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1 대한안과학회지 2019 년제 60 권제 3 호 J Korean Ophthalmol Soc 2019;60(3): ISSN (Print) ISSN (Online) Original Article 얼굴전산화단층촬영사진을이용한안구용적측정치와안축장과의상관관계 Semi-automatic Measurement of Ocular Volume from Facial Computed Tomography and Correlation with Axial Length 정준규 1 박인기 2 최삼진 3 신재호 1 Junkyu Chung, MD 1, In Ki Park, MD, PhD 2, Samjin Choi, PhD 3, Jae-Ho Shin, MD, PhD 1 경희대학교의학전문대학원강동경희대학교병원안과학교실 1, 경희대학교의학전문대학원경희의료원안과학교실 2, 경희대학교의과대학의공학교실 3 Department of Ophthalmology, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine 1, Seoul, Korea Department of Ophthalmology, Kyung Hee University Medical Center, Kyung Hee University School of Medicine 2, Seoul, Korea Department of Bioengineering, Kyung Hee University School of Medicine 3, Seoul, Korea Purpose: To measure the ocular volume from facial computed tomography (CT) scans using a semi-automatic computer program, and to analyze possible correlations between the axial length and ocular volume using regression analysis. Methods: Forty eyes from 20 facial CT scans were used to measure the ocular volumes. The cross-sectional ocular areas were calculated using a semi-automatic program based on MATLAB r2009a (MathWorks, Inc., Natick, MA, USA), and the ocular volumes were calculated from serial cross-sectional areas. The axial lengths were measured by A-scan ultrasound. Statistical analysis including regression analysis was used to determine possible correlations between the ocular volumes and axial lengths. Results: The mean ocular volumes measured in males and females were 7.16 ± 1.80 cm 3 and 7.24 ± 3.38 cm 3, respectively. The mean axial lengths measured in males and females were ± 0.69 mm and ± 1.64 mm, respectively. There were positive correlations using Pearson s correlation coefficient and the partial correlation coefficient adjusted by axial length. Using regression analysis, the following statistically significant equation was derived: (ocular volume [cm 3 ] = axial length 3 [mm 3 ] axial length 2 [mm 2 ] [p < 0.001, R 2 = 0.384]). Conclusions: The ocular volume measurement tool in this study was noninvasive and very useful, without special equipment. Accurate estimation of ocular volumes by a statistical equation was feasible, and these findings may be helpful in further study of various ocular diseases and in predicting preoperative and postoperative ocular volumes. J Korean Ophthalmol Soc 2019;60(3): Keywords: Axial length, Facial computed tomography, Ocular volume, Volume measurements Received: Revised: