Symptom Assessment in Dry Eye 설문을 통한 증상 점수와 안구건조증 검사들 사이의 관계 분석
Relationships between Symptoms and Signs of Dry Eye Using Symptom Assessment in Dry Eye Questionnaires
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목적: 안구건조증 환자의 SANDE 증상 점수 양상을 탐색하고, 안구건조증 검사들 사이의 관계를 분석하고자 했다. 대상과 방법: 안구건조증 환자 173명을 후향적 분석했다. 환자의 SANDE 점수, 자가면역질환 및 안수술 병력을 조사하고, 쉬르머검사, 눈물막파괴시간, 안구표면염색점수, 눈물 오스몰농도, 눈물 MMP-9 검사를 시행했다. 이를 토대로 SANDE 점수 분포와 안구건조증소견들에 따른 SANDE 점수 분포 변화 및 상관관계를 분석했다. 특히 눈물막파괴시간(<5/≥5), 안구표면염색점수(<3/≥3)로 구분해 비교했다. 결과: 환자들의 평균 SANDE 점수는 52.6 ± 28.1점이었다. 안구표면염색점수가 3점 이상 군에서 3점 미만 군보다 SANDE 점수가 높았고(79.1 ± 21.6/51.1 ± 27.6, p=0.030), 눈물막파괴시간이 5초 이상 군에서 5초 미만 군보다 SANDE 점수가 낮았다(47.2 ± 25.6/55.6 ± 29.0, p=0.050). 또한 눈물막파괴시간은 SANDE 점수와 음의 상관관계, 안구표면염색점수는 SANDE 점수와 양의 상관경향을 보였다(R=-0.151/0.111, p=0.024/0.073). 안구표면염색점수가 0, 1, 2, 3인 세부군으로 구분했을 때, 점수 증가에 따라 SANDE 점수도 증가하는 경향을 보였다(p for trend=0.008). 타 안구건조증 소견들은 SANDE 점수와 관련성이 없었다. 결론: SANDE 설문을 통한 안구건조증 증상 점수는 눈물막파괴시간 및 안구표면염색점수와 관련성을 보였으나, 증상 및 소견 간 불일치가 뚜렷했다.
Abstract
Purpose: To investigate the pattern of Symptom Assessment in Dry Eye (SANDE) questionnaire symptom scores in dry eye disease (DED) patients and to assess the relationships with several dry eye signs. Methods: The medical records of 173 patients with DED were analyzed retrospectively. Each patient’s SANDE score and history of autoimmune disease and ocular surgery were investigated, and Schirmer’s test, tear film breakup time (TBUT), ocular surface staining score (OSS), tear osmolarity, and tear MMP-9 test were assessed. The distribution of SANDE scores and relationships between the SANDE score and various dry eye signs were analyzed. The relationships between the SANDE scores of TBUT (< 5 / ≥ 5) and OSS (< 3 / ≥ 3) subgroups were compared. Results: The average SANDE score was 52.6 ± 28.1. The SANDE scores were significantly higher in OSS ≥ 3 than in OSS < 3 (79.1 ± 21.6 vs. 51.1 ± 27.6, p = 0.030), and TBUT ≥ 5 had marginally significantly lower SANDE scores than TBUT < 5 (47.2 ± 25.6 vs. 55.6 ± 29.0, p = 0.050). TBUT was significantly negatively (R = -0.151, p = 0.024) correlated with the SANDE score, while OSS was marginally significantly positively (R = 0.111, p = 0.073) correlated. As OSS increased, the SANDE scores tended to increase (p for trend = 0.008). Other dry eye signs were not associated with the SANDE score. Conclusions: The DED symptom score from the SANDE questionnaire was related to TBUT and OSS, but there was still a discrepancy between the symptoms and signs of DED.
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