녹내장 유형에 따른 혈청 호모시스테인, 비타민 B12, 비타민 B6 및 엽산 농도의 비교

주병주,황영훈,이주화,김태진,Byung Ju Choo,Young Hoon Hwang,Joo Hwa Lee,Tai Jin Kim 대한안과학회 2013 대한안과학회지 Vol.54 No.1

Purpose: To compare the levels of serum homocysteine, vitamin B12, vitamin B6 and folate in patients with normal-tension glaucoma, pseudoexfoliation glaucoma and high-tension glaucoma. Methods: Thirty-two healthy subjects, 35 patients with normal-tension glaucoma, 22 patients with pseudoexfoliation glaucoma and 31 patients with high-tension glaucoma were included in the present study. Fasting venous samples were collected from all the participants. The levels of serum homocysteine, vitamin B12, vitamin B6 and folate were measured. One-way analysis of variance was used for the comparison of homocysteine, vitamin B12, vitamin B6 and folate levels among the 4 groups. Results: The mean homocysteine levels in the pseudoexfoliation glaucoma and high-tension glaucoma group were 17.91 ± 5.11 and 17.60 ± 3.89 μmol/l, respectively, which were significantly higher than that of the control group (p = 0.014, p = 0.013, respectively). The mean vitamin B6 levels in the pseudoexfoliation glaucoma and high-tension glaucoma group were 17.67 ± 14.32 and 17.00 ± 10.58 nmol/l, respectively, which were significantly lower than that of the control group (p = 0.026, p = 0.008, respectively). Conclusions: Hyperhomocysteinemia may play a role as a risk factor in the development or progression of pseudoexfoliation glaucoma and high-tension glaucoma.

리바운드안압계를 이용하여 측정한 시야검사 전후 안압 차이

박중현,김진영,이은경,이혜진,정진호,이상윤 대한안과학회 2020 대한안과학회지 Vol.61 No.1

Purpose: To investigate the effect of a visual field (VF) test on intraocular pressure (IOP) and relevant parameters in a normal group and an open-angle glaucoma group, and to determine the appropriate time of IOP measurements. Methods: The IOP was measured by a rebound tonometer before and after a VF test for the normal, normal-tension glaucoma, and high-tension glaucoma groups, and IOP differences after the VF tests were compared among groups. Parameters including age, sex, axial length, central corneal thickness, IOP before the VF test, the VF index, mean deviation, VF test duration, and usage of IOP lowering medications were investigated, and the correlations of these parameters with IOP changes after VF tests were determined using linear regression analyses. Results: A total of 232 participants (232 eyes) included 55 normal subjects, 131 normal-tension glaucoma patients, and 46 high-tension glaucoma patients. The IOP differences after VF tests were not statistically significant in the normal and high-tension glaucoma groups, and the difference was 0.31 mmHg in the normal-tension glaucoma group (p = 0.013). Multivariate regression analyses revealed that axial length (p = 0.005) and IOP before the VF test (p < 0.001) were relevant factors in the total number of patients, and the axial length (p = 0.017), IOP before the VF test (p = 0.001), and duration (p = 0.029) were found to be significantly associated with IOP differences in the normal-tension glaucoma group. Conclusions: The IOP changes after VF tests using the rebound tonometer were significant in the normal-tension glaucoma group, but were within an acceptable range. The IOP value measured after a VF test is clinically valid in clinical practice. 목적: 정상 대상군과 개방각녹내장 환자군에서 시야검사가 안압에 미치는 영향 및 관련 인자들을 분석하고 적절한 안압측정 시점에 대해 논의하고자 한다. 대상과 방법: 2015년 10월부터 2016년 4월까지 내원한 정상 대상자, 정상안압녹내장환자, 고안압녹내장환자를 대상으로 험프리시야검사 시행 전후로 리바운드안압계로 안압 측정한 후 각 군별로 변화 양상을 비교하였다. 또한 나이, 성별, 안축장길이, 중심각막두께, 검사 전 안압, 시야검사 결과, 시야검사 시행 시간, 안압하강제 사용 개수 및 종류 등에 대해 각 군별 비교를 시행하고, 안압 변화와의 관계를 회귀분석으로 분석하였다. 결과: 정상 대상군 55명, 정상안압녹내장환자군 131명, 고안압녹내장환자군 46명을 포함한 232명(232안)에서 확인된 시야검사 전후 안압 차이는 정상 대상군 및 고안압녹내장환자군에서 유의한 차이가 없었고, 정상안압녹내장군에서 0.31 mmHg의 변화를 보였다(p=0.013). 전체 환자군을 대상으로 다변량 회귀분석 결과, 안축장의 길이(p=0.005)와 검사 전 안압(p<0.001)이 검사 전후 안압 변화와 유의한 연관인자로 파악되었고, 정상안압녹내장군에서는 안축장의 길이(p=0.017), 검사 전 안압(p=0.001), 그리고 검사 시간(p=0.029)이 유의한 연관을 보였다. 결론: 정상안압녹내장군에서 리바운드안압계로 측정 시 시야검사 전후로 유의한 안압 차이를 보였으나, 이는 수용 가능한 범위로 시야검사 이후 측정된 안압이 임상적으로 활용 가능함을 확인하였다.