Accepted: Address reprint requests to Jae-Ho Shin, MD, PhD Department of Ophthalmology, Kyung Hee University Hospital at Gangdong, #892 Dongnam-ro, Gangdong-gu, Seoul 05278, Korea Tel: , Fax: pbloadsky@naver.com * This research was supported by the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT & Future Planning (2017R1C1B ). * Conflicts of Interest: The authors have no conflicts to disclose. 안구는시각을느끼게해주는감각기관이다. 안구는외상, 종양, 선천성녹내장, 망막모세포종등의안과적질환에의해그크기와용적이변하는것으로알려져있으며안구모양및크기에따라굴절오차가발생하는것이밝혀진바있다. 1,2 공막돌륭술과같은수술로인해안구의크기와용적이변한다는보고와유리체강내주사술후유리체강의부피증가로인한안압상승이보고된바있다 년 Kim et al, 년 Ha et al 9 은실리콘기름제거술후일시 c2019 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. 210

2 - 정준규외 : CT 측정안구용적, 안축장상관관계 - 적인저안압의위험인자로긴안축장을보고하였으며일시적인저안압과안구용적이관련이있음을제시하였다. 또한안구내용물제거술후안구내삽입물을삽입하는경우원래의안구용적보다큰삽입물을사용하면추후삽입물의탈출이나노출과같은문제가발생할수있다. 10 따라서안과적질환이나굴절오차의평가, 수술후안압변동의예측, 수술전정확한삽입물의선택등을위해안구의용적을정확하게측정하기위한여러연구가진행되어왔다. 안구를적출하여용적을측정하는중량법, 안축장을통해구형으로가정된안구의대략적인용적을구하는방법등이제시된바있으며, 최근얼굴전산화단층촬영영상및자기공명영상을이용한안구용적의측정이보고된바있다 하지만이러한방법들은안구를구형으로가정하여용적을계산하거나, 안구용적측정을위해관찰자가수동으로경계를그려야하는수작업이많아오차발생가능성을피하기 어려운단점이있다. 이에따라본연구는이전연구 14 에서보다손쉽게단면적이측정가능한 MATLAB (MATLAB r2009a, MathWorks, Inc., Natick, MA, USA) 을기반으로한반자동화측정프로그램을이용하여저자들이고안한알고리즘을통해정상성인의얼굴전산화단층촬영사진으로부터안구용적을측정및계산하고, 이를안축장과비교분석하였다. 대상과방법 2016년 1월부터 12월까지강동경희대병원안과에내원하여백내장수술을받았던환자중얼굴전산화단층촬영을시행했던환자들중성인환자 20명 ( 남성 10명, 여성 10명 ), 40안을대상으로하였다. 전산화단층촬영전에안구용적에영향을줄수있는외상및안구종양의병력이있거나안구 A B Figure 1. The process of measurement of cross-sectional areas from axial scans (A) and from coronal scans (B). The white arrows are ocular contours which were automatically displayed by the program. The seed points are marked with arrowheads and the results of automated measurement are marked with black arrows. This process was repeated in all scan sections that show an ocular contours. Each measured cross-sectional area was calculated as a volume through a conversion formula. 211

3 - 대한안과학회지 2019 년제 60 권제 3 호 - 내수술과거력이있는환자는대상에서제외하였다. 얼굴전산화단층촬영은 3 mm 간격의단면두께로시행하였고, 촬영사진들중축영상 (axial scan), 관상영상 (coronal scan) 을대상으로저자들의이전연구에서소개하였던경희대학교의과대학의공학교실에서 MATLAB을기반으로고안한컴퓨터프로그램의알고리즘을통해숙련된 3명의안과의사가안구용적을반자동으로측정하여평균치를사 용하였다. 컴퓨터프로그램에단층촬영영상을입력하면 Otsu 알고리즘에의해안구및안와구조가단순화되어출력된다. 단순화되어출력된영상의안구내부중아무곳이나관찰자가클릭하면 Snake 알고리즘을통해자동적으로안구의단면적을측정하고이는화소 (pixel) 값으로나타난다. 이를통해구한각영상의단면적을통해부피 (voxel) 를계산하여안구의용적 (cm 3 ) 을도출하였다 (Fig. 1, 2). 안축장과전방깊이는 A-scan 초음파 (Aviso, Quantel Medical, Cournon-d'Auvergne, France) 를이용해숙련된 1명의안과의사가 1안당평균 30회연속측정하여평균치를사용하였다. 