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이식편대숙주질환과 관련된 건성안 환자에서 사이클로스포린A과 제대혈청 병합치료의 효과

Effect of Combined Treatment with Cyclosporine A and Cord Serum for Dry Eye Associated with Graft-Versus-Host-Disease

윤경철|오한진|최정한
대한안과학회 (The Korean Ophthalmological Society)|2013.04|대한안과학회지 (Journal of The Korean Ophthalmological Society)|제54권 제4호|pp. 587-594

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키워드

Dry eyeCyclosporin AGraft-versus-host diseaseUmbilical cord serum
주제분류안과학

초록

목적: 이식편대숙주질환과 관련된 건성안 환자에서 사이클로스포린 A와 제대혈청 점안액 병합치료의 효과를 알아보고자 하였다. 대상과 방법: 이식편대숙주질환에서 심한 건성안이 발생한 18명의 환자를 0.05% 사이클로스포린 A와 20% 제대혈청을 같이 사용한1군, 0.05% 사이클로스포린 A를 사용한 2군, 인공눈물만 사용한 3군으로 나누어 치료 전과 후 1, 3, 6개월째 눈물막파괴시간, 쉬르머검사, 눈물청소율, 각막상피병증 검사를 시행하였다. 결과: 1군에서 눈물막파괴시간, 눈물청소율, 그리고 각막상피병증 검사는 치료 전과 후 6개월째 각각 3.25 ± 1.18초와 6.63 ± 0.96초(p＜0.01), 2.38 ± 0.72와 3.13 ± 0.72 (p＜0.01), 6.31 ± 2.15와 0.88 ± 0.89 (p＜0.01)로 유의한 호전이 있었다. 1군이 2군과 3군보다 눈물막파괴시간은 3, 6개월째, 각막상피병증 검사는 1, 3, 그리고 6개월째 더 큰 효과를 보였다. 결론: 이식편대숙주질환과 관련된 건성안 환자에서 0.05% 사이클로스포린과 20% 제대혈청점안액 병합치료가 효과적으로 사용될 수있을 것으로 생각한다.

Abstract

Purpose: To investigate the efficacy of combined treatment with 0.05% cyclosporine A and 20% umbilical cord serum eye drops for severe dry eye associated with graft-versus-host disease (GVHD). Methods: Eighteen patients with severe dry eye associated with GVHD were treated with 0.05% cyclosporine A and 20%umbilical cord serum eye drops (group 1, n = 16), 0.05% cyclosporine A eye drops (group 2, n = 10) or artificial tears only (group 3, n = 10). Tear film break up time (BUT), Schirmer test, tear clearance rate (TCR), and keratoepithelio pathy score were measured before and 1, 3 and 6 months after treatment. Results: In group 1, significant improvement was observed in tear film BUT (from 3.25 ± 1.18 s to 6.63 ± 0.96 s, p < 0.01),TCR (from 2.38 ± 0.72 to 3.13 ± 0.72, p < 0.01) and keratoepithelio pathy score (from 6.31 ± 2.15 to 0.88 ± 0.89, p < 0.01)6 months after treatment. Compared with group 2 and group 3, group 1 showed significant improvement in BUT (3 and 6months after treatment) and keratoepitheliopathy score (1, 3 and 6 months after treatment). Conclusions: Combined treatment with 0.05% cyclosporine A and 20% umbilical cord serum eye drops is effective for severe dry eye associated with GVHD.

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