건성안 환자에서 페놀레드 검사의 임상적 유용성
Clinical Usefulness of the Phenol Red Thread Test as Diagnostic Tool in Dry Eye Patient
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목적: 페놀레드 검사와 기존에 사용되던 쉬르머 검사, 눈물막 파괴시간 간의 비교를 통해 건성안 진단에 있어서 페놀레드 검사의 임상적 유용성을 확인하고자 하였다. 대상과 방법: Dry Eye Workshop (DEWS) 1, 2등급의 건성안 환자 30명과 정상 대조군 25명을 대상으로 오른쪽 눈에서 페놀레드 검사,쉬르머 검사, 눈물막 파괴시간 검사를 각각 시행하고, 각 검사의 민감도와 특이도, 재현성을 비교하였으며 세 검사 간의 상관관계를비교 분석하였다. 결과: 민감도와 재현성에 있어서는 눈물막 파괴시간이 특이도에 있어서는 페놀레드 검사가 우수한 결과를 보였다. 페놀레드 검사는특이도와 재현성 면에서 쉬르머 검사에 비해 우세하였다. 건성안과 정상안 모두에서 페놀레드 검사는 쉬르머 검사에 비해 눈물막 파괴시간과 더 큰 상관관계를 보였다. 또한 검사 결과를 건성안 군에 한정할 경우 페놀레드 검사와 쉬르머 검사 간 상관관계가 유의하게증가하였다. 결론: 페놀레드 검사는 쉬르머 검사에 비해 자극이 적고 검사 시간이 짧은 장점이 있다. 또한 페놀레드 검사는 특이도와 재현성, 눈물막 파괴시간과의 관련성에 있어 쉬르머 검사보다 우위에 있다. 건성안 군에서 페놀레드 검사와 쉬르머 검사 간의 상관관계는 더욱증가한다. 따라서 페놀레드 검사는 건성안 진단에 있어 쉬르머 검사의 대안으로 사용될 수 있다.
Abstract
Purpose: To evaluate the clinical usefulness of the phenol red thread test as a diagnostic tool of dry eye by comparing the phenol red thread test, Schirmer’s test and tear break-up time. Methods: The present study included 30 dry eye patients belonging to dry eye workshop grade 1 or 2 and 25 normal subjects. Phenol red thread test, Schirmer’s test, and tear break-up time were performed on each subject’s right eye. The sensitivity, specificity and repeatability of each test were compared, and the correlations between the 3 tests were also analyzed. Results: Tear break-up time was superior to the other tests in terms of sensitivity and repeatability. The phenol red thread test was better than Schirmer’s test in terms of specificity and repeatability. In all 55 patients including dry eye patients and normal subjects, the phenol red thread test showed a greater correlation with tear break-up time than did Schirmer’s test. In addition, in 25 dry eye patients, the correlation between the phenol red thread test and Schirmer’s test increased significantly. Conclusions: The phenol red thread test is less irritating and requires a shorter testing time than Schirmer’s test. Additionally, the phenol red thread test is superior to Schirmer’s test in terms of specificity, repeatability, and relation to tear break-up time. In addition, the correlation between the phenol red thread test and Schirmer’s test significantly increases in dry eye patients. Therefore, the phenol red thread test is a good substitute option for Schirmer’s test in diagnosing dry eye.
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