결 과 Figure 2. Flow chart of measuring ocular volume from facial computed tomography using MATLAB (MATLAB r2009a, MathWorks, Inc., Natick, MA, USA) based semi-automatic program. Otsu s algorithm and snake algorithm were used to detect eyeball and to check eyeball anatomy. 얼굴전산화단층촬영을시행한 20명중제외기준에해당하는 2명을제외한 18명, 36안 ( 남자 20안, 여자 16안 ) 을대상으로하였고, 이들의평균연령은 68.5 ± 10.4세 (range: 47-84) 였다. 안구용적의측정결과남성은축영상 (axial scan) 에서우측 6.97 ± 1.67 cm 3, 좌측 7.02 ± 1.81 cm 3, 관상영상 (coronal scan) 에서우측 7.58 ± 2.09 cm 3, 좌측 7.05 ± 1.81 cm 3 로측정되었다. 여성은축영상 (axial scan) 에서우측 7.43 ± 3.86 cm 3, 좌측 6.86 ± 3.80 cm 3, 관상영상 (coronal scan) 에서우측 7.46 ± 3.30 cm 3, 좌측 7.22 ± 3.21 cm 3 로측정되었다 (Table 1). Paired t-test에서남녀각각축영상과관상영상을통해측정된안구용적측정값은서로유의한차이를보이지않았다 (p=0.128, p=0.610). Mann-Whitney test에서남녀의안구용적측정값은서로유의한차이를보이지않았다 (p=0.272). A-scan 초음파를이용해안축장과전방깊이를측정하였다. 안축장은남성은 ± 0.69 mm (range: ), 여성은 ± 1.64 mm (range: ) 였으며 t-test 에서남성과여성의안축장은서로유의한차이가없었다 (p=0.558). 전방깊이는남성은 3.46 ± 0.53 mm (range: ), 여성은 3.04 ± 0.47 mm (range: ) 였으며 t-test에서남성과여성의전방깊이는서로유의한차이 Table 1. The average data of the ocular volume (cm 3 ) Male Female Axial scan Coronal scan Axial scan Coronal scan Right eye 6.97 ± ± ± ± 3.30 ( ) * ( ) * ( ) * ( ) * Left eye 7.02 ± ± ± ± 3.21 ( ) * ( ) * ( ) * ( ) * Mean 7.16 ± ± 3.38 Values are presented as mean ± standard deviation (range). * Range of measured value. 212

4 - 정준규외 : CT 측정안구용적, 안축장상관관계 - 를보였다 (p=0.02). 축영상과관상영상을통해측정한안구용적과안축장과의 Pearson 상관계수는 (p<0.01) 이며전방깊이를고려한안구용적과안축장의편상관계수또한 (p<0.01) 으로서로유의한양의상관관계를보이는것으로측정되었다 (Fig. 3). 안구용적과안축장간의회귀분석을통해도출된 3차모형통계식은다음과같으며통계적으로유의한선형모형및 2차모형또한도출되었다 (Table 2). 안축장 mm) 안구용적과안축장의세제곱간의회귀분석도시행되었으며통계적으로유의한선형, 2차, 3차모형통계식이도출되었다 (Table 3). 고찰 안구용적 (cm 3 ) = 안축장 3 (mm 3 ) 안축장 2 (mm 2 ) (p<0.001, R 2 =0.384, 관측 Figure 3. Scatter plot of ocular volume (volume, cm 3 ) and AXL (mm). There were positive correlations in Pearson correlation coefficient and partial correlation coefficient adjusted by AXL. AXL = axial length. 1970년 Tomlinson and Phillips 15 의보고에따르면안구의평균적인안축장은근시 (24.61 ± 1.00 mm), 정시 (23.40 ± 1.38 mm), 원시 (22.53 ± 1.02 mm) 로측정되었으며 2014년 Bekerman et al 16 에따르면정시인성인에서안구의크기는평균적으로 24.2 mm ( 횡축, 수평 ) 23.7 mm ( 시상축, 수직 ) mm ( 축, 전후 ) 로측정되었고, 성별과연령간의차이는보이지않았다. 근시와원시에서는안축장의길이가 20 mm에서 26 mm까지유의한차이를보이는것으로나타났으며, 안와의너비가클수록안구의수평직경이유의하게큰것으로나타났다. 이번연구를통해측정된안축장의길이또한성별에따라차이를보이지않았으며남녀각각평균 mm, mm로측정되었다. 본연구에서측정된전방깊이는평균남성 3.46 mm, 여성 3.04 mm로남성이유의하게깊었다. 1995년 Kim et al 17 의연구에따르면국내도시에거주하는성인남녀의전방깊이는남녀각각 2.96 mm, 2.81 mm로남성이유의하게깊었으며국외의보고에서도남녀각각 3.16 mm, 3.01 mm 로남성이유의하게깊었다. 18 안축장을통해안구용적을회귀분석한국외의보고에따르면전방깊이는안구용적과서로유의성을보이지않았으며본연구에서도전방깊이는안구용적과유의한상관관계를보이지않았다 (p=0.253). 