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마이봄샘 기능이상에서 두 가지 안구건조증 설문지와 안구건조증 지표와의 연관성

Association between Dry Eye Questionnaires and Dry Eye Sign in Meibomian Gland Dysfunction

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목적: 마이봄샘이상기능에서 안구건조증 설문지 Ocular surface disease index (OSDI), Standardized Patient Evaluation of Eye Dryness (SPEED)를 이용하여 안구건조증 지표들 간의 연관성을 확인하고자 하였다. 대상과 방법: 41명의 대상자에게 안구건조증 설문지 및 Meibomian gland dysfunction (MGD) grade, Shirmer test, Oxford grading system, tear break up time (TBUT), 각막고위수차검사, 전안부 빛간섭단층촬영을 시행하여 연관성을 비교 분석하였다. 결과: OSDI와 SPEED는 유의한 상관관계를 보였으며(R=0.278, p=0.011), SPEED에서는 Oxford grade (R=0.478, p<0.001), MGD grade (R=0.280, p=0.011)와 유의한 상관관계를 보였고, OSDI에서는 MGD grade (R=0.651, p<0.001), TBUT (R=-0.360, p=0.001), 나이(R=-0.230, p=0.037)와 상관관계가 있음을 확인할 수 있었다. 다중회귀분석에서 MGD grade가 OSDI 설문지에 영향을 주며(β=0.580, p<0.001), Oxford grade가 SPEED 설문지에 유의하게 영향을 준다(β=0.447, p<0.001). 결론: 한국인에서 OSDI 설문지는 MGD grade와 연관성이 높았으며, SPEED 설문지는 각막표면 상태와 연관성이 높았다. 그러므로마이봄샘기능이상에서 임상적으로 OSDI 설문지가 유용할 것으로 보인다.

Abstract

Purpose: The Ocular Surface Disease Index (OSDI) and the Standardized Patient Evaluation of Eye Dryness (SPEED) which are standard questionnaires of dry eye syndrome were used to determine the associations between clinical dry eye tests and meibomian gland dysfunctions (MGD). Methods: Forty-one patients with MGD were enrolled in this study. The score of the dry eye syndrome questionnaire and the degree of blepharitis (score: 0-4), Schirmer test results, degree of fluorescence staining of cornea (Oxford Grading System), tear break-up time (TBUT), Pentacam imaging, and anterior segment optical coherence tomography results were used to compare and analyze the results of each test for possible correlations with the dry eye questionnaire answers. Results: There was a significant correlation between OSDI and SPEED (R = 0.278, p = 0.011). SPEED was correlated with the Oxford grade (R = 0.478, p < 0.001) and MGD grade (R = 0.280, p = 0.011) while there was no significant correlation with corneal aberrations, tear meniscus height, tear meniscus area, Schirmer test results, or TBUT. The OSDI correlated with the MGD grade (R = 0.651, p < 0.001), TBUT (R = -0.360, p = 0.001), and age (R = -0.230, p = 0.037). Using multiple regression analyses, the MGD grade affected the OSDI (β = 0.580, p < 0.001) and the Oxford grade significantly influenced the SPEED (β = 0.447, p < 0.001). Conclusions: In Koreans, the OSDI questionnaire answers were associated with the MGD grade and SPEED questionnaire answers were associated with the corneal surface status. The OSDI questionnaire was therefore clinically useful in patients with meibomian gland dysfunction.

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