플릭텐각결막염환자의 눈물간섭계를 이용한 임상양상 분석
Clinical Aspects of Phlyctenular Keratoconjunctivitis Using a Tear Film Interferometer
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초록
목적: 눈물간섭계를 이용하여 플릭텐각결막염환자의 마이봄샘 형태와 눈물 지질층 두께 변화를 분석하고자 하였다. 대상과 방법: 플릭텐각결막염으로 진단된 환자 13명 19안의 후향적 의무기록 분석을 하였다. 눈물막파괴시간과 각결막 염색검사를 시행하고 눈물간섭계로 눈물 지질층 두께, 부분 눈꺼풀 깜빡임, 마이봄샘을 촬영하여 분석하였다. 눈꺼풀의 모세혈관확장, 마이봄샘개구부의 막힘, 눈꺼풀테의 불규칙성과 두꺼워짐, 마이봄샘의 손실을 보았으며 이를 점수화하였다. 결과: 환자의 평균 연령은 21.3 ± 10.1세로, 평균 눈물막파괴시간 및 옥스포드 각막염색 점수는 각각 2.6 ± 1.2초 및 1.9 ± 0.8이었다. 10세 미만의 환자에서도 마이봄샘의 변화가 관찰되었다. 평균 눈물 지질층은 79.6 ± 27.4 μm이고 불완전 눈꺼풀 깜박임은 20초 동안 3.8 ± 5.9였다. 눈물 지질층의 그래프는 편평형, 오르막형, 내리막형 및 혼합형과 같은 다양한 패턴을 보여주었다. 결론: 이 연구는 마이봄샘 기능이상과 눈물 지질층의 변화가 플릭텐각결막염환자에서 나타남을 보여주었다. 10세 이하의 어린 나이에 플릭텐각결막염환자에서도 치료 과정에서 이런 변화를 고려해야할 것으로 생각한다.
Abstract
Purpose: To evaluate clinical findings in phlyctenular keratoconjunctivitis patients and assess the function and morphology of Meibomian glands using an interferometer (LipiView®, TearScience, Morrisville, NC, USA) in such patients. Methods: This retrospective study included 19 eyes of 13 patients diagnosed with phlyctenular keratoconjunctivitis. The lipid layer thickness (LLT) and meibograph of each eye was quantified by tear interferometry. Tear film break-up time (TBUT) and corneal staining score were measured. Meibomian gland morphology (lid margin vascularity, plugging of gland orifices, lid margin irregularity, lid margin thickening, and partial glands) was evaluated based on anterior photographs and meibographs. Results: The mean age was 21.3 years (8-44 years). Mean BUT and Oxford corneal staining scores were 2.6 ± 1.2 seconds and 1.9 ± 0.8, respectively. Abnormal findings of the Meibomian glands were observed in all patients. The mean LLT was 79.6 ± 27.4 μm and the incomplete eye blinking frequency was 3.8 ± 5.9 during 20 seconds. The graphs of the tear lipid layer showed various patterns such as flat, up-hill, down-hill, and mixed. Conclusions: Meibomian gland dysfunctions and changes in the tear film lipid layer were noted in patients with phlyctenular keratoconjunctivitis. These factors are to be considered for the treatment of phlyctenular keratoconjunctivitis in young patients under 10 years of age.
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