
http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
고도 축성 근시에서 시신경 형태의 다양성과 녹내장과의 연관성
서정현,이승현 대한안과학회 2024 대한안과학회지 Vol.65 No.10
목적: 고도 축성 근시안에서 시신경유두 형태의 다양성을 확인하고, 빛간섭단층촬영을 통한 시신경 깊은 층의 구조를 분석하여 고도 축성 근시가 있는 눈에서 시신경유두 형태 변화 정도와 녹내장과의 연관성을 확인하고자 하였다. 대상과 방법: 안축장이 26 mm 이상 27 mm 미만인 고도 축성 근시가 있는 69안(정상안 33안, 녹내장 36안)의 의무기록을 후향적으로 분석하였다. 안저사진에서 확인한 시신경 유두의 기울기 정도에 따라(기울기=1.3) 두 그룹으로 나누어 사상판 깊이, 시신경 유두주위 위축 너비, 브루크막 개방 넓이를 포함한 시신경 유두 깊은 층의 형태학적 특징을 비교하고, 녹내장성 손상 정도와 연관이 있는 인자를 분석하였다. 결과: 전체 대상안의 평균 시신경유두 기울기는 1.31 ± 0.23이었다. 기울기가 큰 군(≥1.3, 30안)에서 작은 군(<1.3, 39안)에 비해 녹내장 빈도가 높았고(p=0.035), 심한 시야결손(p<0.001), 얇은 망막신경섬유층 두께(p=0.046), 넓은 감마 시신경 유두주위 위축 너비(p<0.001)를 보였다. 시신경 유두 기울기는 시야결손 정도와 연관된 인자 분석에서 통계적으로 유의한 관련이 있었지만(p=0.018), 망막신경섬유층의 두께 감소와는 유의한 관련이 없었다(p=0.203). 결론: 비슷한 정도의 안축장을 가진 고도 축성 근시안에서 시신경유두 기울기는 다양할 수 있으며, 기울기가 클수록 심한 시야결손을 보였다. 이는 근시의 진행에 따른 시신경유두 형태 변화의 양상에 따라 녹내장 손상의 정도에 영향을 줄 수 있다는 것을 시사한다. Purpose: To investigate optic disc morphology in high axial myopia and its associations with the deep-layer structure of the optic disc using optical coherence tomography and glaucoma. Methods: We retrospectively reviewed the medical records of 69 eyes (33 normal and 36 glaucomatous eyes) with an axial length of 26-27 mm. The eyes were categorized into two groups based on the optic disc tilt ratio (≥ 1.3 or < 1.3). Characteristics of optic disc morphology, including lamina cribrosa depth, peripapillary atrophy width, and Bruch’s membrane opening area, were compared between the two groups. Furthermore, factors related to mean deviation and global retinal nerve fiber layer (RNFL) thickness were analyzed. Results: The mean optic disc tilt ratio was 1.31 ± 0.23. Eyes with a tilt ratio ≥ 1.3 (30 eyes) had a higher likelihood of glaucoma (p = 0.035) and severe visual field (VF) defects (p < 0.001), a thinner global RNFL thickness (p = 0.046), and larger gamma peripapillary atrophy width (p < 0.001) compared to eyes with a tilt ratio < 1.3 (39 eyes). Linear regression analysis revealed that the optic disc tilt ratio was significantly associated with VF loss (p = 0.018) but not with global RNFL thinning (p = 0.203). Conclusions: Variations in optic disc morphology are observed in eyes with similar axial lengths, and a higher optic disc tilt ratio is associated with more severe VF defects. These findings suggest the potential influence of optic disc morphological changes due to axial elongation on the severity of glaucomatous damage.
서정현,김호성,정승채,최충곤,김상준,김경원 대한영상의학회 2020 Korean Journal of Radiology Vol.21 No.4
Objective: We aimed to determine the optimized image-based surrogate endpoints (IBSEs) in targeted therapies for glioblastoma through a systematic review and meta-analysis of phase III randomized controlled trials (RCTs). Materials and Methods: A systematic search of OVID-MEDLINE and EMBASE for phase III RCTs on glioblastoma was performed in December 2017. Data on overall survival (OS) and IBSEs, including progression-free survival (PFS), 6-month PFS (6moPFS), 12-month PFS (12moPFS), median PFS, and objective response rate (ORR) were extracted. Weighted linear regression analysis for the hazard ratio for OS and the hazard ratios or odds ratios for IBSEs was performed. The associations between IBSEs and OS were evaluated. Subgroup analyses according to disease stage (newly diagnosed glioblastoma versus recurrent glioblastoma), types of test treatment, and types of response assessment criteria were performed. Results: Twenty-three phase III RCTs published between 2000 and 2017, including 8387 patients, met the inclusion criteria. OS showed strong correlations with PFS (standardized β coefficient [R] = 0.719), 6moPFS (R = 0.647), and 12moPFS (R = 0.638). OS showed no correlations with median PFS and ORR. In subgroup analysis according to types of therapies, PFS showed the highest correlations with OS in targeted therapies for cell cycle pathways (R = 0.913) and growth factor receptors and their downstream pathways (R = 0.962). 12moPFS showed the highest correlation with OS in antiangiogenic therapy (R = 0.821). The response assessment in neuro-oncology criteria provided higher correlation coefficients between OS and IBSEs than the Macdonald criteria. Conclusion: Overall, PFS is an optimized IBSE in targeted therapies for glioblastoma; however, 12moPFS is optimal in antiangiogenic therapy.