건성안 환자에서 눈 깜박임에 따른 눈물막 지질층 그래프 패턴 분석
Investigation of Tear Lipid Layer Patterns According to Blinking Among Dry Eye Patients
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목적: 건성안 환자의 눈 깜박임에 따른 눈물막 지질층 그래프 패턴의 임상 지표에 차이가 있는지 분석해 보고자 하였다. 대상과 방법: 2018년 8월부터 2020년 1월까지 Lipiview®를 시행받은 132명의 의무기록을 후향적으로 분석하여 과거력, 세극등검사, 눈물막파괴시간, 눈물분비 정도, 안구표면질환지수, 눈물 지질층 두께, 눈 깜박임 수, 지질층 그래프 패턴을 확인하였다. 건조증은 meibomian gland dysfunction (MGD), aqueous deficiency dry eye (ADDE), combined ADDE/MGD (Combine)으로 나누었으며, 그래프 패턴은 상승형, 안정형, 하강형, 혼합형으로 나누었다. 결과: 지질층 그래프는 상승형 45명, 안정형 16명, 하강형 53명, 혼합형 18명이었고, 패턴별 비교시 안구표면염색점수(p=0.001), 지질층 두께(p=0.019), 총 눈 깜박임 횟수(p=0.001), 부분 눈 깜박임 횟수(p=0.013), 부분 눈 깜박임의 비율(p=0.001)에서 차이를 보였다. 건조증 세부군별 패턴은 MGD는 하강형 44.7%, Combine은 하강형 40.7%, 상승형 35.8%, ADDE는 상승형 38.5%로 흔했다. 결론: Lipiview®에서 보이는 눈 깜박임에 따른 지질층 패턴은 눈 깜박임 횟수, 불완전 눈 깜박임 비율 및 눈물 지질층의 두께와 연관이 있다.
Abstract
Purpose: To investigate tear lipid layer patterns according to blinking using an interferometer for dry eye patients. Methods: We retrospectively reviewed the medical records of 132 patients who underwent dry eye disease-related evaluation, including LipiView®, between August 2018 and January 2020. Data including past history, slit-lamp examination, tear film break-up time, Schirmer, Oxford score grading, lipid layer thickness (LLT), number of blinks, and tear lipid layer patterns according to blinking were collected. We subdivided dry eye as meibomian gland dysfunction (MGD), aqueous deficiency dry eye (ADDE), and combined ADDE/MGD (Combine); we also classified the tear lipid layer patterns as uphill, flat, downhill, and mix. Results: The numbers of patients in each tear lipid film pattern were as follows; uphill 45, flat 16, downhill 53, and mix 18. The statistically significant clinical characteristics among the four patterns were Oxford score (p = 0.001), LLT (p = 0.019), number of blinks (p = 0.001), number of partial blinks (p = 0.013), and the partial/total blinks ratio (p = 0.001). The most common pattern for MGD was downhill 44.7%; for Combine, downhill 40.7% and uphill 35.8%; and for ADDE, uphill 38.5%. Conclusions: The tear lipid layer graph patterns according to blinking using LipiView® were associated with the number of blinks, the partial/total blink ratio, and LLT.
참고문헌 (39)
- Stapleton F, "TFOS DEWS II epidemiology report", Ocul Surf, 15, pp.334~365 (2017)
- Ahn JM, "Prevalence of and risk factors associated with dry eye : The Korea National Health and Nutrition Examination Survey 2010-2011", Am J Ophthalmol, 158, pp.1205~1214 (2014)
- Craig JP, "TFOS DEWS II definition and classification report", Ocul Surf, 15, pp.276~283 (2017)
- Davidson HJ, "The tear film and ocular mucins", Vet Ophthalmol, 7, pp.71~77 (2004)
- Bron AJ, "Functional aspects of the tear film lipid layer", Exp Eye Res, 78, pp.347~360 (2004)
- Tsubota K, "New perspectives on dry eye definition and diagnosis : a consensus report by the Asia Dry Eye Society", Ocul Surf, 15, pp.65~76 (2017)
- Chhadva P, "Meibomian gland disease : the role of gland dysfunction in dry eye disease", Ophthalmology, 124, pp.S20~S26 (2017)
- Cruz AAV, "Spontaneous eyeblink activity", Ocul Surf, 9, pp.29~41 (2011)
- Hirota M, "Effect of incomplete blinking on tear film stability", Optom Vis Sci, 90, pp.650~657 (2013)
- Su Y, "Spontaneous eye blink patterns in dry eye : clinical correlations", Invest Ophthalmol Vis Sci, 59, pp.5149~5156 (2018)
- Wang MTM, "Impact of blinking on ocular surface and tear film parameters", Ocul Surf, 16, pp.424~429 (2018)
- Jie Y, "Evaluation of incomplete blinking as a measurement of dry eye disease", Ocul Surf, 17, pp.440~446 (2019)
