건성안 증상을 가지는 환자들에서 각막 통각과민 환자의 임상양상
Clinical Characteristics of Corneal Hyperalgesia in Patients with Dry Eye Symptoms
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목적: 건성안 증상을 가지는 환자 중 각막 통각에 과민한 환자 환자들의 임상양상을 분석해 보고자 하였다. 대상과 방법: 건성안 증상으로 내원한 20세 이상 성인 69명(69안)을 대상으로 하였다. Cochet-Bonnet 촉각측정계를 이용하여 통각 수치가 40 mm 이상인 군은 통각과민군, 40 mm 미만인 경우는 대조군으로 정하였다. 모든 환자는 세극등검사, 눈물막파괴시간, 눈물분비 정도, 마이봄샘 촬영술과 눈물지질층두께, 눈 깜박임 패턴, 안구표면질환지수 설문조사를 시행하였다. 눈 깜박임 패턴은 안정형, 상승형, 하강형, 혼합형의 4가지 유형으로 나누었으며, 부분 눈 깜박임의 비율을 기록하였다. 결과: 통각과민군 38명과 대조군 31명을 비교하였을 때 각막 통각 정도는 통각과민군이 51.18 ± 7.66 mm, 대조군은 21.61 ± 9.25 mm이며, 지각 정도는 통각과민군(59.21 ± 1.85 mm)이 대조군(54.84 ± 10.12 mm)보다 높았다(p=0.048). 눈물막파괴시간검사는 통각과민군(3.47 ± 0.80초)에서 대조군(4.10 ± 1.16초)에 비하여 유의하게 짧았다(p=0.036). 눈 깜박임 패턴은 두 군 간에 유형의 비율에 유의한 차이를 보였으며(p=0.023), 통각과민군에서는 상승형이 35.1% 안정형은 32.4%, 대조군에서는 하강형이 43.3%로 나타났다. 이외의 검사에서는 유의한 차이를 보이지 못하였다. 결론: 건성안 환자 중 각막 통각과민이 있는 환자의 경우 눈물막파괴시간이 대조군에 비해 짧으며, 눈 깜박임 패턴의 유형의 비율이 달랐다.
Abstract
Purpose: We analyzed the clinical characteristics of corneal hyperalgesia patients with dry eye symptoms. Methods: Sixty-nine eyes of 69 adults (aged ≥ 20 years) who visited the hospital due to dry eye symptoms were analyzed. Using a Cochet-Bonnet esthesiometer, patients with ≥ 40 mm corneal sensitivity were designated as the corneal hyperalgesia group, and those with < 40 mm were designated as the control group. All patients were tested by slit lamp biomicroscopy. The tear film break-up time (TFBUT), tear secretion, meibography, tear lipid layer thickness, eye blink pattern and Ocular Surface Disease Index were assessed. The eye blink pattern was divided into four types, flat, uphill, downhill, and mixed, and the rate of partial eye blink was recorded. Results: We compared the 38 eyes in the corneal hyperalgesia group with the 31 eyes in the control group. The pain sensitivity was 51.18 ± 7.66 and 21.61 ± 9.25 mm in the corneal hyperalgesia and control groups, respectively. Tactile sensitivity was higher in the hyperalgesia group (59.21 ± 1.85 mm) than the control group (54.84 ± 10.12 mm) (p = 0.048), and the TFBUT in the hyperalgesia group (3.47 ± 0.80 seconds) was significantly shorter than the control group (4.10 ± 1.16 seconds) (p = 0.036). There was a significant difference in the proportions of the four eye blink patterns between the hyperalgesia and control groups (p = 0.023). In the hyperalgesia group, 35.1% were uphill types and 32.4% were flat types, while in the control group, 43.8% were downhill types. The other tests showed no significant group differences. Conclusions: The TFBUT was shorter in patients with dry eye symptoms than controls, and the proportions of the four eye blink patterns also differed between the groups.
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