법 : 대상자의연령은 20 세부터 69 세사이로선정하였고 20 대부터 60 대까지남녀각각 5 명씩총 50 명, 100 안을대상으로하였다. 대상자모두 Heidelberg Spectralis OCT 로 Enhanced depth image 를얻었고, Heidelberg eye Software (version , Heidelberg Engineering, Heidelberg, Germany) 에서제공하는영상분할과황반두께지도기능을이용하여측정하였다. 결과 : 중심황반두께는망막신경섬유층에서 ± 2.11 μm, 신경절세포층에서 ± 4.16 μm, 내망상층에서 ± 3.20 μm, 내핵층에서 ± 4.66 μm, 외망상층에서 23.27± 6.83 μm, 외핵층에서 ± 9.59 μm, 망막색소상피층에서 ± 1.83 μm, 내망막층에서 ± μm, 광수용체층에서 ± 2.81 μm 였다. 근시에따른각층의두께는유의한차이를보이지않았고, 황반부모든층에서연령에따른유의한차이를보이지않았으며, 중심황반의각층에서여성이남성에비해유의하지는않았으나얇은두께를보였다. 결론 : 황반두께의차이는황반질환의발생에도관련이있는것으로알려져있어서앞으로황반질환의형태를평가하는데있어본연구자료가좋은참고가될수있을것이다. < 대한안과학회지 2016;57(2): > 275

(이성진-김승훈)( ).hwp

(이성진-김승훈)( ).hwp 대한안과학회지 2011 년제 52 권제 3 호 J Korean Ophthalmol Soc 2011;52(3):299-307 pissn: 0378-6471 eissn: 2092-9374 DOI : 10.3341/jkos.2011.52.3.299 = 증례보고 = 정시안에서스펙트럼영역빛간섭단층촬영기를이용한연령과성별에따른황반두께의변화 김승훈 최경식 이성진 순천향대학교의과대학안과학교실