- Eom Y, "Correlation between quantitative measurements of tear film lipid layer thickness and meibomian gland loss in patients with obstructive meibomian gland dysfunction and normal controls", Am J Ophthalmol, 155, pp.1104~1110 (2013)
- Finis D, "Evaluation of lipid layer thickness measurement of the tear film as a diagnostic tool for Meibomian gland dysfunction", Cornea, 32, pp.1549~1553 (2013)
- Markoulli M, "Imaging the tear film : a comparison between the subjective Keeler Tearscope-Plus™ and the objective Oculus®Keratograph 5M and LipiView®Interferometer", Curr Eye Res, 43, pp.155~162 (2018)
- Chou YB, "Value of lipid layer thickness and blinking pattern in approaching patients with dry eye symptoms", Can J Ophthalmol, 54, pp.735~740 (2019)
- Nelson JD, "The international workshop on meibomian gland dysfunction: report of the definition and classification subcommittee", Invest Ophthalmol Vis Sci, 52, pp.1930~1937 (2011)
- Nichols KK, "The international workshop on meibomian gland dysfunction: executive summary", Invest Ophthalmol Vis Sci, 52, pp.1922~1929 (2011)
- Jung JW, "Meibomian gland dysfunction and tear cytokines after cataract surgery according to preoperative meibomian gland status", Clin Exp Ophthalmol, 44, pp.555~562 (2016)
- Bron AJ, "Grading Of corneal and conjunctival staining in the context of other dry eye tests", Cornea, 22, pp.640~650 (2003)
- Yoon KC, "Usefulness of double vital staining with 1% fluorescein and 1% lissamine green in patients with dry eye syndrome", Cornea, 30, pp.972~976 (2011)
- Tsubota K, "Tear dynamics and dry eye", Prog Retin Eye Res, 17, pp.565~596 (1998)
- Stevens S, "Schirmer's test", Community Eye Health, 24, pp.45~ (2011)
- Pult H, "A review of meibography", Optom Vis Sci, 89, pp.E760~E769 (2012)
- 강동현, "플릭텐각결막염환자의 눈물간섭계를 이용한 임상양상 분석", 대한안과학회지, 61(1), pp.1~8 (2020), 대한안과학회
- Arita R, "Tear interferometric patterns reflect clinical tear dynamics in dry eye patients", Invest Ophthalmol Vis Sci, 57, pp.3928~3934 (2016)
- Doane MG, "An instrument for in vivo tear film interferometry", Optom Vis Sci, 66, pp.383~388 (1989)
- Goto E, "Differentiation of lipid tear deficiency dry eye by kinetic analysis of tear interference images", Arch Ophthalmol, 121, pp.173~180 (2003)
- Korb DR, "The effect of two novel lubricant eye drops on tear film lipid layer thickness in subjects with dry eye symptoms", Optom Vis Sci, 82, pp.594~601 (2005)
- Owens H, "Spreading of the tears after a blink : velocity and stabilization time in healthy eyes", Cornea, 20, pp.484~487 (2001)
- Goto E, "Kinetic analysis of tear interference images in aqueous tear deficiency dry eye before and after punctal occlusion", Invest Ophthalmol Vis Sci, 44, pp.1897~1905 (2003)
- Arita R, "Increased tear fluid production as a compensatory response to meibomian gland loss : a multicenter cross-sectional study", Ophthalmology, 122, pp.925~933 (2015)
- Garrigue JS, "Relevance of lipid-based products in the management of dry eye disease", J Ocul Pharmacol Ther, 33, pp.647~661 (2017)
- Korb DR, "Tear film lipid layer thickness as a function of blinking", Cornea, 13, pp.354~359 (1994)
- McMonnies CW, "Incomplete blinking : exposure keratopathy, lid wiper epitheliopathy, dry eye, refractive surgery, and dry contact lenses", Cont Lens Anterior Eye, 30, pp.37~51 (2007)
- Yokoi N, "Rheology of tear film lipid layer spread in normal and aqueous tear-deficient dry eyes", Invest Ophthalmol Vis Sci, 49, pp.5319~5324 (2008)
- Kim HM, "The relationship between morphology and function of the meibomian glands", Eye Contact Lens, 44, pp.1~5 (2018)
- Jones L, "TFOS DEWS II management and therapy report", Ocul Surf, 15, pp.575~628 (2017)
- Fukuoka S, "Increase in tear film lipid layer thickness after instillation of 3% diquafosol ophthalmic solution in healthy human eyes", Ocul Surf, 15, pp.730~735 (2017)