고도근시에서 시신경유두주위 위축 범위에 따른 빛간섭단층촬영의 녹내장 진단력 비교

Comparison of Diagnostic Power Among OCT Parameters According to Peripapillary Atrophy in High Myopic Glaucoma

Purpose: To evaluate diagnostic power to detect glaucoma in high myopic eyes with peripapillary atrophy among optical coherence tomography (OCT) parameters. Methods: Fifty eyes of 31 glaucoma patients with myopia of -6.00 diopters or less and a peripapillary atrophy (PPA) were classified into a group with a PPA located beyond the circumpapillary OCT scan circle (group A) and a group with a PPA confined within the scan circle (group B). Circumpapillary retinal nerve fiber layer (cpRNFL), total macula (TM), and ganglion cell-inner plexiform layer (GCIPL) thickness were measured in each group and the diagnostic power of each measurement was compared by area under the receiver operating characteristic curve (AUC). Results: There were no significant differences in the age, gender, intraocular pressure, optic disc size, and mean deviation between the 2 groups. The spherical equivalent of group A was significantly larger than group B (mean -11.9 vs. -7.3 diopters, p = 0.002). In group A, the AUC of average GCIPL thickness was significantly higher than average cpRNFL and average TM thickness (p < 0.05). Additionally, when comparing parameters that showed the highest AUC value in each method, the AUC of GCIPL thickness was significantly higher than cpRNFL thickness (p = 0.046). In subgroup analysis of spherical equivalent matching between the 2 groups (subgroup A and B), the highest AUC value of GCIPL thickness was significantly higher than cpRNFL and TM thickness in subgroup A (p < 0.05). In group B and subgroup B, there was no statistical significance among AUC values of the 3 different methods (p > 0.05). Conclusions: Assessment of GCIPL parameters is a useful technique for glaucoma diagnosis in patients with high myopia and PPA extending beyond circumpapillary OCT scan circle. <br /> J Korean Ophthalmol Soc 2013;54(12):1844-1855