연령에 따른 안구건조증의 3% 디쿠아포솔나트륨 점안 효능 비교
Comparison of Therapeutic Effects of 3% Diquafosol Tetrasodium with Aging in Dry Eye
0
조회
0
다운로드
8
인용
0
참고문헌
키워드
초록
목적: 60세 전후의 안구건조증 환자에서 3% 디쿠아포솔나트륨 점안액의 나이에 따른 임상 효과를 알아보고자 하였다. 대상과 방법: 68명의 환자를 나이에 따라 60세 미만을 1군 29명(29안), 60세 이상을 2군 39명(39안)으로 나누었다. 3% 디쿠아포솔나트륨의 효용성 평가를 위해 최초 방문, 치료 후 1개월, 2개월, 4개월째 객관적인 지표로 눈물막파괴시간, 쉬르머 I 검사, 각막염색검사를 시행하였고, 주관적인 지표로는 ocular surface disease index (OSDI) 설문지를 시행하여 점수화하였다. 결과: 안구건조증의 두 군 모두에서 3% 디쿠아포솔나트륨 치료 후 1개월, 2개월, 4개월째 눈물막파괴시간, 쉬르머 I 검사, 그리고 OSDI 점수의 유의한 호전이 관찰되었으나, 각막염색점수의 경우 치료 전과 유의한 차이를 보이지 않았다. 나이에 따른 두 군으로 나누어 비교한 결과에서 눈물막파괴시간은 치료 후 1개월째(p=0.012), 2개월째(p=0.005), 4개월째(p=0.001)로 1군에서 2군에 비해 통계적으로 유의한 호전을 보였다. 쉬르머 I 검사의 경우 치료 후 1개월째(p=0.015), 2개월째(p=0.005), 4개월째(p=0.005)로 1군에서 2군에서 보다 유의한 호전을 보였다. 그러나 각막염색점수의 결과와 OSDI 점수의 경우 치료 후 1개월째, 2개월째, 4개월째 두 군 간 유의한 차이는 보이지 않았다(p＞0.05). 결론: 3% 디쿠아포솔나트륨의 효능은 안구건조증 환자의 나이와 상관없이 임상적인 증상호전 및 객관적인 검사치의 개선을 나타내지만, 특히 60세 이전에서 눈물막파괴시간, 쉬르머 I 결과치가 유의하게 증가하는 것으로 나타났다.
Abstract
Purpose: The aim of this study was to evaluate the clinical effect of 3% diquafosol in dry eye patients aged around 60 years. Methods: In total, 68 patients with dry eye syndrome were divided by age into 2 groups, Group I (29 patients, 29 eyes) under the age of 60 years and Group II (39 patients, 39 eyes) over the age of 60 years. To evaluate the effectiveness of 3% diquafosol, we measured the tear film break-up time (tBUT), performed the Schirmer I test, and used the corneal staining score as an objective indicator and the ocular surface disease index (OSDI) score as a subjective indicator at initial visit, 1 month, 2 months, and 4 months. Results: Significant improvements in the tear film break-up time, Schirmer I test, and OSDI were observed at 1,2, and 4 months after treatment with 3% diquafosol tetrasodium in both dry eye groups, but significant difference in the corenal staining score were not observed (p > 0.05). There were statistically significant improvement between the 2 age groups in the tBUT at 1 month (p = 0.012), 2 months (p = 0.005), and 4 months (p = 0.005), and improvements in the Schirmer I test between the 2 age groups at 1 month (p = 0.015), 2 months (p = 0.005), and 4 months (p = 0.005) were also observed. But, there was no significant difference in the corneal staining score and OSDI score between the 2 groups at 1, 2, and 4 months (p > 0.05). Conclusions: Topical 3% diquafosol tetrasodium administration was shown to be an effective treatment to improve clinical symptoms and objective indicators in dry eye patients regardless of age, showing significant improvements in tBUT and the Schirmer I test under the age of 60.
