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히알루론산의 특성 및 건성안을 포함한 안구표면질환에서의 사용

Characteristics of Hyaluronic Acid and Its Use in Ocular Surface Diseases Including Dry Eye

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주제분류안과학

초록

히알루론산(HA)은 척추동물의 상피, 신경, 결합조직의 세포외기질에서 발견된 다당질이다. HA는 높은 수분 보유력, 점탄성, 그리고염증 및 상처회복에 관여하는 신호분자로서의 역할 등 고유의 다양한 특성들 덕분에 건성안을 포함한 안구표면질환 치료에 있어 중요한 치료제로 널리 사용되고 있다. 본 종설에서는 안구표면질환의 치료와 관련된 HA의 물리화학적, 생물학적 특성을 살펴보고, 각결막상피결손, 건성안, 수술 후 건성안 등 안구표면질환에서 HA 점안제가 눈물막에 미치는 영향, HA 점안제의 작용 기전, 임상적인 효과와 부작용에 대하여 그동안 발표된 전임상실험, 임상시험, 메타분석 연구 결과들을 정리하였다. 이를 통하여 건성안을 포함한 안구표면질환에 대한 HA 점안제 사용에 대한 임상적 근거와 주의점을 제시하여 임상적인 판단에 도움을 주고자 한다.

Abstract

Hyaluronic acid (HA) is a polysaccharide found in the extracellular matrix of the epithelial, nervous, and connective tissues of vertebrates. It is widely used in the treatment of ocular surface diseases (OSDs), including dry eye, due to its high water-retaining capacity, viscoelasticity, and role as a signaling molecule in inflammation and wound healing. This paper reviews the physicochemical and biological properties of HA related to the treatment of OSDs and the results of published preclinical studies, clinical trials, and meta-analyses on the effects of HA eye drops on the tear film, the mechanism of action of HA eye drops, and its clinical effects and adverse events in OSDs, such as corneal/conjunctival epithelial defects, dry eye, and postoperative dry eye. This review should help inform clinical judgments by providing clinical evidence and precautions on the use of HA eye drops in OSDs, including dry eye.

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