갑상샘안병증에서 건성안에 영향을 미치는 인자
Risk Factors for Dry Eye in Thyroid-Associated Ophthalmopathy
2
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
목적: 갑상샘안병증 환자에서 건성안에 영향을 미치는 인자들을 알아보고자 하였다. 대상과 방법: 2004년 1월부터 2009년 5월까지 갑상샘안병증으로 진단된 78안을 대상으로 각 환자들에서 안구표면자극증상, 눈물막파괴시간, 쉬르머 검사를 비롯해 성별, 나이, 갑상샘 호르몬 상태, 눈꺼풀틈새폭, 토안, 눈꺼풀후퇴, 안구돌출을 측정하여 건성안에 영향을 미치는 인자들을 다중로지스틱 회귀분석을 통해 알아보았다. 결과: 눈꺼풀틈새(OR=3.422 p=0.022)와 토안(OR=13.068 p=0.049)이 건성안에 대한 유의한 위험인자였다. 그 외 성별, 나이, 갑상샘호르몬상태, 눈꺼풀후퇴, 안구돌출은 건성안과 의미 있는 연관관계를 보이지 않았다. 눈물막파괴시간이 10초 미만일 때의 위험인자로는 눈꺼풀틈새가 유일한 연관된 인자였고(OR=2.787 p=0.045), 쉬르머검사가 10 mm 미만일 때의 유의한 위험인자는 없었다. 결론: 갑상샘안병증 환자에서 건성안에 대한 위험인자로는 눈꺼풀틈새폭과 토안이다.
Abstract
Purpose: To investigate the risk factors for dry eye in thyroid-associated ophthalmopathy patients. Methods: The present retrospective study was conducted on 78 eyes in 39 patients diagnosed with thyroid-associated ophthalmopathy. The risk factors for dry eye in thyroid-associated ophthalmopathy patients were examined by analyzing data including tear break-up time, Schirmer’s test, age, gender, thyroid function status, palpebral fissure width, lagophthalmos,eyelid retraction, and exophthalmos through multiple logistic regression analysis. Results: The risk factors for dry eye disease were palpebral fissure width (OR = 3.422, p = 0.022) and lagophthalmos (OR = 13.068, p = 0.049). Age, gender, thyroid hormone status, eyelid retraction and exophthalmos did not show significant association with dry eye in multiple logistic regression analysis. The only risk factor for tear film break-up time less than 10seconds was palpebral fissure width (OR = 2.787, p = 0.045), and none of the risk factors for Schirmer’s test less than 10mm at 5 minutes were statistically significant. Conclusions: Risk factors for dry eye in thyroid ophthalmopathy patients were palpebral fissure width and lagophthalmos.
참고문헌 (29)
- Rootman J, "Thyroid Orbitopathy", pp.169~212 (2003), Lippincott Williams & Wilkins
- Char DH, "Thyroid eye disease", Br J Ophthalmol, 80, pp.922~926 (1996)
- Gilbard JP, "Ocular surface drying and tear film osmolarity in thyroid eye disease", Acta Ophthalmol, 61, pp.108~116 (1983)
- Brasil MV, "Tear film analysis and its relation with palpebral fissure height and exophthalmos in Graves ophthalmopathy", Arq Bras Oftalmol, 68, pp.615~618 (2005)
- Tsai CC, "Exophthalmos of patients with Graves disease in Chinese of Taiwan", Eye, 20, pp.569~573 (2006)
- Tellez M, "Graves ophthalmopathy in relation to cigarette smoking and ethnic origin", Clin Endocrinol, 36, pp.291~294 (1992)
- 우경인, "한국인 갑상샘 기능 이상 환자에서 갑상샘눈병증의 임상 특징", 대한안과학회지, 49(9), pp.1387~1396 (2008), 대한안과학회
- Bartley GB, "Clinical features of Graves ophthalmopathy in an incidence cohort", Am J Ophthalmol, 121, pp.284~290 (1996)
- Eckstein AK, "Thyrotropin receptor autoantibodies are independent risk factors for Graves ophthalmopathy and help to predict severity and outcome of the disease", J Clin Endocrinol Metab, 91, pp.3464~3470 (2006)
- Gerding MN, "Association of thyrotrophin receptor antibodies with the clinical features of Graves ophthalmopathy", Clin Endocrinol, 52, pp.267~271 (2000)
- Mourits MP, "Clinical activity score as a guide in the management of patients with Graves ophthalmopathy", Clin Endocrinol, 47, pp.9~14 (1997)
- Kaercher T, "Classification and diagnosis of dry eye", Dev Ophthalmol, 41, pp.36~53 (2008)
- Lemp MA, "Dry eye secondary to mucus deficiency", Trans Am Acad Ophthalmol Otolaryngol, 75, pp.1223~1227 (1971)
- Jones LT, "The lacrimal secretory system and its treatment", Am J Ophthalmol, 62, pp.47~60 (1966)
- The Eyelid, "Moses RA", pp.11~36 (1987), Mosby
- Kendler DL, "The initial clinical characteristics of Graves orbitopathy vary with age and sex", Arch Ophthalmol, 111, pp.197~201 (1993)
- 고동아, "갑상샘연관안와병증의 역학과 임상양상", 대한안과학회지, 47(5), pp.683~689 (2006), 대한안과학회
- Kohn LD, "Thyrotropin receptor autoantibodies (TSHRAbs) epitopes, origins and clinical significance", Autoimmunity, 36, pp.331~337 (2003)
- Kim WB, "Clinical significance of classification of Graves disease according to the characteristics of TSH receptor antibodies", Korean J Intern Med, 16, pp.187~200 (2001)
- Kim WB, "The prevalence and clinical significance of blocking thyrotropin receptor antibodies in untreated hyperthyroid Graves disease", Thyroid, 10, pp.579~586 (2000)
- Gomez JM, "Thyroid stimulating antibodies in patients with Gravesophthalmopathy", 3, pp.59~61 (1991)
- 오한진, "건성안이 동반된 갑상샘안병증 환자에서 사이클로스포린 A 점안액 사용 후 눈물막과 안구표면의 변화", 대한안과학회지, 48(5), pp.630~636 (2007), 대한안과학회
- Wiersinga WM, "Graves ophthalmopathy: a rational approach to treatment", Trends Endocrinol Metab, 13, pp.280~287 (2002)
- Gayton JL, "Etiology, prevalence, and treatment of dry eye disease", Clin Ophthalmol, 3, pp.405~412 (2009)
- Viso E, "Prevalence of and associated factors for dry eye in a Spanish adult population", Ophthalmic Epidemiol, 16, pp.15~21 (2009)
- Sahai A, "Dry eye prevalence and attributable risk factors in a hospital-based population", Indian J Ophthalmol, 53(2005), pp.87~91 (2005)
- Calonge M, "Impression cytology of the ocular surface", Exp Eye Res, 78, pp.457~472 (2004)
- Liang H, "Conjunctival and corneal reactions in rabbits following short and repeated exposure to preservative free tafluprost, commercially available latanoprost and 0.02% benzalkonium chloride", Br J Ophthalmol, 92, pp.1275~1282 (2008)
- Xiong C, "A rabbit dry eye model induced by topical medication of a preservative benzalkonium chloride", Invest Ophthalmol Vis Sci, 49, pp.1850~1856 (2008)