비쇼그렌 건성안 환자의 진단에서 눈물막 삼투압 측정의 임상적 유의성
Clinical Significance of Tear Film Osmolarity for Non-Sjögren Dry Eye Diagnosis
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목적: 비쇼그렌 건성안 환자들에게서 눈물막 삼투압(tear film osmolarity)과 건성안 지표와의 상관관계를 비교함으로써 눈물막 삼투압의 진단 도구로서의 가치를 평가하고자 한다. 대상과 방법: 본 단면연구(Cross-sectional study)에는 274명(274안)의 비쇼그렌 건성안 환자들을 대상으로, 눈물막 삼투압(tear film osmolarity)과 흔히 통용되는 건성안 지표: 쉬르머 검사(Schirmer’s test), 눈물막파괴시간(tear film break-up time), 안구표면지수(ocular surface disease index), 각막염색점수(Corneal staining score)를 측정한 후, Spearman 상관분석을 이용하여 눈물막 삼투압수치와 그 외 지표들 사이의 상관관계를 각각 비교하였다. 결과: 본 연구에서 대상 환자군의 평균 눈물막 삼투압 값은 296.34 ± 21.08 mOsm/L였고, 눈물막 삼투압 수치와 쉬르머검사(r=-0.431, p<0.001), 눈물막파괴시간(r=-0.131, p=0.031)은 눈물 삼투압 수치와 통계적으로 유의한 음의 상관관계를 보였으며, 안구표면질환지수(r=0.191, p=0.001) 및 각막염색점수(r=0.150, 0.013)와는 통계적으로 유의한 양의 상관 관계를 보였다. 결론: 눈물막의 삼투압이 다수의 비쇼그렌 건성안 환자군을 대상으로 하여도 기존에 사용되는 건성안 지표들과 유의한 상관관계가 있었으나, 단일 진단도구로서의 가능성에 대해서는 추후 연구가 필요할 것이다.
Abstract
Purpose: To evaluate the diagnostic value of tear film osmolarity for non-Sjogren dry eye syndrome through measuring the correlation between tear osmolarity and several conventional dry eye parameters. Methods: In this observational cross-sectional study, 274 patients (274 eyes) with non-Sjogren dry eye syndrome were examined using tear film osmolarity and the following conventional dry eye parameters: Schirmer’s test, tear film break-up time, ocular surface disease index (OSDI), and corneal staining score. The correlations between tear film osmolarity and each conventional dry eye parameter were assessed using Spearman’s correlation coefficients. Results: The mean tear film osmolarity of the study population was 296.34 ± 21.08 mOsm/L. The tear film osmolarity was significantly negatively correlated with the Schirmer’s test value (r = -0.431, p < 0.001) and tear break-up time (r = -0.131, p = 0.031), while it was significantly positively correlated with the OSDI scores (r = 0.191, p = 0.001) and corneal staining scores (r = 0.150, p = 0.013). Conclusions: Tear film instability was significantly correlated with other conventional dry eye parameters. However, additional studies are required to determine its feasibility as a stand-alone diagnostic tool.
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