노년층에서 건성안 관련 요인에 관한 연구
목적 : 한국인 노년층을 대상으로 건성안 관련 요인을 분석하고자 하였다.
방법 : 노년 36명(72안, 남 17명, 여 19명, 평균연령 62.11±4.84세)을 대상으로 SPEED 건성안 설문지를 이 용하여 건성안을 판별하고, 눈물의 양은 OCCUTUBE로, 눈물막 안정성은 눈물막파괴시간검사(TBUT)로 평가하였 으며, 눈물막 지방층 두께(LLT)와 눈깜박임 양상 및 마이봄샘 이상은 LIPIVIEW IIⓇ로 측정하고 Image J® 프로 그램을 이용하여 분석하였다.
결과 : 건성안의 SPEED 설문값은 10.11±4.91점, OCCUTUBE 측정값 및 TBUT는 각각 3.38±1.15 mm, 4.49±1.31초로 정상안과 차이가 없었으나, 지질층 두께는 80.36±20.78 nm로 정상안보다 두꺼웠다(p=0.021). 마이봄샘이 손상된 grade(MG dropout, MG curling, Gland thickness)는 각각 1.17±0.70, 0.47±0.61, 0.61±0.60로 정상안보다 유의하게 손상이 심했다. 지질층 두께는 SPEED 설문값과 양의 상관성을 보였고(p<0.009), 마이봄샘 손실률과 음의 상관성을 보였고, 마이봄샘 손상도는 마이봄샘 비대 및 손실과 상관성이 있었다(p<0.050).
결론 : SPEED 설문지로 감별한 노년층 건성안의 원인은 눈물막 지질층 두께와 관련이 있으며, 지질층 두께는 과분비성 마이봄샘 기능이상과 관련이 있는 것으로 사료된다.
Purpose : To evaluate the causes related to dry eye in the elderly Koreans.
Methods : Dry eyes were screened using the SPEED questionnaire for the 36 elderly subjects (72 eyes, 17 males, 19 females, average age 62.11±4.84 years old). The amount of tear was evaluated by OCCUTUBE, and the stability of the tear film was evaluated by the tear film break-up time test. Tear lipid layer thickness (LLT), blinking counts and meibomian gland damage were measured by LIPIVIEW II® and analyzed with the Image J® program.
Results : In the dry eyes, the score of SPEED questionnaire was 10.11±4.91 points, and the measured score of OCCUTUBE and the TBUT was 3.38±1.15 mm, 4.49±1.31 sec, respectively, which was not significantly different from those of the normal eyes. However, LLT (80.36±20.78 nm) was significantly thicker than that of the normal eyes (p=0.021). Meibomian gland (MG) damage grade (MG dropout, MG curling and, Gland thickness) was 1.17±0.70, 0.47±0.61 and, 0.61±0.60, respectively, which was more damaged than those of the normal eyes. LLT was positively correlated with the SPEED score (p<0.009), and negatively correlated with MG loss. And the MG score was correlated with gland thickness and MG loss (p<0.050).
Conclusion : In the elderly dry eyes screened with the SPEED questionnaire, the dry eye symptoms could be associated with LLT, and LLT is thought to be related to hypersecretory MG dysfunction.