목적 : 황반원공 환자의 술 후 촬영한 OCT에서 중심와두께 및 시세포층 상태와 술 후 시력과의 상관관계를 조사하였다. 대상과 방법 : 황반원공 술 후 6개월 이상 경과관찰 가능하였던 22눈에서 측정한 OCT상 중심와에 감각신경망막결손 없이 원공폐쇄를 보인 16눈을 대상으로, 술 후 시력이 안정되었을 때 0.4 이상인 군과 0.4 미만인 군으로 나누었다. OCT에서 시세포층 변성 정도에 따라 양호한 상태에서 불량한 순서대로 1, 2, 3등급으로 분류하고 중심와두께를 조사 후 술 후 시력과 상관관계를 조사하였다. 결과 : 안정시력이 0.4 이상인 군은 6눈, 0.4 미만인 군은 10눈이었으며 각 군에서 술 후 안정시력에 도달한 시기는 평균 20주와 12주였다. 술 후 시력과 OCT상 중심와두께 사이의 상관계수는 -0.15였다. 1군에서 OCT상 시세포층 상태가 1등급 2안, 2등급 3안, 3등급 1안이었으며 2군에서는 각각 0, 2, 8안으로 황반원공 술 후 시력이 0.4 미만인 군에서 3등급이 의미 있게 많았다(p=0.035). 결론 : 황반원공 술 후 OCT를 이용하여 시세포층의 변성정도를 평가할 수 있었다. 술 후 시력예후는 OCT에서 측정한 중심와두께보다 시세포층의 변성정도와 상관관계가 있는 것으로 생각된다.

Purpose: To suggest parameters on optical coherence tomography (OCT) implicating visual prognosis after macular hole surgery, foveal thickness and photoreceptor layer were assessed by OCT after successful closure of the macular hole. Methods: Twenty-two eyes underwent macular hole surgery and were followed up 6 months or longer. Of these, 16 eyes which were closed without neurosensory retinal defect were enrolled. OCT and visual acuity were reviewed and collected retrospectively. The photorecepter layer was graded as 1 to 3 according to the relative area of degeneration in the 1-mm of foveal center. Correlations between visual acuity and OCT parameters including the grade of the photorecepter layer and the foveal thickness were statistically analyzed. Results: Visual acuities of six eyes were 0.4 or greater. Visual acuity became stable by 20 weeks in the high acuity group and by 12 weeks in the low acuity group. The correlation between visual acuity and foveal thickness was weak (correlation efficiency: -0.15). The photoreceptor layer was graded as 1 in two eyes, 2 in three eyes and 3 in one eye among high acuity group, whereas the layer was graded as 1 in no eyes, 2 in two eyes and 3 in eight eyes among low acuity group. The difference in the number of eyes graded as 3 between the high and low acuity groups was statistically significant (p=0.035). Conclusions: The photoreceptor layer, using OCT, can be graded according to the area of degeneration. Functional outcome correlated with the grade of photoreceptor degeneration rather than foveal thickness.

Purpose: To suggest parameters on optical coherence tomography (OCT) implicating visual prognosis after macular hole surgery, foveal thickness and photoreceptor layer were assessed by OCT after successful closure of the macular hole. Methods: Twenty-two eyes underwent macular hole surgery and were followed up 6 months or longer. Of these, 16 eyes which were closed without neurosensory retinal defect were enrolled. OCT and visual acuity were reviewed and collected retrospectively. The photorecepter layer was graded as 1 to 3 according to the relative area of degeneration in the 1-mm of foveal center. Correlations between visual acuity and OCT parameters including the grade of the photorecepter layer and the foveal thickness were statistically analyzed. Results: Visual acuities of six eyes were 0.4 or greater. Visual acuity became stable by 20 weeks in the high acuity group and by 12 weeks in the low acuity group. The correlation between visual acuity and foveal thickness was weak (correlation efficiency: -0.15). The photoreceptor layer was graded as 1 in two eyes, 2 in three eyes and 3 in one eye among high acuity group, whereas the layer was graded as 1 in no eyes, 2 in two eyes and 3 in eight eyes among low acuity group. The difference in the number of eyes graded as 3 between the high and low acuity groups was statistically significant (p=0.035). Conclusions: The photoreceptor layer, using OCT, can be graded according to the area of degeneration. Functional outcome correlated with the grade of photoreceptor degeneration rather than foveal thickness.

Macular hole, OCT, Photoreceptor layer