빅 데이터를 이용한 뚜렛증후군 환자와 관련된 안과적 임상양상의 유병률 조사 = Prevalence of Ophthalmic Manifestations Related to Tourette Syndrome Based on Big Data

국문 초록 (Abstract)

목적: 뚜렛증후군 환자와 관련된 안과적 임상양상의 유병률을 빅 데이터를 이용해 알아보고자 하였다. 대상과 방법: 국내에서 2012년 1월 1일부터 2016년 12월 31일까지 뚜렛증후군 진단코드(F95.2)를 받은 18세 이전의 환자들을 대상으로 하였다. 뚜렛증후군과 관련되었다고 보고된 안과적 임상 양상인 틱 장애, 눈꺼풀연축, 불수의적 주시 이상, 사시와 더불어 조사된 적이 없었던 약시와 굴절이상을 안과적 임상 코드로 선정하여 심평원에서 추출한 표본을 바탕으로 한 빅 데이터를 이용하여 빈도를 조사하였다. 결과: 총 3,643명의 뚜렛증후군 환자가 연구 대상으로 포함되었으며 남자가 2,777명, 여자가 866명이었고, 틱 장애는 3,643명(100%), 눈꺼풀연축 진단코드를 받은 환자 수는 48명(1.3%)이었으며 불수의적 주시 이상 진단코드는 9명(0.2%), 사시 진단 코드를 받은 환자수는 109명(3%)이었다. 또한, 약시 진단코드를 가진 환자수는 29명(0.8%)이었으며, 굴절이상 진단코드를 가진 환자수는 1,306명(35.8%)이었다. 결론: 뚜렛증후군은 여러 안과적 이상을 동반할 수 있으므로 신경정신과 의사와 안과의사의 협력과 정기적인 안과검진이 필요할 것으로 생각된다.

다국어 초록 (Multilingual Abstract)

Purpose: To investigate the prevalence of ophthalmic manifestations in patients with Tourette syndrome using big data based on samples extracted from the Health Insurance Review and Assessment Service. Methods: The study participants included Korean patients under the age of 18 years who had received a Tourette syndrome diagnostic code (F95.2) between January 1, 2012, and December 31, 2016. Ophthalmic manifestations reported to be related to Tourette syndrome such as tic disorder, blepharospasm, involuntary gaze abnormality, and strabismus were selected as ophthalmic clinical diagnostic codes; amblyopia and refractive errors that had never been investigated in conjunction with Tourette syndrome were also selected. Prevalence was investigated using big data. Results: A total of 3,643 Tourette syndrome patients (2,777 men and 866 women) were included in the study. The number of patients receiving a tic disorder diagnostic code was 3,643 (100%); blepharospasm, 48 (1.3%); involuntary gaze abnormalities, 9 (0.2%); and strabismus, 109 (3%). In addition, the number of patients receiving an amblyopia diagnostic code was 29 (0.8%), and the number of patients with a refractive errors code was 1,306 (35.8%). Conclusions: Tourette syndrome can be accompanied by several ophthalmic manifestations. Thus, cooperation between a neuropsychiatrist and an ophthalmologist, and regular ophthalmological examinations, are considered necessary.

목차 (Table of Contents)

• 대상과 방법 결과 고찰

참고문헌 (Reference)

1 Jankovic J, "Tourette’s syndrome" 345 : 1184-1192, 2001

2 Jankovic J., "Tourette syndrome. Phenomenology and classification of tics" 15 : 267-275, 1997

3 Robertson MM, "The Gilles de la Tourette syndrome : the current status" 154 : 147-159, 1989

4 Schiefer U, "Refractive errors" 113 : 693-702, 2016

5 Knight T, "Prevalence of tic disorders : a systematic review and meta-analysis" 47 : 77-90, 2012

6 Tatlipinar S, "Ophthalmic manifestations of Gilles de la Tourette syndrome" 11 : 223-226, 2001

7 Bollen EL, "Oculomotor control in Gilles de la Tourette syndrome" 51 : 1081-1083, 1988

8 Leckman JF, "Neurobiological substrates of Tourette's disorder" 20 : 237-247, 2010

9 Lee J, "Neuroanatomy, extrapyramidal system" StatPearls Publishing

10 Poston KL, "Movement disorder emergencies" 255 (255): 2-13, 2008

11 Fu Z, "Global prevalence of amblyopia and disease burden projections through 2040 : a systematic review and meta-analysis" 104 : 1164-1170, 2020

12 Hashemi H, "Global and regional prevalence of strabismus : a comprehensive systematic review and meta-analysis" 27 : 54-65, 2019

13 Jankovic J, "Dystonic tics in patients with Tourette's syndrome" 6 : 248-252, 1991

14 Szejko N, "Dystonic tics in patients with Gilles de la Tourette syndrome" 53 : 335-340, 2019

15 American Psychiatric Association, "Diagnostic and statistical manual of mental disorders"

16 Valls-Sole J, "Blepharospasm : update on epidemiology, clinical aspects, and pathophysiology" 7 : 45-, 2016