빛간섭단층혈관조영술을 이용한 백내장수술 후 황반 모세혈관총 분석

Analysis of Macular Capillary Plexuses after Cataract Surgery via Optical Coherence Tomography Angiography

목적: 빛간섭단층혈관조영술을 이용해 백내장수술 후 황반 모세혈관총 혈관밀도(vessel density, VD) 변화를 알아보았다. 대상과 방법: 2018년 7월부터 2019년 6월까지 백내장수술을 받은 24명 24안을 대상으로 후향적 분석을 하였다. 황반표층 모세혈관총(superficial capillary plexus, SCP)과 심부 모세혈관총(deep capillary plexus, DCP), 시신경유두내, 시신경유두주위의 VD와 중심오목무혈관 부위 면적 변화를 술 전, 술 후 1주, 1개월, 3개월, 6개월에 얻은 빛간섭단층혈관조영영상을 이용해 분석하였다. 결과: 중심오목 SCP와 DCP, 중심오목부근 SCP와 DCP, 중심오목주위 SCP와 DCP의 VD는 각각 술 전 15.42 ± 6.61%와 28.43 ± 7.62%, 47.28 ± 5.76%와 53.06 ± 3.89%, 45.20 ± 5.01%와 46.62 ± 5.89%에서 술 후 증가하여 6개월에 17.20 ± 6.21%와 30.52 ± 7.06%, 50.34 ± 5.00%와 53.90 ± 4.20%, 48.52 ± 4.32%와 50.96 ± 5.57%로 모두 유의하게 증가된 상태를 유지하였다(각각 p<0.001, p=0.001, p=0.002, p=0.014, p<0.001, p=0.002). 시신경유두내, 시신경유두주위 VD 및 중심오목무혈관 부위 면적은 유의한 변화가 없었다(각각 p=0.068, p=0.332, p=0.206). 결론: 백내장수술 후 황반 모세혈관총 VD는 SCP와 DCP에서 술 후 1주, 1개월, 3개월, 6개월에 모두 유의하게 증가하였다.

Purpose: We used optical coherence tomography angiography (OCTA) to evaluate changes in the vessel densities of macular capillary plexuses after cataract surgery. Methods: We performed a retrospective chart review of 24 eyes of 24 cataract patients who underwent phacoemulsification cataract surgery from July 2018 to June 2019. The changes in vessel density (VD) in the macular superficial capillary plexus (SCP), the deep capillary plexus (DCP), inside the disc, and in the peripapillary area and foveal avascular zone (FAZ), were analyzed on OCTA images obtained preoperatively and at 1 week, and 1, 3, and 6 months, postoperatively. Results: The VDs of the foveal SCP and DCP increased significantly from 15.42 ± 6.61 and 28.43 ± 7.62% preoperatively to 17.20 ± 6.21 and 30.52 ± 7.06% at 6 months postoperatively (p < 0.001, p = 0.001). The VDs of the parafoveal SCP and DCP increased significantly from 47.28 ± 5.76 and 53.06 ± 3.89% preoperatively to 50.34 ± 5.00 and 53.90 ± 4.20% at 6 months postoperatively (p = 0.002, p = 0.014). The VDs of the perifoveal SCP and DCP increased significantly from 45.20 ± 5.01 and 46.62 ± 5.89% preoperatively to 48.52 ± 4.32 and 50.96 ± 5.57% at 6 months postoperatively (p < 0.001, p = 0.002). The VDs of the area inside the disc, and of the peripapillary area and FAZ, did not change significantly (p = 0.068, 0.332, and 0.206, respectively). Conclusions: After cataract surgery, the VDs of the SCP and DCP increased significantly at 1 week, and 1, 3, and 6 months, postoperatively.