건성안 지표와 서로 다른 두 기기로 측정된 전면 각막 고위수차의 관계 분석
Relationship between Dry Eye Parameters and Anterior Corneal Higher‐Order Aberrations Measured by Two Different Instruments
0
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
목적: 정상안과 건성안에서 KR-1W®와 Pentacam®을 이용하여 측정된 전면 각막 수차를 비교하고, 건성안 지표와 고위 수차 간의관계를 분석하였다. 대상과 방법: 정상안 71안과 건성안 71안에 대하여 두 기기를 이용하여 전면 각막 수차를 측정하였다. 건성안 환자에 대해 각막표면형광염색, 플루오레신 눈물막 파괴 검사와 쉬르머 I 검사를 시행하였고, Ocular surface disease index (OSDI)를 통해 주관적 증상을조사하였다. 결과: 두 기기 모두에서 건성안이 정상안에 비해 각막 수차가 컸으나, KR-1W®로 측정한 고위수차만이 통계적으로 유의한 차이를보였다. 서로 다른 기기로 측정된 각막 전면 고위수차는 모두 점상각막염의 정도와 유의한 양의 상관관계를 보였다. 또한 눈물막 파괴검사 및 쉬르머 I 검사와는 전반적으로 음의 상관관계를, OSDI와는 양의 상관관계를 보였다. 결론: 정상안에 비해 건성안의 각막 전면 고위수차는 증가되어 있으며, 건성안의 중증도가 증가함에 따라 수차도 증가하였다. 또한Pentacam®보다 KR-1W®가 눈물막의 불안정성을 확인하는 데에 있어서 더 유용할 것으로 생각한다.
Abstract
Purpose: To compare the corneal first surface higher-order aberrations (HOAs) of normal subjects and patients with dry eye usingKR-1W® (Topcon Corp., Tokyo, Japan) and Pentacam® HR (Oculus Inc., Dutenhofen, Germany). We analyzed the relationshipbetween the aberrations and the diagnostic parameters of dry eye. Methods: We evaluated anterior corneal HOAs in 71 normal eyes and 71 dry eyes using KR-1W® and Pentacam®. Dry eye patientswere examined for fluorescein staining, tear break-up time (TBUT), and Schirmer I test. Ocular Surface Disease Index(OSDI) was used for assessment of subjective symptoms in dry eye patients. Results: HOAs measured by both instruments were greater in the dry eye group than in the control group, although HOAs usingKR-1W® only achieved statistical significance. The anterior corneal HOAs measured by the 2 instruments were significantly correlatedwith superficial punctate keratitis. Moreover, TBUT and the Shirmer I test negatively correlated, and OSDI positively correlated,with anterior corneal HOAs. Conclusions: The HOAs in patients with dry eye were significantly different from controls and tended to increase with diseaseseverity. KR-1W® might be more useful than Pentacam® to detect tear film instabilities.
참고문헌 (27)
- Miljanović B., "Impact of dry eye syndrome on vision-related quality of life", Am J Ophthalmol, 143, pp.409~415 (2007)
- Goto E., "Impaired functional visual acuity of dry eye patients", Am J Ophthalmol, 133, pp.181~186 (2002)
- Thibos LN., "Clinical applications of the Shack-Hartmann aberrometer", Optom Vis Sci, 76, pp.817~825 (1999)
- Koh S., "Serial measurements of higher-order aberrations after blinking in normal subjects", Invest Ophthalmol Vis Sci, 47, pp.3318~3324 (2006)
- Miranda MA., "Repeatability of corneal and ocular aberration measurements and changes in aberrations over one week", Clin Exp Optom, 92, pp.253~266 (2009)
- Piñero DP., "Intrasubject repeatability of internal aberrometry obtained with a new integrated aberrometer", J Refract Surg, 27, pp.509~517 (2011)
- Denoyer A., "Tear film aberration dynamics and vision-related quality of life in patients with dry eye disease", Ophthalmology, 119, pp.1811~1818 (2012)
- 최시환, "웨이브프론트의 연속 측정방법으로 분석한 눈물막의 불안정성에 따른 고위수차 변화", 대한안과학회지, 53(8), pp.1076~1080 (2012), 대한안과학회[DOI]
- Uchino Y., "Changes in dry eye diagnostic status following implementation of revised Japanese dry eye diagnostic criteria", Jpn J Ophthalmol, 56, pp.8~13 (2012)
- Bron AJ., "Grading of corneal and conjunctival staining in the context of other dry eye tests", Cornea, 22, pp.640~650 (2003)
- Schiffman RM., "Reliability and validity of the Ocular Surface Disease Index", Arch Ophthalmol, 118, pp.615~621 (2000)
- Carkeet A., "Higher order ocular aberrations after cycloplegic and non-cycloplegic pupil dilation", J Refract Surg, 19, pp.316~322 (2003)
- Campbell CE., "A new method for describing the aberrations of the eye using Zernike polynomials", Optom Vis Sci, 80, pp.79~83 (2003)
- Kim JH., "Changes of higher-order aberrations with the use of various mydriatics", Ophthalmic Physiol Opt, 29, pp.602~605 (2009)
- "Methodologies to diagnose and monitor dry eye disease: report of the Diagnostic Methodology Subcommittee of the International Dry Eye WorkShop (2007)", Ocul Surf, 5, pp.108~152 (2007)
- Charman WN., "Wavefront aberration of the eye : a review", Optom Vis Sci, 68, pp.574~583 (1991)
- Williams D., "Visual benefit of correcting higher order aberrations of the eye", J Refract Surg, 16, pp.S554~S559 (2000)
- Kaido M., "Corneal fluorescein staining correlates with visual function in dry eye patients", Invest Ophthalmol Vis Sci, 52, pp.9516~9522 (2011)
- Montés-Micó R., "Changes in ocular aberrations after instillation of artificial tears in dry-eye patients", J Cataract Refract Surg, 30, pp.1649~1652 (2004)
- Huang B., "The effect of punctal occlusion on wavefront aberrations in dry eye patients after laser in situ keratomileusis", Am J Ophthalmol, 137, pp.52~61 (2004)
- Kopf M., "Tear film surface quality with soft contact lenses using dynamic videokeratoscopy", Journal of Optometry, 1, pp.14~21 (2008)
- Barkana Y., "Central corneal thickness measurement with the Pentacam Scheimpflug system, optical lowcoherence reflectometry pachymeter, and ultrasound pachymetry", J Cataract Refract Surg, 31, pp.1729~1735 (2005)
- Read SA., "Corneal topography with Scheimpflug imaging and videokeratography : comparative study of normal eyes", J Cataract Refract Surg, 35, pp.1072~1081 (2009)
- Shankar H., "Repeatability of corneal first-surface wavefront aberrations measured with Pentacam corneal topography", J Cataract Refract Surg, 34, pp.727~734 (2008)
- Savini G., "Repeatability of automatic measurements by a new Scheimpflug camera combined with Placido topography", J Cataract Refract Surg, 37, pp.1809~1816 (2011)
- Wang Y., "Changes of higher order aberration with various pupil sizes in the myopic eye", J Refract Surg, 19(2 Suppl), pp.S270~S274 (2003)
- Nichols KK., "The repeatability of clinical measurements of dry eye", Cornea, 23, pp.272~285 (2004)