리바운드안압계를 이용하여 측정한 시야검사 전후 안압 차이 = The Difference in Intraocular Pressure before and after Visual Field Test Measured by Rebound Tonometer

다국어 초록 (Multilingual Abstract)

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.

국문 초록 (Abstract)

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.

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