13 따라서전방깊이는성별간에유의한차이가있었으나, 안 Table 2. Regression analysis of axial length and ocular volume Model R 2 p-value Linear model V = AXL <0.01 Quadratic model V = AXL AXL <0.01 Cubic model V = AXL AXL <0.01 Range of observed axial length was from mm to mm. V = ocular volume (cm 3 ); AXL = axial length (mm); R 2 = coefficient of determination. Table 3. Regression analysis of the cube of axial length and ocular volume Model R 2 p-value Linear model V = Cube <0.01 Quadratic model V = Cube Cube <0.01 Cubic model V = Cube Cube <0.01 V = ocular volume (cm 3 ); AXL = axial length (mm); R 2 = coefficient of determination. 213

5 - 대한안과학회지 2019 년제 60 권제 3 호 - 축장및안구용적은성별간에유의한차이를보이지않았으므로성별의구분없이안축장을통해안구용적의크기를분석함에있어어려움이없다. 안구내종양, 선천녹내장과같은안과적질환이나근시나원시로인한안구의형태적변화로인해안구의용적이변할수있다고알려져있다. 1,2 1980년 Lee 3 의연구에따르면공막돌륭술과같은안구의수술이안구용적에변화를일으킬수있으며, 2008년 Park and Choi 4 에의해유리체강내트리암시놀론주사술직후평균안압은 45.8 mmhg까지유의하게증가하는것이보고되었고그원인으로유리체용적의증가가지목되었다. 일정한안구용적에대해유리체용적이증가함에따라안압의상승이발생하는것으로유추할수있다. 유리체강내베바시주맙, 라니비주맙주사술후발생하는안압변동에대해서도국외에서많은보고가이루어졌으며주사이후안축장과안압상승간에관계를제시하였다. 5-7 또한동물실험연구에서는 ml의인산완충식염수돼지안구내주사가 14.9 mmhg의안압상승을일으키는것으로나타났다. 19 이와같이적은유리체용적의변화로도큰안압변동을일으킬수있다. 2010년 Kim et al, 년 Ha et al 9 은실리콘기름제거술이후일시적인저안압의위험요소로긴안축장을제시하였다. Ha et al 9 은전방수의생성이안축장과관계없이일정하다고가정한다면안축장이길수록안구용적이크기때문에저안압에취약하다고하였다. 실리콘기름을제거한후 Balanced salt solution (BSS) 등다른충전물로채우게되는경우본연구의알고리즘을통해정확한안구용적측정하여주입할용량을선택해일시적저안압을예방할수있을것으로기대된다. 실리콘기름의단점을보완한안구내실리콘삽입물 (intraocular silicone implant) 이안구내충전물로써동물대상연구가보고되었다. 20 삽입물은구형의풍선모양주머니에실리콘이담겨있는형태로향후이와같은삽입물이인간대상으로적용될때본연구를통해도출한통계식을이용하여안축장에따라개인별로더적합한부피를가진맞춤형삽입물제작도가능할것으로생각된다. 주입할실리콘기름이나삽입물혹은 BSS의부피를결정함에있어안구용적보다는유리체강의용적을측정하는것이더적합하겠으나앞선고찰에서살펴본대로전방깊이는안구용적과유의한관계가없으므로안축장의증가에따른안구용적의증가는주로유리체강의증가에기인하는것으로유추할수있다. 따라서본연구를통해구한안구용적에서평균적인전방부피와수정체부피를빼는것만으로도유리체용적을구하는데어려움이없을것이다. 안구내용물제거술을시행받은뒤안구내삽입물을삽입 할때정확한기존안구의용적에맞지않는경우삽입물이노출되는합병증이발생할수있다. 10 안구내용물제거술을받을환자들은안와의해부학적구조및안구내종양유무를확인하기위해사전에전산화단층촬영을하는경우가많기때문에본연구의알고리즘을이용한다면보다정확한안구용적을측정할수있어정확한안구내삽입술의부피를결정할수있다. 안구용적측정방법은과거부터다양한방법이제시되었는데, 중량법을이용한안구용적측정은안구를제거해야하므로임상적으로적용하기어렵다. 11 광학생체인식장비가개발됨에따라안축장을비교적정확하게측정할수있게되었고, 이를이용해안구를구형으로가정하여대략적인안구용적을예측할수있었으나실제안구의모양을반영하지못하며장비가구비되어야하는단점이있었다. 얼굴전산화단층촬영을이용한안구용적의측정이아프리카나이지리아환자를대상으로 2013년 Igbinedion and Ogbeide 12 에의해시도된바있고측정된안구용적은평균 5.28 cm 3 였다. 이연구는영상을통해얻은안축장및안구너비평균값을통해안구를구로가정하여용적을측정하여계산하였다는한계가있었다. 광학생체인식장비를통해얻은안축장과자기공명영상을통해얻은안구용적간회귀분석을시도한연구가 2014년 Nagra et al 13 에의해있었고측정한안구용적은평균 8.17 cm 3 였다. 한국인성인남녀 36안을조사한본연구에서는남성의안구용적의평균은 7.16 ± 1.80 cm 3, 여성의안구용적의평균은 7.24 ± 3.38 cm 3 로측정되어앞선연구들과차이를보였다. 측정된안구용적은 A-scan 초음파를이용해측정된안축장과유의한상관관계가있었고안축장과안구용적간의유의한회귀분석통계식을도출할수있었다. 안축장과안구용적간의회귀분석에서통계식은 3차모형이선형모형과 2차모형보다적합한것으로나타났으며안축장의세제곱과안구용적간의모형에서도 3차모형이선형과 2차모형보다설명력이뛰어난것으로나타났다. 안구가완벽한구형이라면안구용적은안축장의세제곱에선형으로비례하게되므로안축장의세제곱과안구용적간의회귀분석에서선형모형이가장적합해야하며 2차항이나 3차항이포함된통계식은선형모형보다설명력이부족해야한다. 하지만본연구에서안축장의세제곱과안구용적간에 3차모형이가장설명력이뛰어났으며이는안구의부피를계산할때안구를단순히구형으로가정하여계산하는것은한계가있음을시사한다. 본연구에서는기존의 Igbinedion and Ogbeide 12 의연구와달리안구의모양을구로가정하지않았으며얼굴전산화단층촬영을통해얻은영상을반자동프로그램을이용하 214

