본태성 안검경련 환자에서 보툴리눔 독소 주사 후 안압과 건성안 수치의 변화
Changes in Intraocular Pressure and Dry Eye Signs after Botulinum Toxin Injections to Treat Patients with Essential Blepharospasm
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목적: 본태성 안검경련 환자에서 보툴리눔 독소 A 주사 전과 후에 안압과 건성안 검사 수치의 변화에 대하여 알아보고자 한다. 대상과 방법: 2021년 11월부터 2022년 7월까지 본원에서 본태성 안검경련으로 진단된 환자 39명 78안을 대상으로 전향적 연구를 시행하였다. 주사 전과 주사 후 1개월, 3개월에 골드만편평안압계를 이용하여 안압을 측정하였고 비침습적 눈물막파괴시간, 눈물지질층두께, 눈물띠높이, 마이봄샘 소실률은 IDRAⓇ (SBM Sistemi, Turin, Italy)를 이용하여 측정하였다. 결과: 평균 안압은 보톡스 주사 전, 주사 후 1개월, 3개월에 각각 14.33 ± 3.47 (7-21) mmHg, 13.45 ± 3.54 (9-21) mmHg, 13.28 ± 2.98 (7-20) mmHg로 주사 전에 비해 유의하게 감소하였다(p=0.002, p=0.004). 건성안 증상을 보인 24안에서 보톡스 주사 1개월후 비침습적 눈물막파괴시간이 통계적으로 유의한 차이를 보였고 눈물지질층두께, 눈물띠높이, 마이봄샘 소실률은 통계적으로 유의한차이를 보이지 않았으며(p=0.007, p=0.201, p=0.586, p=0.435), 3개월 후 비침습적 눈물막파괴시간을 포함한 모든 건성안 수치가통계적으로 유의하지 않았다(p=0.202, p=0.542, p=0.240, p=0.721). 결론: 본태성 안검경련 환자에서 동반될 수 있는 건성안 증상 완화와 안압상승 완화에 보툴리눔 독소 A 주사가 일시적이지만 효과가있음을 알 수 있었다.
Abstract
Purpose: This study investigates the intraocular pressures and dry eye signs before and after botulinum toxin (botox) injections for patients with essential blepharospasm. Methods: From November 2021 to July 2022, a prospective study examined 78 eyes of 39 patients diagnosed with essential blepharospasm. Before injection and 1 and 3 months after injection, intraocular pressures (IOPs) were measured using a Goldmann applanation tonometer. The noninvasive breakup time (NIBUT), lipid layer thickness (LLT), tear meniscus height (TMH), and meibomian gland clearance were assessed with the aid of the IDRA platform (SBM Sistemi, Turin, Italy). Results: The average IOPs were 14.33 ± 3.47 (7-21), 13.45 ± 3.54 (9-21), and 13.28 ± 2.98 (7-20) mmHg before, and 1 and 3 months after, botox injection respectively (p = 0.002 , p = 0.004). Twenty-four eyes of 12 patients with dry eye symptoms evidenced a significant difference in the NIBUT 1 month after Botox injection, but no significant difference in any of the LLT, TMH, or meibomian gland areal loss percentage (p = 0.007, 0.201, 0.586, and 0.435 respectively). After 3 months, no dry eye parameter change, including the NIBUT, was significant (p = 0.202, 0.542, 0.240, and 0.721 respectively). Conclusions: Botulinum toxin A injection temporarily relieved dry eye symptoms and reduced the IOP in patients with essential blepharospasm.
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