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건성안에서 사이클로스포린 0.05% 점안 후 눈물 삼투압의 변화

The Effect of Topical Cyclosporine 0.05% on Tear Osmolarity for Dry Eye Syndrome

최태훈|김세경|최철명|성 산|강현승
대한안과학회 (The Korean Ophthalmological Society)|2015.02|대한안과학회지 (Journal of The Korean Ophthalmological Society)|제56권 제2호|pp. 174-179

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키워드

CyclosporineDry eye syndromeRestasisTear osmolarity
주제분류안과학

초록

목적: 건성안 환자에서 사이클로스포린 0.05% (Restasis; Allergan, Irving, CA)의 점안효과를 눈물 삼투압과 다른 건성안 지표들을통하여 알아보고자 하였다. 대상과 방법: 기존의 인공눈물을 사용하고 있는 건성안 환자 86명(남자 16명, 여자 70명)을 대상으로 국소 사이클로스포린 0.05% 사용 전,사용 후 1개월, 3개월, 6개월째에 눈물삼투압검사(tear osmolarity), 눈물막파괴시간(TBUT), 안구표면염색점수(ocular surface staining),쉬르머 검사(Schirmer test), 그리고 ocular surface disease index (OSDI)를 이용하여 건성안 증상의 호전 여부를 평가하였다. 결과: 사이클로스포린 0.05% 점안 전 평균 TBUT는 4.41 ± 1.63초, 1개월째 5.34 ± 2.36초(p=0.305), 3개월째 6.26 ± 2.16초(p=0.022),6개월째 5.95 ± 1.90초(p=0.197)였으며, OSDI는 점안 전 45.02 ± 22.38점에서 1개월째 44.13 ± 22.23점(p=0.242), 3개월째 34.98 ±20.19점(p=0.032), 6개월째 49.11 ± 22.06점(p=0.660)으로 각 항목에서 3개월째에 유의한 호전을 보였다. 눈물 삼투압과 쉬르머 검사, 안구표면염색점수는 6개월의 기간 동안 점안 전에 비해 모두 호전되었으나 통계학적으로 유의한 변화를 보이지는 않았다. 결론: 6개월의 사이클로스포린 0.05% 사용기간 동안 일반적인 건성안 증상의 호전은 3개월간 유지되었으며, 눈물 삼투압의 유의한변화는 보이지 않았다.

Abstract

Purpose: To evaluate the effect of topical cyclosporine 0.05% (Restasis; Allergan, Irving, CA, USA) on tear osmolarity in patientswith dry eye disease. Methods: The present study was a single-center, randomized, prospective, and longitudinal trial. Patients who had been usingartificial tears to treat dry eye disease were prescribed cyclosporine 0.05% and evaluated using tear osmolarity, tear break-uptime, ocular surface staining score, Schirmer test, and the Ocular Surface Disease Index for symptomatic improvement. Clinicalmeasurements of commonly used objective tests were performed at baseline and after 1, 3, and 6 months. Results: At the end of the study, patients demonstrated statistically significant improvement in tear break-up time (6.26 ± 1.26sec at 3 months vs. 4.41 ± 1.63 sec at baseline, p = 0.022) and OSDI (34.98 ± 20.19 at 3 months vs. 45.02 ± 22.38 at baseline,p = 0.032) only at 3 months. Other measures such as Schirmer test, ocular surface grade, and tear osmolarity also showedimprovement. However, the differences were not significant. Conclusions: Over a 6-month period, topical cyclosporine 0.05% showed beneficial effects on symptoms and other commonlyused signs of dry eye disease for 3 months; however, the tear osmolarity values were not significantly improved.

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