눈물막파괴시간이 짧은 건성안에서 3% 디쿠아포솔나트륨점안액의 임상효과
Clinical Efficacy of Topical 3% Diquafosol Tetrasodium in Short Tear Film Break-Up Time Dry Eye
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목적: 눈물막파괴시간이 짧은 건성안에서 3% 디쿠아포솔나트륨 점안의 임상적 효과를 알아보고자 하였다. 대상과 방법: 눈물막파괴시간이 5초 이하이고 기초눈물분비량이 5 mm 이상인 건성안 환자들 중 무방부제성 0.1% 히알루론산 인공누액 점안으로 호전이 없었던 30명을 대상으로 전향적인 연구를 시행하였다. 모든 대상자는 3% 디쿠아포솔나트륨을 하루 6회 추가하여점안하였다. 쉬르머검사를 통한 기초눈물분비량, 눈물막파괴시간, 플루레신을 이용한 각막염색점수, 리사민그린을 이용한 결막염색점수 및 안구표면질환지수(ocular surface disease index, OSDI)를 치료 전과 치료 후 1개월, 3개월째에 각각 시행하여 비교 분석하였다. 결과: 눈물막파괴시간은 치료 전과 치료 1개월, 3개월째 각각 3.3 ± 1.2초, 4.4 ± 1.0초(p＜0.01), 4.9 ± 1.1초(p＜0.01)로 치료 후유의한 호전을 보였다. OSDI 또한 치료 전과 치료 1개월, 3개월째 각각 43.5 ± 24.4점, 34.6 ± 25.0점(p=0.01), 26.7 ± 21.5점(p ＜0.01)으로 치료 전에 비해 유의한 호전을 보였다. 기초눈물분비량, 플루레신 각막염색점수 및 리사민그린을 통한 결막염색점수는유의한 변화를 보이지 않았다. 모든 환자에서 점안을 중단할 만한 심각한 부작용은 발생하지 않았다. 결론: 3% 디쿠아포솔나트륨 점안은 눈물막파괴시간이 짧은 건성안에서 눈물막 안정성과 건성안 증상을 개선시키는 효과적인 치료방법으로 생각한다.
Abstract
Purpose: To evaluate the clinical efficacy of topical diquafosol tetrasodium 3% ophthalmic solution in patients with short tear filmbreak-up time (BUT) dry eye. Methods: This prospective study involved 30 eyes in 30 patients with dry eye who had tear film BUT values ≤5 seconds andschirmer’s 1 test ≥ 5 mm, and showed no improvement with non-preservative sodium hyaluronate (SH) 0.1% artificial tears. Allpatients were treated with topical diquafosol tetrasodium 3% 6 times a day, in addition to SH 0.1% artificial tears. Schirmer’s 1test, tear film BUT, keratoepitheliopathy score with fluorescein, conjunctival staining score with lissamine green, and Ocular surfacedisease index (OSDI) score were evaluated at before treatments, and 1 month and 3 months after treatments. Results: Significant improvements of tear film BUT and OSDI were observed at 1 month and 3months after diquafosol tetrasodium3% administration. At before treatment, and followed up at 1 and 3 months, tear film BUTs were 3.3 ± 1.2, 4.4 ± 1.0 (p <0.01) and 4.9 ± 1.1 seconds (p < 0.01), respectively, and OSDI scores were 43.5 ± 24.4, 34.6 ± 25.0 (p = 0.01) and 26.7 ± 21.5(p < 0.01), respectively. There were no significant changes of Schirmer’s score, keratoepitheliopathy, and conjunctival stainingscore. After diquafosol tetrasodium 3% administration, severe adverse effects were not found in any of the patients. Conclusions: Topical diquafosol tetrasodium 3% administration was shown to be an effective treatment for improvements of tearfilm stability and dry eye symptoms.
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