참고문헌 (32)
- "The definition and classification of dry eye disease: report of the Definition and Classification Subcommittee of the International Dry Eye WorkShop (2007)", Ocul Surf, 5, pp.75~92 (2007)
- Paulsen AJ., "Dry eye in the beaver dam offspring study : prevalence, risk factors and health-related quality of life", Am J Ophthalmol, 157, pp.799~806 (2014)
- Damasceno RW., "Involutional entropion and ectropion of the lower eyelid : prevalence and associated risk factors in the elderly population", Ophthal Plast Reconstr Surg, 27, pp.317~320 (2011)
- Sullivan DA., "Do sex steroids exert sex-specific and", or opposite effects on gene expression in lacrimal and meibomian glands?, 2009, pp.15, 1553~1572
- Tsubota K., "The antiaging approach for the treatment of dry eye", Cornea, 31(Suppl 1), pp.S3~S8 (2012)
- Foulks GN, "Pharmacological management of dry eye in the elderly patient", Drugs Aging, 25, pp.105~118 (2008)
- Fujihara T., "Improvement of corneal barrier function by the P2Y(2)agonist INS365 in a rat dry eye model", Invest Ophthalmol Vis Sci, 42, pp.96~100 (2001)
- Matsumoto Y., "Efficacy and safety of diquafosol ophthalmic solution in patients with dry eye syndrome : a Japanese phase 2 clinical trial", Ophthalmology, 119, pp.1954~1960 (2012)
- Kamiya K., "Clinical evalution of the additive effect of diquafosol tetrasodium on sodium hyaluronate monotherapy in patients with dry eye syndrome : a prospective, randomized, multicenter study", Eye(Lond), 26, pp.1363~1368 (2012)
- Takamura E., "A randomised, double-masked comparison study of diquafosol versus sodium hyaluronate ophthalmic solutions in dry eye patients", Br J Ophthalmol, 96, pp.1310~1315 (2012)
- Kaido M., "Effects of diquafosol tetrasodium administration on visual function in short break-up time dry eye", J Ocul Pharmacol Ther, 29, pp.595~603 (2013)
- Shimazaki-Den S., "Effects of diquafosol sodium eye drops on tear film stability in short BUT type of dry eye", Cornea, 32, pp.1120~1125 (2013)
- 정현호, "눈물막파괴시간이 짧은 건성안에서 3% 디쿠아포솔나트륨점안액의 임상효과", 대한안과학회지, 56(3), pp.339~344 (2015), 대한안과학회
- Lemp MA., "Distribution of aqueous-deficient and evaporative dry eye in a clinic-based patient cohort : a retrospective study", Cornea, 31, pp.472~478 (2012)
- Yoon KC., "Usefulness of double vital staining with 1% fluorescein and 1% lissamine green in patients with dry eye syndrome", Cornea, 30, pp.972~976 (2011)
- Tsubota K, "Tear dynamics and dry eye", Prog Retin Eye Res, 17, pp.565~596 (1998)
- Kaido M., "Punctal occlusion in the management of chronic Stevens-Johnson syndrome", Ophthalmology, 111, pp.895~900 (2004)
- Miller KL., "Minimal clinically important difference for the ocular surface disease index", Arch Ophthalmol, 128, pp.94~101 (2010)
- Yamaguchi M., "Clinical usefulness of diquafosol for real-world dry eye patients : a prospective, open-label, non-interventional, observational study", Adv Ther, 31, pp.1169~1181 (2014)
- Koh S., "Long-term results of treatment with diquafosol ophthalmic solution for aqueous-deficient dry eye", Jpn J Ophthalmol, 57, pp.440~446 (2013)
- Roszkowska AM., "Age-related modifications of corneal sensitivity", Ophthalmologica, 218, pp.350~355 (2004)
- Sharma A., "Aging : a predisposition to dry eyes", J Ophthalmol, 2014, pp.781683~ (2014)
- Gong L., "A randomised, parallel-group comparison study of diquafosol ophthalmic solution in patients with dry eye in China and Singapore", Br J Ophthalmol, 99, pp.903~908 (2015)
- Yamaguchi M., "Real-world assessment of diquafosol in dry eye patients with risk factors such as contact lens, meibomian gland dysfunction, and conjunctivochalasis : subgroup analysis from a prospective observational study", Clin Ophthalmol, 9, pp.2251~2256 (2015)
- Nichols KK., "The repeatability of clinical measurements of dry eye", Cornea, 23, pp.272~285 (2004)
- Tomlinson A., "Tear film osmolarity : determination of a referent for dry eye diagnosis", Invest Ophthalmol Vis Sci, 47, pp.4309~4315 (2006)
- Zhang X., "Interferon-γ exacerbates dry eye-induced apoptosis in conjunctiva through dual apoptotic pathways", Invest Ophthalmol Vis Sci, 52, pp.6279~6285 (2011)
- Gu Q., "Prescription drug use continues to increase: U.S. prescription drug data for 2007-2008", NCHS Data Brief, (42), pp.1~8 (2010)
- Somogyi A., "Amiloride disposition in geriatric patients : importance of renal function", Br J Clin Pharmacol, 29, pp.1~8 (1990)
- Zemba M., "Ocular surface in glaucoma patients with topical treatment", Oftalmologia, 55, pp.94~98 (2011)
- Mangoni AA., "Age related changes in pharmacokinetics and pharmacodynamics : basic principles and practical applications", Br J Clin Pharmacol, 57, pp.6~14 (2004)
- Koh S., "Effect of diquafosol ophthalmic solution on the optical quality of the eyes in patients with aqueous-deficient dry eye", Acta Ophthalmol, 92, pp.e671~e675 (2014)