장기적 경구 스테로이드 복용이 녹내장 및 고안압증에 미치는 영향
Influence of Long-term Oral Steroid Intake on Glaucoma and Ocular Hypertension
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목적: 경구 스테로이드를 장기적으로 복용하는 환자들에서 녹내장 혹은 고안압증과 관련된 유의한 위험인자를 탐색하고 위험인자를가진 환자들의 안압 관리에 도움이 되고자 한다. 대상과 방법: 2020년 11월부터 2021년 2월까지 경구 스테로이드를 6개월 이상 장기간 복용하고 있는 690명의 환자들을 대상으로의무기록을 단면적으로 분석하였다. 기본 인구학적 정보 및 안압검사, 약제의 종류, 용량, 복용한 기간, 안과적 과거력과 안압하강제사용력을 확인하였고 녹내장 혹은 고안압증과 관련된 위험인자를 분석하였다. 결과: 녹내장 혹은 고안압증으로 진단된 안과 그렇지 않은 안을 대상으로 진행한 일반화 선형모형분석에서 경구 스테로이드의 종류, 나이, 복용한 기간은 두 군에서 차이가 없었으나, 용량은 통계적으로 유의하였다(odds ratio, 1.09; p=0.0294). 결론: 경구 스테로이드를 장기적으로 복용 시 종류, 나이, 복용한 기간에 따른 녹내장 혹은 고안압증의 유병률 차이는 없었다. 그러나경구 스테로이드 복용 용량이 높은 환자들의 안에서 녹내장 및 고안압증의 유병률이 상승된 것으로 조사되어, 가능한 저용량으로복용하는 것이 안압 관리에 있어 보다 더 유리할 것으로 생각된다.
Abstract
Purpose: The aim of this study was to evaluate the risk factors associated with glaucoma or ocular hypertension (OHT) in patients taking oral corticosteroids for extended periods, and to aid in managing intraocular pressure (IOP) in patients with these risk factors. Methods: A cross-sectional study was performed involving 690 patients who visited a tertiary referral hospital and had been using oral corticosteroids for more than six months. Patients' demographics, tonometry results, drug type, dosage, duration, ophthalmic history, and the use of glaucoma eye drops were analyzed to determine the risk factors associated with glaucoma or OHT. Results: In a generalized linear model analysis comparing patients' eyes diagnosed with glaucoma or ocular hypertension to those without such diagnoses, no statistical difference was observed between the two groups in terms of drug type, age, and duration of oral corticosteroid use. However, the dosage was found to be statistically significant (odds ratio 1.09, p = 0.0294). Conclusions: No difference in the incidence of glaucoma or OHT was found based on the type of oral steroid, age, or duration of use. However, a higher incidence of glaucoma and OHT was observed among patients taking higher doses of oral steroids. Therefore, it is suggested that using lower doses of oral steroids may be more beneficial for managing IOP.
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