샤임플러그 전안부사진기를 이용한 눈물막의 두께 측정 및 건성안지표와의 관계 분석
Measurement of Precorneal Tear Film Using Scheimpflug Camera and Relationship with Parameters for Dry Eye
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목적: 정상안과 건성안 두 군에서 PentacamⓇ (Oculus, Wetzlar, Germany)을 이용하여 측정한 각막 앞 눈물막 두께(precorneal tear film thickness, PTFT)를 포함한 전안부 계측값을 비교해 보고, 건성안 군에서 PTFT와 건성안 지표들과의 관련성을 알아보고자 하였다. 대상과 방법: 정상안 31안(23명), 건성안 31안(25명)을 대상으로 PentacamⓇ을 이용하여 측정한 PTFT, 각막두께 및 난시 값을 비교하였다. 건성안 군에서 PTFT와 플루오레신 눈물막 파괴 시간(fluorescein tear break-up time, FBUT), 쉬르머 I 검사 및 안구표면질환지수(ocular surface disease index, OSDI)와의 관련성을 알아보았다. 결과: 평균 PTFT는 정상안에서 37.6 ± 2.0 μm, 건성안에서 21.1 ± 2.0 μm로 건성안 군의 PTFT가 정상안에 비해 유의하게 얇았다(p＜0.01). 건성안 군에서 각막두께는 더 두꺼웠으나 임상적으로 의미 있는 차이는 없었고, 각막난시의 빈도 및 정도가 높은 경향을보였지만 통계적으로 유의하지 않았다. 건성안 군에서 OSDI는 FBUT 및 쉬르머 I 검사와 약한 음의 상관관계를 보였으나 유의하지않았고, PTFT와는 통계적으로 유의한 음의 상관관계를 보였다(r=-0.46, p＜0.01). PTFT는 FBUT와 쉬르머 I 검사와 약한 양의 상관관계를 보였으나 통계적으로 유의하지 않았다. 결론: 건성안에서 PentacamⓇ 으로 측정한 PTFT는 정상군에 비해 유의하게 얇았으며 주관적인 증상과 연관성을 보여 건성안 환자의진단 및 치료에 유용하게 활용될 수 있을 것으로 생각된다.
Abstract
Purpose: To compare the anterior segment parameters including precorneal tear film thickness (PTFT) using Pentacam® (Oculus, Wetzlar, Germany) between normal control and dry eye groups and to examine the relationships between the PTFT and other parameters for dry eye. Methods: The present study included 23 normal controls (31 eyes) and 25 patients with dry eyes (31 eyes). We compared measurements including PTFT, corneal thickness and astigmatism using Pentacam® and analyzed the correlations among the PTFT and fluorescein tear break-up time (FBUT), Schirmer I test (without anesthesia), and ocular surface disease index (OSDI). Results: The mean PTFT in dry eyes (21.1 ± 2.0 μm) was significantly thinner than in normal eyes (37.6 ± 2.0 μm; p < 0.01). In the dry eye group, the corneal thickness was thicker than in the normal eye group but there were no clinically significant differences. The dry eye group experienced more frequent and severe corneal astigmatism compared with the normal group. OSDI scores showed a weak negative correlation with objective clinical measures of dry eye (FBUT, Schirmer I test) but was not statistically significant. However, OSDI was statistically significantly negatively correlated with PTFT (r = -0.46, p < 0.01). The PTFT showed a weak positive correlation with FBUT and Schirmer I test without statistical significance. Conclusions: The mean PTFT using Pentacam® in the dry eye group was thinner than in the normal group. Additionally, the PTFT was correlated with subjective symptoms. Therefore, the PTFT measurement using Pentacam® could be considered a useful method for diagnosis and treatment of dry eye.
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