한국인 정상치를 이용한 Stratus 광간섭단층촬영기의 초기 정상안압녹내장 진단 능력

Diagnostic Ability of Stratus OCT Using Korean Normative Database for Early Detection of Normal-Tension Glaucoma

Purpose: To determine if korean normative database improve diagnostic ability of Stratus OCT for detection of glaucoma. Methods: Peripapillary retinal nerve fiber layer (RNFL) and optic nerve head regions were measured using a Stratus OCT. The normative data were collected from 129 normal individuals. We obtained values at the 5% and 1% levels according to the disc area stratified into equal thirds to minimize the error by the individual variation of optic disc size and these levels were considered abnormal. One eye of each 94 normal-tension glaucoma patients with early visual field defects (mean deviaton = -3.84±1.40dB) and 87 another normal subjects were enrolled. Glaucoma was defined by visual field defects. Results: The use of Korean normative database had higher sensitivity and no significant difference of specificity than that of a Stratus OCT except for a few parameters. The criteria that show the highest diagnostic ability were 1 ≥ quadrants RNFL thickness abnormal at the < 5% when using a Korean normative database (sensitivity = 81.9%, specificity = 81.6%) and 1 ≥ clock hours abnormal at the < 5% when using a Stratus OCT normative database (sensitivity = 71.3%, specificity = 87.4%) (p=0.004, p=0.180, respectively, McNemar test). Conclusions: The criterion using a Korean normative database had higher sensitivity and no difference of specificity compared with criterion using a Stratus OCT normative database. The best criterion using a Korean normative database may be helpful for early detection of normal-tension glaucoma.