마이봄샘 기능부전을 동반한 안구건조증 환자에 대한 펄스광선 치료의 임상효과
Therapeutic Effect of Intense Pulsed Light of Dry Eye with Meibomian Gland Dysfunction
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목적: 마이봄샘 기능부전을 포함한 안구건조증 환자를 대상으로 펄스광선 치료(intense pulsed light, IPL)를 시행한 후 안구건조증에 대한 임상적 분석을 통해 치료 효과를 알아보고자 하였다. 대상과 방법: 마이봄샘 기능부전으로 진단된 환자 62명 124안을 대상으로 후향적 연구를 시행하였다. 대상 환자는 3주 간격으로 3차례의 IPL을 치료받았으며, 치료 전과 3주 간격의 시간에 따른 Meibomian gland expressibility (MGE), Meibomian gland secretion score (MGS), 눈물띠검사(TMH), 비침습적 눈물막파괴시간(noninvasive break-time, NIBUT), 플루오레신 각막염색 점수(Oxford scale), 환자의 증상(Ocular Surface Diseases Index [OSDI], 주관적인 증상 개선 정도)를 비교하였다. 결과: IPL 치료 후 마이봄샘 기능관련 지표(MGE, MGS), 안구 표면 관련 지표(NIBUT, Oxford scale), 안구건조 증상(OSDI score, 주관적인 증상 개선 정도)은 치료 전과 비교하여 IPL 1차 후, IPL 3차 후 통계적으로 유의하게 개선되었다(모두 p<0.05). 하지만 눈물띠검사는 IPL 치료 전후 비교에서 통계적으로 유의한 변화를 보이지 않았다. 결론: 마이봄샘 기능부전을 가진 안구건조증 환자에게 IPL 치료는 눈물막을 안정시키고, 마이봄샘 기능 이상 및 주관적인 증상을 개선시키므로 안구건조증의 효과적인 치료가 될 수 있음을 확인하였다.
Abstract
Purpose: To evaluate the therapeutic effect of intense pulsed light (IPL) therapy for the treatment of dry eye with meibomian gland dysfunction (MGD). Methods: A retrospective study was conducted for 124 eyes of 62 patients with dry eye with MGD who underwent 3 IPL sessions at 3 week intervals. All patients underwent clinical examination before and during treatment as well as 3 weeks after the last treatment. Measured parameters include Meibomian gland expressibility (MGE), Meibomian gland secretion (MGS) score, tear meniscus height (TMH), noninvasive break-time (NIBUT), corneal staining score (Oxford scale), Ocular Surface Diseases Index (OSDI), and subjective ocular discomfort improvement. Results: Meibomian gland function (MGE, MGS), ocular surface parameters (NIBUT, Oxford scale) and dry eye symptom (OSDI, subjective ocular discomfort improvement) of patients were significantly improved from baseline to after the 1st IPL, and the 3rd IPL weeks (p < 0.05 for all). However, no significant difference in TMH was observed. Conclusions: This study showed that IPL was a useful and effective treatment in patients of dry eye with MGD to stabilizes the tear film and improve meibomian gland function and ocular symptoms.
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