목적 : 당뇨 및 당뇨망막병증의 진행이 시신경 유두 및 망막신경섬유층에 형태학적 변화를 유발하는지 알아보기 위해 정상 안압을 갖는 당뇨환자에서 당뇨망막병증의 정도에 따른 변화를 빛간섭단층촬영을 이용하여 분석하였다. 대상과 방법 : 제 2형 당뇨환자 192명을 대상으로 안저검사를 시행하여 정상망막군, 경도 및 중등도 비증식당뇨망막병증군, 중증도 비증식당뇨망막병증군, 증식당뇨망막병증군으로 분류하였고 빛간섭단층촬영을 시행한 후 정상대조군과 비교하였다. 결과 : 비증식당뇨망막병증군들에서 다른 군들에 비해 망막신경섬유층의 평균 두께 및 코쪽 사분원 두께가 감소하였으며 반면에 증식당뇨망막병증군에서는 귀쪽 사분원의 망막신경섬유층 두께가 증가한 양상을 보였다. 당뇨 유병기간이 길수록 망막신경섬유층의 평균 두께 및 코쪽 사분원의 두께가 감소하였다. 시신경 유두 분석 지표의 차이를 분석한 결과 각 군간 유의한 차이를 발견할 수 없었다. 결론 : 비증식당뇨망막병증환자에서 망막신경섬유층의 평균 두께 및 코쪽 사분원의 두께가 감소하였다. 당뇨환자에서 녹내장을 진단하거나 진행여부를 판단할 때 당뇨 및 당뇨망막병증에 의한 변화를 고려해야 한다.

Purpose: Retinal nerve fiber layer (RNFL) thickness and optic nerve head (ONH) in diabetic patients with normal tension were analyzed using optical coherence tomography (OCT), which revealed that diabetes induce morphologic changes in optic disc and RNFL thickness. Methods: A total of 192 patients with type 2 diabetes were analyzed with fundus examination and classified as having normal retina, mild - moderate, severe nonproliferative retinopathy (NPDR), or proliferative retinopathy (PDR). These patients were evaluated with OCT and compared with normal control group. Results: The mean average thickness and nasal average thickness of RNFL in mild-moderate, and severe NPDR groups decreased compared with those of the other groups. There was an increase in the temporal average thickness of RNFL in the PDR group. As the duration of diabetes increased, the mean average and nasal average of RNFL thickness also decreased. The severity of diabetic retinopathy didn’t show statistically significant differences in a topographic analysis of the optic nerve head. Conclusions: The mean average thickness and nasal average of RNFL decreased in NPDR groups. Diabetic changes should be considered when diabetes patients are diagnosed with glaucoma or glaucoma progression.

Purpose: Retinal nerve fiber layer (RNFL) thickness and optic nerve head (ONH) in diabetic patients with normal tension were analyzed using optical coherence tomography (OCT), which revealed that diabetes induce morphologic changes in optic disc and RNFL thickness. Methods: A total of 192 patients with type 2 diabetes were analyzed with fundus examination and classified as having normal retina, mild - moderate, severe nonproliferative retinopathy (NPDR), or proliferative retinopathy (PDR). These patients were evaluated with OCT and compared with normal control group. Results: The mean average thickness and nasal average thickness of RNFL in mild-moderate, and severe NPDR groups decreased compared with those of the other groups. There was an increase in the temporal average thickness of RNFL in the PDR group. As the duration of diabetes increased, the mean average and nasal average of RNFL thickness also decreased. The severity of diabetic retinopathy didn’t show statistically significant differences in a topographic analysis of the optic nerve head. Conclusions: The mean average thickness and nasal average of RNFL decreased in NPDR groups. Diabetic changes should be considered when diabetes patients are diagnosed with glaucoma or glaucoma progression.