Investigation of the Association between Normal-tension Glaucoma and Single Nucleotide Polymorphisms in Natriuretic Peptide Gene

( Jin Wook Jeoung ),( Dong Myung Kim ),( Hyun Soo Ko ),( Sung Sup Park ),( Ji Yeon Kim ),( Sung Yeun Kim ),( Tai Woo Yoo ) 대한안과학회 2007 Korean Journal of Ophthalmology Vol.21 No.1

Purpose: The expression of natriuretic peptides in the neural bundles of the anterior portion of the optic nerves and their functions in regulating vessel tone and blood flow may suggest a possible role in the pathogenesis of glaucoma. The purpose of this study was to investigate the association between normal-tension glaucoma and the genetic variations of atrial natriuretic peptide (Nppa) and natriuretic peptide receptor A (Npr1) gene. Methods: Sixty-seven Korean normal-tension glaucoma (NTG) patients and 100 healthy subjects (as normal controls) were enrolled. DNA from peripheral blood leukocytes was extracted, and the genotypes of five polymorphisms (c.94G>A, c.454T>C, IVS1+16C>T, IVS2+701G>A, and c.-764C>G) in the Nppa gene and one polymorphism (c.1023G>C) in the Npr1 gene were determined using the restriction fragment length polymorphism and the SNaPshot methods. The genotype and allele frequencies of these polymorphisms in patients with NTG and normal controls were compared using the Fisher`s exact test and the chi-square test. Results: In both groups, the genotype distributions were in accordance with the Hardy-Weinberg equilibrium. There was no significant difference in the frequency of the Nppa and Npr1 alleles or genotypes in the normal-tension glaucoma group as compared to the control group. Conclusions: Nppa and Npr1 gene polymorphisms are not associated with normal-tension glaucoma, suggesting that this gene does not have an important role in the pathogenesis of optic neuropathy in this disease.

정상안압녹내장의 시야 진행과 시신경유두주위위축의 관련성

한종철,서울,임동희,기창원.Jong Chul Han. MD. Wool Suh. MD. Dong Hui Lim. MD. Changwon Kee. MD. PhD 대한안과학회 2012 대한안과학회지 Vol.53 No.6

Purpose: To evaluate the relations between progression of glaucoma in visual field and peripapillary area change in normal tension glaucoma (NTG). Methods: We respectively evaluated 66 patients (66 eyes) with normal tension glaucoma; these patients were classified as progressive glaucoma group and non-progressive glaucoma group by visual field test. Interobserver and intraobserver agreement was evaluated for qualitative assessment. Zone β change was measured by Image J (National Institute of Health, Bethesda, USA) by two methods. One method used paired t-test and the other method used CV (correlation of variation) to define significant progression of zone β. Results: 46 patients (46 eyes) were classified as progressive glaucoma and 20 patients (20 eyes) were classified as non-progressive glaucoma. There was no statistically significant different change of zone β between two groups and there were no changes of zone β over coefficient of variation (CV). Conclusions: The measurement of change of zone β seems to be of no use in recognition of progression in normal tension glaucoma. J Korean Ophthalmol Soc 2012;53(6):807-812

