한국인 거짓비늘증후군 환자에서 전신 질환 및 안과 질환과의 연관성
Association with Systemic and Ophthalmic Disease in Korean Pseudoexfoliation Syndrome Patients
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목적: 거짓비늘증후군으로 진단된 환자들의 전신 질환 및 안과 질환과의 관련성 여부를 비교 분석하고자 하였다. 대상과 방법: 본원 안과에 내원한 환자 중 2016년 1월부터 2021년 1월까지 거짓비늘증후군으로 진단받은 207안과 비슷한 연령대의거짓비늘증후군이 없는 201안의 의무기록을 후향적으로 분석하였다. 각 군의 나이, 성별, 당뇨, 고혈압, 심혈관 질환, 뇌혈관 질환의전신 질환과 망막혈관폐쇄, 나이관련황반변성, 녹내장, 백내장수술 빈도와 수술 관련 합병증 빈도를 비교하였다. 또한 로지스틱 회귀분석으로 거짓비늘증후군과 연관이 있는 인자를 분석하였다. 결과: 거짓비늘증후군에서 당뇨, 고혈압의 빈도, 나이관련황반변성, 녹내장, 백내장수술 과거력, 백내장수술 시 합병증이 대조군에 비해 유의하게 높았으며(all Ps≤0.049), global retinal nerve fiber layer thickness, mean deviation, pattern standard deviation, 산동시 동공 직경도 유의한 차이를 보였다(all Ps<0.001). 거짓비늘증후군과 연관된 인자를 찾기 위한 단변량 및 다변량 분석에서 모두당뇨, 나이관련황반변성, 녹내장의 유무가 유의한 결과를 보였다(odds ratio [OR]=1.613, p=0.041; OR=3.071, p=0.001; OR=17.800, p<0.001). 결론: 거짓비늘증후군에서 당뇨, 고혈압뿐만 아니라 나이관련황반변성, 녹내장이 높은 빈도를 보이고, 특히 나이관련황반변성과 녹내장은 거짓비늘증후군과 깊은 연관성을 보이므로 임상적 고려가 필요할 것으로 사료된다.
Abstract
Purpose: To analyze the association of systemic and ophthalmic disease in patients with pseudoexfoliation syndrome. Methods: We retrospectively reviewed the records of 207 patients with pseudoexfoliation syndrome and 201 age-matched controls without pseudoexfoliation syndrome seen from January 2016 to January 2021. Age, sex, systemic diseases such as diabetes mellitus, hypertension, cardiovascular and cerebrovascular disease, and ocular disease including retinal vascular occlusion, age-related macular degeneration (AMD), glaucoma, cataract surgery rate, complications related to cataract surgery, and ocular characteristics were compared. Factors associated with pseudoexfoliation syndrome were analyzed using logistic regression. Results: The frequencies of diabetes mellitus, hypertension, AMD, glaucoma, a history of cataract surgery, and complications related to cataract surgery were significantly higher in patients with pseudoexfoliation syndrome (all Ps ≤ 0.049). The pseudoexfoliation syndrome group had a significantly thinner global retinal nerve fiber layer, worse mean deviation and pattern standard deviation, and smaller dilated pupil size than the controls (all Ps < 0.001). In univariate and multivariate logistic regressions, the presence of diabetes mellitus (odds ratio [OR] = 1.613, p = 0.041), AMD (OR = 3.071, p = 0.001), and glaucoma (OR = 17.800, p < 0.001) were associated with pseudoexfoliation syndrome. Conclusions: Diabetes mellitus, hypertension, AMD, and glaucoma were more frequent in pseudoexfoliation syndrome patients. Since pseudoexfoliation syndrome is closely related to AMD and glaucoma, this requires clinical consideration.
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