만성 안구 이식편대숙주병 환자에서 0.03% Tacrolimus 안약의 치료효과
Therapeutic Effects of 0.03% Tacrolimus Eye Drops for Chronic Ocular Graft-Versus-Host Disease
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목적: 불응성 만성 안구 이식편대숙주병 환자에서 0.03% Tacrolimus 안약의 치료효과목적: 불응성 만성 안구 이식편대숙주병 건성안 환자에서 0.03% tacrolimus 안약의 치료효과를 알아보고자 하였다. 대상과 방법: 만성 안구 이식편대숙주병으로 건성안이 동반된 환자 12명의 24안, 점안 스테로이드제 및 0.05% cyclosporine제로 건성안 증상과 징후가 호전되지 않은 환자들을 대상으로, 상기 두 가지 안약을 2주간 중단 후 0.03% tacrolimus 안약을 하루에 2회씩한 달간 점안하였다. 눈물약, 눈물 연고 및 안검 세척제는 점안 전 용법과 동일하게 사용하였다. 안구표면질환지수, 눈물막 파괴 검사, 눈물분비량 및 각결막 염색검사를 시행하였다. 결과: 각결막염색과 눈물막파괴 검사, 안구표면질환지수는 점안 4주째 통계적으로 유의하게 향상되었다(p＜0.05). 눈물분비량은 유의한 변화가 나타나지 않았다(p＞0.05). 결론: 불응성 만성 안구 이식편대숙주병 환자에서 0.03% tacrolimus 안약은 큰 부작용 없이 건성안 증상 및 징후를 호전시킬 수 있다.
Abstract
Purpose: To evaluate the therapeutic effects of 0.03% tacrolimus eye drops on dry eye associated with chronic ocular graft-versus- host disease (GVHD). Methods: This study included 24 eyes of 12 patients with refractory dry eye associated with chronic ocular GVHD who were unresponsive to topical steroid and 0.05% topical cyclosporine. The topical steroid and cyclosporine were discontinued for 2 weeks before treatment and 0.03% tacrolimus eye drops were applied twice a day for 1 month. Artificial tears, ointment, and lid cleanser were used in the same manner before initiating tacrolimus treatment. Ocular staining score, tear break-up time, ocular surface disease index (OSDI), and Schirmer I test score were evaluated. Results: Ocular staining score, tear break-up time, and OSDI improved with statistical significance (p < 0.05) after 28 days of treatment. Schirmer I test did not show statistical improvement after treatment. Conclusions: The use of 0.03% tacrolimus eye drops were effective for refractory dry eye associated with chronic ocular GVHD.
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