6 - 정준규외 : CT 측정안구용적, 안축장상관관계 - 여안구의용적을측정하였기때문에관찰자의수작업으로인한오차를줄일수있었다. 이번연구는한국인을대상으로하였으며저자들의문헌고찰에따르면동아시아인종을대상으로영상검사를통해안구용적을측정하고안축장과의회귀분석을시행한첫번째연구이다. 동아시아인종은비교적안축장이길고근시가많은것으로알려져있으며고도근시에서포도종과같은안구용적에영향을미치는형태적변화가발견될수있다. 21,22 따라서본연구의통계식을이용하여동아시아인의안구용적을예측하는데유럽과남아시아인종을대상으로한 Nagra et al 13 의기존연구의통계식보다더정확한값을기대할수있다. 또한본연구를통해더정확한안구용적측정이가능하게되었고기체망막유착술이나안구내실리콘기름주입술에서안압상승을막을수있는정확한가스나실리콘기름의용량에대한연구나안구적출이나안구내용제거술이후삽입할삽입물의정확한부피결정에대한연구등이후행될것으로기대된다. 이번연구의제한점은소규모연구이며성인정상인만대상으로하였다는점이다. 또한본연구에서도출된통계식은유의하나설명력 (R 2 ) 이 0.384로낮은것으로나타났으며본연구의관측범위인 mm에서 mm를벗어나는안축장에대해서는적용의한계가있다. 추후나이와병력이다양한환자들을대상으로한추가연구뿐아니라더좁은간격의얼굴전산화단층촬영을이용하여오차를최소화하고더다양한안축장을가진환자를대상으로안구용적에영향을미치는다른변수를함께회귀분석을하는연구가필요할것으로생각된다. REFERENCES 1) Lim LS, Chong GH, Tan PT, et al. Distribution and determinants of eye size and shape in newborn children: a magnetic resonance imaging analysis. Invest Ophthalmol Vis Sci 2013;54: ) Liebovitch LS. Why the eye is round. In: Fischbarg J, ed. Advances in Organ Biology. Elsevier, 2005; chap ) Lee JH. Experimental scleral buckling reduction of ocular volume by scleral buckles. J Korean Ophthalmol Soc 1980;21: ) Park SY, Choi KS. Intraocular pressure elevation after intravitreal triamcinolone acetonide of different volumes: comparing 0.1 ml vs 0.05 ml. J Korean Ophthalmol Soc 2008;49: ) Adelman RA, Zheng Q, Mayer HR. Persistent ocular hypertension following intravitreal bevacizumab and ranibizumab injections. J Ocul Pharmacol Ther 2010;26: ) Cacciamani A, Oddone F, Parravano M, et al. Intravitreal injection of bevacizumab: changes in intraocular pressure related to ocular axial length. Jpn J Ophthalmol 2013;57: ) Kotliar K, Maier M, Bauer S, et al. Effect of intravitreal injections and volume changes on intraocular pressure: clinical results and biomechanical model. Acta Ophthalmol Scand 2007;85: ) Kim SW, Oh J, Yang KS, et al. Risk factors for the development of transient hypotony after silicone oil removal. Retina 2010;30: ) Ha SW, Kwon SJ, Park DH, Shin JP. Transient hypotony after silicone oil removal in rhegmatogenous retinal detachment. J Korean Ophthalmol Soc 2013;54: ) Catalu CT, Istrate SL, Voinea LM, et al. Ocular implants-methods of ocular reconstruction following radical surgical interventions. Rom J Ophthalmol 2018;62: ) Wales RC. Ocular