조절펄스광선조사가 눈물막 지질층 두께 및 안구건조증에 미치는 효과
Effect of Intense Regulated Pulse Light on Thickness of Tear Film Lipid Layer and Dry Eye Syndrome
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초록
목적: 건성안 환자에서 조절펄스광선조사가 미치는 임상 효과 및 눈물막지질층 두께 변화에 대하여 알아보고자 하였다. 대상과 방법: 건성안에 대한 주관적인 불편감을 호소하는 환자 중 마이봄샘기능부전 소견을 보이며, 눈물막파괴시간이 10초 이하인 25명을 대상으로 후향적 연구를 시행하였다. 모든 대상자에 대한 조절펄스광선조사는 시술 당일, 15일, 45일 총 3회에 걸쳐 시행되었으며, 시술 전후 눈물막파괴시간, 쉬르머검사, 안구표면염색점수, 안구표면질환지수(Ocular Surface Disease Index, OSDI) 및 눈물막지질층의 두께를 측정하여 비교 분석하였다. 결과: 조절펄스광선조사 시술 후 눈물막파괴시간은 3.7 ± 1.2초에서 4.4 ± 2.1초로 증가되어 통계적으로 유의한 차이를 보였으며(p=0.03), 쉬르머검사 및 안구표면염색 점수 결과는 통계적으로 유의한 차이를 보였다(p<0.01, p=0.01). OSDI는 39.5 ± 17.5점에서 30.4 ± 18.7점으로 통계적으로 유의한 향상을 보였다(p=0.01). 눈물막지질층 두께는 통계적으로 유의한 변화를 보이지 않았다(p=0.49). 결론: 조절펄스광선조사 시술은 눈물막파괴시간, 쉬르머검사, 안구표면염색점수 및 주관적인 건성안 증상을 개선시키는 효과적인 치료 방법이라 생각된다.
Abstract
Purpose: To evaluate the clinical effect of intense regulated pulse light (IRPL) and changes in tear film thickness in dry eye patients. Methods: A retrospective study was conducted on 25 patients with Meibomian gland dysfunction who had subjective dry eye discomfort and whose tear film break-up time (TBUT) was < 10 seconds. All patients were treated with IRPL three times on days 1, 15, and 45. TBUT, Schirmer 1 test results, cornea staining score with fluorescein, ocular surface disease index (OSDI), and lipid layer thickness were measured and compared before and after the procedure. Results: TBUT was significantly increased from 3.7 ± 1.2 s to 4.4 ± 2.1 s after IRPL (p = 0.03). Schirmer 1 test and cornea staining scores changed significantly (p < 0.01 and p = 0.01, respectively). OSDI also showed a statistically significant improvement from 39.5 ± 17.5 points to 30.4 ± 18.7 points (p = 0.01). However, no significant difference in lipid layer thickness was observed (p = 0.49). Conclusions: IRPL is an effective treatment modality to improve TBUT, Schirmer 1 test scores, cornea staining scores, and subjective dry eye symptoms.
참고문헌 (20)
- Uchino M, "Prevalence of dry eye disease among Japanese visual display terminal users", Ophthalmology, 115, pp.1982~1988 (2008)
- Guo B, "Prevalence of dry eye disease in Mongolians at high altitude in China : the Henan eye study", Ophthalmic Epidemiol, 17, pp.234~241 (2010)
- Han SB, "Prevalence of dry eye disease in an elderly Korean population", Arch Ophthalmol, 129, pp.633~638 (2011)
- "The definition and classification of dry eye disease: report of the definition and classification subcommittee of the international dry eye workShop", Ocul Surf, 5, pp.75~92 (2007)
- Nelson JD, "The international workshop on meibomian gland dysfunction : report of the definition and classification subcommittee", Invest Ophthalmol Vis Sci, 52, pp.1930~1937 (2011)
- Nichols KK, "The international workshop on meibomian gland dysfunction : introduction", Invest Ophthalmol Vis Sci, 52, pp.1917~1921 (2011)
- 현준영, "Korean Guidelines for the Diagnosis and Management of Dry Eye: Development and Validation of Clinical Efficacy", Korean Journal of Ophthalmology, 28(3), pp.197~206 (2014), 대한안과학회
- Craig JP, "Prospective trial of intense pulsed light for the treatment of meibomian gland dysfunction", Invest Ophthalmol Vis Sci, 56, pp.1965~1970 (2015)
- Vora G, "Intense pulsed light therapy for the treatment of evaporative dry eye disease", Curr Opin Ophthalmol, 26, pp.314~318 (2015)
- Piccolo D, "Unconventional use of intense pulsed light", Biomed Res Int, 2014, pp.618206~ (2014)
- Papageorgiou P, "Treatment of rosacea with intense pulsed light : significant improvement and longlasting results", Br J Dermatol, 159, pp.628~632 (2008)
- Knop E, "The international workshop on meibomian gland dysfunction: report of the subcommittee on anatomy, physiology, and pathophysiology of the meibomian gland", Invest Ophthalmol Vis Sci, 52, pp.1938~1978 (2011)
- Nichols KK, "The international workshop on meibomian gland dysfunction : executive summary", Invest Ophthalmol Vis Sci, 52, pp.1922~1929 (2011)
- Freedman HL, "Heat retention in varieties of warm compresses: a comparison between warm soaks, hard-boiled eggs and the re-heater", Ophthalmic Surg, 20, pp.846~848 (1989)
- Toyos R, "Intense pulsed light treatment for dry eye disease due to meibomian gland dysfunction : a 3-year retrospective study", Photomed Laser Surg, 33, pp.41~46 (2015)
- 문인희, "건성안 환자들의 주관적인 안구 불편감과 안검염 중증도의 관계", 대한안과학회지, 57(10), pp.1507~1513 (2016), 대한안과학회
- Isreb MA, "Correlation of lipid layer thickness measurements with fluorescein tear film break-up time and Schirmer's test", Eye(Lond), 17, pp.79~83 (2003)
- Nichols JJ, "Evaluation of tear film interference patterns and measures of tear break-up time", Optom Vis Sci, 79, pp.363~369 (2002)
- Korb DR, "Meibomian gland diagnostic expressibility : correlation with dry eye symptoms and gland location", Cornea, 27, pp.1142~1147 (2008)
- Mishima S, "The oily layer of the tear film and evaporation from the corneal surface", Exp Eye Res, 1, pp.39~45 (1961)