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가변각막보정 주사레이져편광측정기를 이용한 국소 시야 결손을 가지는 녹내장 환자의 진단
조현수,성민철,국문석,Hyun-Soo Cho,M,D,Min-Cheol Seong,M,D,Michael S,Kook,M,D 대한안과학회 2005 대한안과학회지 Vol.46 No.9
Purpose: To evaluate the ability of scanning laser polarimetry parameters and a novel deviation-map algorithm to discriminate between healthy and early glaucomatous eyes with localized visual field defects confined in one hemifield. Methods: In this prospective case-controlled study, 61 glaucomatous eyes with localized visual field defects and 66 normal controls were enrolled. Humphrey field analyzer 24-2 glaucoma hemifield test and scanning laser polarimetry (GDx-VCC?) were used. Results: There were significant differences in the mean parametric values of TSNIT average, superior average, inferior average, and TSNIT SD (P<0.05) between the glaucoma group and normal subjects. The sensitivity of each GDx-VCC variable was as follows: TSNIT average, 47.5%; superior average, 31.1%; inferior average, 47.5%; and TSNIT SD, 24.6% (when abnormal was defined as P<0.05). The overall sensitivities combining each probability scale and severity score at 80%, 90%, and 95% specificity were 90.2%, 72.1%, and 59%, respectively. There was a statistically significant correlation between the GDx-VCC severity score and the visual field severity score (P<0.05). Conclusions: GDx-VCC parameters may not be sufficiently sensitive to detect glaucomatous patients with localized visual field damage. Our algorithm using the GDx-VCC deviation map may enhance the understanding of GDx-VCC in terms of the locality, deviation size, and severity of localized RNFL defects in eyes with localized visual field loss.
황종욱,정지용,조현수,국문석.Jong Uk Hwang. M.D.. Ji Yong Jung. M.D.. Hyun Soo Cho. M.D.. Michael Scott Kook. M.D. 대한안과학회 2006 대한안과학회지 Vol.47 No.2
Purpose: We investigated the diagnostic ability of scanning laser polarimetry with variable corneal compensation (GDx VCC) parameters to distinguish glaucomatous eyes with different degrees of visual field abnormality from normal eyes. Methods: Subjects were divided into a control group (n=47) and an early to moderate glaucoma group (n=100). The latter included 53 early glaucoma patients (mean deviation > -6dB with a Humphrey Field Analyzer). Using a receiver operating characteristic (ROC) curve, the diagnostic power of GDx VCC parameters was analyzed and the correlations between those parameters and Humphrey Field Analyzer (HFA) indices were statistically analyzed. Results: Nerve fiber indicator (NFI) provided the best discriminating ability with the highest area under the ROC curve (AUROC) value for detecting eyes with early to moderate perimetric glaucoma. TSNIT average showed the highest AUROC value for detecting eyes with early perimetric glaucoma. The optimal NFI cut-off value to discriminate between the control group and early to moderate group was 22, offering the best combination of sensitivity (88.0%) and specificity (83.0%). The optimal TSNIT average cut-off value to discriminate between the control group and early glaucoma group was 53.49 μm, providing the best combination of sensitivity (84.9%) and specificity (85.1%). Most of the thickness parameters showed higher AUROC values than those of the ratio or modulation parameters. A statistically significant correlation was found between the GDx VCC parameters and HFA indices. Conclusions: Measurement of the retinal nerve fiber layer (RNFL) by scanning laser polarimetry with variable corneal compensation is useful in discriminating between normal and glaucomatous eyes.