measurement by simple gravimetric methods. Invest Ophthalmol Vis Sci 1977;16: ) Igbinedion BO, Ogbeide OU. Measurement of normal ocular volume by the use of computed tomography. Niger J Clin Pract 2013; 16: ) Nagra M, Gilmartin B, Logan NS. Estimation of ocular volume from axial length. Br J Ophthalmol 2014;98: ) Choi JH, Park IK, Choi SJ, Shin JH. Measurement of orbital volume from facial CT scans using a semi-automatic computer program. J Korean Ophthalmol Soc 2015;56: ) Tomlinson A, Phillips CI. Applanation tension and axial length of the eyeball. Br J Ophthalmol 1970;54: ) Bekerman I, Gottlieb P, Vaiman M. Variations in eyeball diameters of the healthy adults. J Ophthalmol 2014;2014: ) Kim NS, Choi YJ, Hong YJ. The anterior chamber depth according to age in normal urban adult. J Korean Ophthalmol Soc 1995;36: ) Huang Q, Huang Y, Luo Q, Fan W. Ocular biometric characteristics of cataract patients in western China. BMC Ophthalmology 2018; 18:99. 19) Morris HJ, Tang J, Cruz Perez B, et al. Correlation between biomechanical responses of posterior sclera and IOP elevations during micro intraocular volume change. Invest Ophthalmol Vis Sci 2013;54: ) Bayoudh W, Carstesen D, Walter P, Weinberger AWA. Intraocular silicone implant to treat chronic ocular hypotony: an in vivo trial. Graefes Arch Clin Exp Ophthalmol 2017;255: ) Ikuno Y. Overview of the complications of high myopia. Retina 2017;37: ) Wong YL, Saw SM. Epidemiology of pathologic myopia in asia and worldwide. Asia Pac J Ophthalmol (Phila) 2016;5:

7 - 대한안과학회지 2019 년제 60 권제 3 호 - = 국문초록 = 얼굴전산화단층촬영사진을이용한안구용적측정치와안축장과의상관관계 목적 : 얼굴전산화단층촬영영상과반자동화프로그램을이용하여안구용적을측정하고안구용적의안축장과의상관관계및안구용적을추정하는회귀분석을연구하고자하였다. 대상과방법 : 얼굴전산화단층촬영을시행한 20 명, 40 안을대상으로반자동화프로그램 (MATLAB r2009a, MathWorks, Inc., Natick, MA, USA) 을이용하여얼굴전산화단층촬영사진의축영상과관상영상의안구단면적을각각측정하였고, 측정단면적을누적하여안구용적을계산하였다. 안축장은 A-scan 초음파를이용하여측정되었으며, 안구용적과안축장간회귀분석을포함한통계적분석을시행하였다. 결과 : 안구용적의측정결과, 남성은평균 7.16 ± 1.80 cm 3, 여성은평균 7.24 ± 3.38 cm 3 였다. 또한안축장의측정결과남성은평균 ± 0.69 mm, 여성은평균 ± 1.64 mm 로측정되었으며안구용적과안축장은남녀간유의한차이가없었다. 안구용적과안축장은 Pearson 상관계수와전방깊이를고려한편상관계수에서모두유의한양의상관관계를보였으며단순회귀분석을통해유의한통계식이도출되었다 ( 안구용적 [cm 3 ] = x 안축장 3 [mm 3 ] x 안축장 2 [mm 2 ] [p<0.001, R 2 =0.384]). 결론 : 본연구의안구용적측정법은비침습적인얼굴전산화단층촬영을이용한것으로특별한장치없이안구용적을측정하는데매우유용한도구이다. 본연구의안축장과의통계식을통해안구용적의추정또한정확하게할수있을것으로기대되며이들을통해여러안질환및수술전후안구용적에대한추가연구에도움이될수있을것으로생각된다. < 대한안과학회지 2019;60(3): > 정준규 / Junkyu Chung 경희대학교의학전문대학원강동경희대학교병원안과학교실 Department of Ophthalmology, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine 216

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