녹내장과 정상안의 중심망막혈관 직경 비교

장민욱,김용연 대한안과학회 2009 대한안과학회지 Vol.50 No.5

Purpose: To compare the diameter of central retinal vessels between patients with normal-tension glaucoma, primary open-angle glaucoma and healthy (control) eyes. Methods: The authors reviewed 30 eyes of 30 normal-tension glaucoma patients, 20 eyes of 20 primary open-angle glaucoma patients and 30 eyes of normal persons who had no systemic vascular diseases. The diameters of the central retinal arteries and veins were measured and calculated using a revised Parr-Hubbard formula, and results were compared between the groups. Results: The diameter of the central retinal vessel showed no statistical differences between the eyes with normal-tension glaucoma and primary-open angle glaucoma. However, there were significant differences between the eyes of patients with glaucoma and the normal control eyes (p<0.05). Conclusion: The diameter of the central retinal vessels in glaucoma patients were narrower than that in the control group. Our results suggest that the diameter of the central retinal vessels may affect the development of glaucoma both in normal tension and primary open-angle types, or that glaucomatous damage may influence the diameter of the central retinal vessels. 목적: 정상안압녹내장 환자와 원발개방각녹내장 환자 및 정상인을 대상으로 중심망막혈관 직경을 구하여 비교하고자 하였다. 대상과 방법: 고혈압, 당뇨 및 심혈관계 질환이 없으며 본원에서 처음으로 진단받은 정상안압녹내장 환자 30명, 원발개방각녹내장 환자 20명 그리고 정상인 30명을 대상으로 망막동맥 및 정맥의 직경을 측정하고 이 값을 토대로 변형된 Parr-Hurbard 공식을 이용하여 중심망막동맥 및 정맥의 직경을 구하여 비교하였다. 결과: 정상안압녹내장 환자에서 중심망막동맥 및 정맥의 직경은 원발개방각녹내장 환자와의 비교에서 유의한 차이를 보이지 않았으나 (p>0.05) 두 녹내장 군 모두 정상안과의 비교에서는 혈관직경이 유의하게 좁았다(p<0.05). 결론: 녹내장 환자의 중심망막혈관 직경은 정상인에 비해 좁았다. 이는 정상안압녹내장 및 원발개방각녹내장의 발생 및 진행에 혈관직경 혹은 혈역학적 요인이 영향을 미칠 가능성 혹은 녹내장의 진행이 혈관직경에 영향을 미칠 가능성을 시사한다.

+90디옵터 렌즈와 광간섭단층촬영을 이용한 시신경유두함몰비의 비교

조병주 대한안과학회 2008 대한안과학회지 Vol.49 No.4

Purpose: The author compared the effect of the cup-to-disc ratio using the Volk Superfield lens and optical coherence tomography (OCT) to evaluate its usefulness in glaucoma diagnosis and follow-up. Methods: One hundred ninety-seven eyes of 100 patients were enrolled: 34 normal, 75 glaucoma suspected, 43 normal tension glaucoma (NTG), 45 primary open angle glaucoma (POAG). Routine ophthalmic examinations, fundus examinations, and cup-to-disc ratio measurement using the Superfield lens after pupil dilatation, visual field test, OCT optic nerve head analysis, and OCT retinal nerve fiber layer analysis were performed. The author compared cup-to-disc ratio using the Superfield lens and OCT in normal, glaucoma suspected, normal tension glaucoma, and primary open angle glaucoma. Results: Using the Superfield lens, the mean cup-to-disc ratio was 0.36±0.07 in normal eyes, 0.61±0.12 in suspected glaucoma, 0.75±0.11 in NTG, 0.70±0.17 in POAG. Using OCT, the mean cup-to-disc ratio was 0.58±0.13 in normal eyes, 0.69±0.12 in suspected glaucoma, 0.80±0.10 in NTG, and 0.76±0.15 in POAG. In all groups, cup-to-disc ratio using OCT were greater than using the Superfield lens and were statistically significant. Conclusions: Considering these differences in the clinical assessment of glaucoma, the combined use of the Superfield lens and OCT would be helpful in its diagnosis and follow-up.

정상안압녹내장 환자에서 혈액검사를 통한 전신적 인자에 대한 분석

이나영,안명덕,Na Young Lee,Myung Douk Ahn 대한안과학회 2010 대한안과학회지 Vol.51 No.2

Purpose: In this study, we evaluated systemic hemodynamic factors of normal tension glaucoma. Methods: Forty patients with normal tension glaucoma and thirty healthy people were investigated with regard to hemoglobin, hematocrit, RBC count, WBC count, platelet count, fasting glucose, HbA1c, total cholesterol, triglycerides, LDL, HDL, and highsensitivity C-reactive protein (hsCRP). Also, ET-1 and MCP-1 were measured using enzyme-linked immunosorbent assay kits. Results: The results of the blood examinations showed no statistically significant differences in hemoglobin, hematocrit, RBC count, WBC count, platelet count, fasting glucose, HbA1c, total cholesterol, LDL, HDL, and hsCRP. Only triglycerides showed a statistically significant difference between the groups (P=0.03). The level of serum ET-1 was significantly higher in the normal tension glaucoma group (P=0.007). The results of MCP-1 showed no statistically significant difference. Conclusions: We conclude that normal tension glaucoma Is associated with an increased level of triglycerides and that the level of ET-1 could be a hemodynamic cause of normal tension glaucoma. J Korean Ophthalmol Soc 2010;51(2):241-247

