| 녹F-021 |
| 빛간섭단층촬영에서 Guided Progression Analysis를 이용한 ganglion cell-inner plexiform layer의 녹내장성 진행 분석 |
| 울산대학교 의과대학 서울아산병원 안과학교실(1), Carl Zeiss Meditec, Inc, R&D (2) |
| 신중원(1), 성경림(1), Gary C. Lee(2), Mary K. Durbin(2), Daniel Cheng(2) |
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목적 : To examine the performance of Guided Progression Analysis (GPA) in spectral-domain optical coherence tomography (OCT) to detect progressive ganglion cell-inner plexiform layer (GCIPL) and retinal nerve fiber layer (RNFL) thinning in glaucoma.
방법 : A total of 196 eyes of 123 POAG patients with a mean follow-up time 5.0 years were included. Progressive GCIPL and RNFL thinning were assessed by OCT GPA. Glaucoma progression was determined by VF progression using EMGT criteria or VFI. Eyes were classified as mild or moderate-to-advanced group by VF MD of -6dB. The rate of change of GCIPL and RNFL thickness was compared between progressors and non-progressors. The VF survival estimates between eyes with and without progressive GCIPL or RNFL thinning were evaluated by the Kaplan-Meier survival analysis and compared with the log-rank test.
결과 : A total of 76 (38.8%) and 43 (21.9%) eyes were identified as progressive GCIPL and RNFL thinning by OCT GPA, 48 (24.5%) eyes determined as progressors by VF criteria. The rate of average GCIPL thickness change was significantly higher in progressors than non-progressors regardless of glaucoma severity (all p<0.05). Eyes with progressive GCIPL thinning had lower VF survival estimates compared with eyes without progressive GCIPL thinning regardless of glaucoma severity (all p<0.001). However, RNFL GPA showed a poor performance to detect progressive RNFL change in moderate-to-advanced glaucoma.
결론 : GCIPL GPA provides a new approach to evaluate glaucoma progression. Particularly, it may be more useful for detecting progression in advanced stage of glaucoma than RNFL GPA.
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