정상안압녹내장의 빠른 시야손상진행 위험요인

유인정,이정민,기창원,In Jeong Lyu,Jung Min Lee,Changwon Kee 대한안과학회 2012 대한안과학회지 Vol.53 No.7

Purpose: To evaluate risk factors of rapid visual field progression in normal-tension glaucoma. Methods: The authors of the present study reviewed the medical records of patients with normal-tension glaucoma who were treated between 2001 and 2011. The rapid progression group was composed of patients who showed a visual field index progression rate of ≤ -2.0%/yr, and the slow progression group was composed of patients who showed a visual field index progression rate of > -1.0%/yr using a Humphrey visual field analyzer (HFA). Age, sex, diabetes, hypertension, migraine history, family history of glaucoma, refractive error, central corneal thickness, disc hemorrhage, beta-zone parapapillary atrophy, baseline mean deviation, pattern standard deviation, initial IOP, mean follow-up IOP, peak IOP, IOP fluctuation, and number of eye drops between the 2 groups were compared. Results: Among the 52 patients with normal-tension glaucoma, 26 were classified into the rapid progression group and 26 were classified into the slow progression group. The mean visual field index progression rate was -3.92%/yr and -0.42%/yr, respectively. In the univariable model, migraine history, disc hemorrhage, beta-zone parapapillary atrophy, and number of eye drops were associated with rapid visual field progression. According to multivariate analysis, disc hemorrhage and number of eye drops were statistically significant risk factors. Conclusions: Disc hemorrhage and number of eye drops were associated with rapid visual field progression in normal tension glaucoma patients. J Korean Ophthalmol Soc 2012;53(7):996-1001

초기 정상안압녹내장과 초기 원발개방각녹내장의 망막신경섬유층 두께 비교

문선경,전루민,최규룡,Sun-Kyung Moon,Roo-Min Jun,Kyu-Ryong Choi 대한안과학회 2010 대한안과학회지 Vol.51 No.2

Purpose: To investigate the comparison of retinal nerve fiber layer (RNFL) thickness parameters measured by optical coherence tomography (Stratus OCT 3000TM) and visual field indices in early normal-tension glaucoma (NTG) and early primary open-angle glaucoma (POAG). Methods: Sixty-one early normal-tension glaucomatous eyes, 21 early primary open-angle glaucomatous eyes and 34 healthy control eyes were enrolled in this cross-sectional study. Each subject received a visual field test (Humphrey C30-2) and the fast RNFL thickness algorithm test by OCT. The correlations between RNFL thickness and visual field indices were analyzed. The sensitivity and specificity for the detection of early glaucoma were determined with the area under the receiver operating characteristics curve (AUROC). Results: All RNFL thickness values except for the temporal quadrant RNFL thickness were significantly decreased in the early NTG and POAG groups (p<0.05). In early POAG, the average and superior quadrant RNFL thicknesses were significantly thinner than in the early NTG group. Significant correlations were observed between the PSD and the average and superior quadrant RNFL thicknesses in the early NTG and POAG groups (p<0.05). The average RNFL thickness for early glaucoma had the widest AUROC among all of the parameters. Conclusions: In the early NTG group with visual field defects similar to those of early POAG, RNFL defects measured by OCT were less severe, particularly in the average and superior quadrant RNFLs. J Korean Ophthalmol Soc 2010;51(2):248-253

정상안압녹내장에서 근시가 녹내장의 진행에 미치는 영향

손세운,기창원,Sae Woon Sohn,Chang Won Kee 대한안과학회 2007 대한안과학회지 Vol.48 No.4

Purpose: To evaluate the influence of myopia on the progression of normal tension glaucoma. Methods: A retrospective study of 72 patients with normal tension glaucoma who were treated from 1984. Subjects were divided into 4 groups which are myopic group (D<-1), moderate myopic group (D<-3), severe myopic group (D<-6) and non-myopic group (D>-1). The change of MD (Mean deviation) and CPSD (corrected pattern standard deviation) of non-myopic group were compared to other myopic groups. In addition, we corrected each analysis in commensurate with age, basal IOP, post treated IOP, existence of hypertension and diabetes mellitus in order to preclude the possibility which these factors would influence to the progression. Results: There was no statistically significant difference between non-myopic group and each myopic groups in MD and CPSD changes against refraction. Moreover, with the correction of other factors, there was no statistically significant difference (Mixed method, P>0.1). Conclusions: Myopia did not affect the progression of normal tension glaucoma once treated.