Analysis of Prevalence and Risk Factors for Dry Eye Syndrome in Korean Adults; Based on the 5th National Health and Nutrition Examination Survey (2012)

Young-Woo Jeon,Jung-Hyun Kim,Seung-Sun Baek,Kang-Oh Rhee,Tae-Yong Lee,Hyun Lee 대한시과학회 2017 대한시과학회지 Vol.19 No.1

목 적: 본 연구는 제5기 국민건강영양조사(2012) 자료를 이용하여 한국 성인의 건성안 유병률과 위험요 인을 알아보고자 하였다. 방 법: 19세 이상 성인 중 안과의사에게 건성안 검진을 받은 5,698명(남자 2,368명, 여자 3,330명)을 대 상으로 인구사회학적 특성, 전신질환 특성, 건강관련행위 특성에 따른 건성안의 유병률과 위험요인을 분석 하였다. 결 과: 전체 연구대상자의 건성안 유병률은 13.5%이었다. 인구사회학적 특성별 건성안 유병률은 남성보 다 여성이, 50세 미만군보다 50세 이상군이, 농촌지역보다 도시지역에서 통계적으로 유의하게 높았으며, 전 신질환별 건성안 유병률은 고혈압, 이상지혈증, 골관절염, 류마티스 관절염, 우울증, 신부전증이 있는 경우 에 유의하게 높았다. 건강관련행위별 건성안 유병률은 비흡연자, 비음주자, 수면시간이 짧은 군이 높았다. 건성안 빈도는 여성에서(OR 2.29, CI 1.89-2.77)와 50세 이상군에서(OR 1.21, CI 1.01-1.46), 농촌지역에 서(OR 1.96, CI 1.56-2.47)에서 더 높았다. 유의한 모든 변수를 보정한 후에 건성안의 위험인자는 신부전 (OR 2.82, CI 1.48-5.69), 갑상선(OR 1.62, CI 1.16-2.26), 류마티스 관절염(OR 1.54, CI 1.01-2.33), 이상 지혈증(OR 1.42, CI 1.13-1.78), 우울증(OR 1.36, CI 1.11-1.66), 골관절염(OR 1.27, CI 1.02-1.57)이었다. 결 론: 우리나라 19세 이상 성인의 건성안 유병률은 13.5%으로 높은 수준이며, 50세 이상, 도시지역 거 주자, 여성과 신부전증, 갑상선, 류마티스 관절염, 이상지혈증, 우울증, 골관절염 환자에서 건성안의 위험이 높으므로 해당 위험요인을 가진 사람들을 대상으로 한 교육과 홍보를 통해 건성안증상을 조기 발견하여 적 절하게 대처하도록 할 필요가 있다 Purpose: The purpose of present study was to investigate the prevalence and risk factors for dry eye syndrome in Korean adults using data from the 5th National Health and Nutrition Examination Survey (2012). Methods: We analyzed the prevalence and risk factors for dry eye syndrome according to characteristics of sociodemographic, systemic diseases, and health related behaviors of 5,698 adults, men 2,368(41.6%) and women 3330(58.4%), aged 19 years and older, who were diagnosed with the dry eye syndrome by ophthalmologists. Results: The prevalence of dry eye syndrome was 13.5% in this population. The prevalence of dry eye syndrome in the sociodemographic characteristics was significantly higher in women than in men, in 50 years and older than under 50 years people, and in urban area than in rural area residents. The prevalence of dry eye syndrome by systemic diseases was significantly higher in subjects with hypertension, dyslipidemia, osteoarthritis, rheumatoid arthritis, depressive disorder, and renal failure. The prevalence of dry eye syndrome by health related behaviors was higher in non-smokers, non-drinkers, and short time sleepers. The dry eye syndrome was more frequent in women (OR 2.29, CI 1.89-2.77), in 50 years and older people (OR 1.21, CI 1.01-1.46), and rural area resident s (OR 1.96, CI 1.56-2.47). After adjusting for all significant variables, independent risk factors for dry eye syndrome were renal failure (multi-variable odds ratio (OR) 2.82, 95% confidence interval (CI) 1.48-5.69), thyroid disease (OR 1.62, CI 1.16-2.26), rheumatoid arthritis (OR 1.54, CI 1.01-2.33), dyslipidemia (OR 1.42, CI 1.13-1.78), depressive disorder (OR 1.36, CI 1.11-1.66), and osteoarthritis (OR 1.27, CI 1.02-1.57). Conclusion: The prevalence of dry eye syndrome in adults aged 19 and over was 13.5%. The dry eye syndrome was more frequent in women, 50 years and older people, and in urban residents, as a socio-demographic factor. Systemic disease factors related to dry eye were renal failure, thyroid disease, rheumatoid arthritis, dyslipidemia, depressive disorder, osteoarthritis. We suggest that people with dry eye syndrome risk factors should be provided about dry eye symptoms through the education, so that they can be found early and appropriately treated dry eye.

중년기 안구건조증 환자의 안구건조 증상정도와 안구피로가 시력관련 삶의 질에 미치는 영향

윤혜숙,김현경 한국가정간호학회 2022 가정간호학회지 Vol.29 No.3

Purpose: This is a cross-sectional study aimed to investigate the effects of dry eye syndrome symptoms and eye fatigue on the vision-related quality of life (QOL) of middle-aged patients with dry eye syndrome. Methods: The participants of this study were 94 ophthalmology clinic outpatients aged 40–59 years who were diagnosed with dry eye syndrome at A and S Ophthalmology Clinics in D City, South Korea, and were exhibiting dry eye syndrome symptoms. Data were collected from July 5, 2021 to July 22, 2021, and analyzed using independent t-test, analysis of variance, Scheffe test, Pearson’s correlation coefficient, and multiple regression analysis using the SPSS/WIN 25.0 program. Results: The severity of dry eye syndrome symptoms and asthenopia (r=.73, p<.001) in the participants were positively correlated, whereas the severity of dry eye syndrome symptoms and vision-related quality of life (r=-.76, p<.001) were negatively correlated. Additionally, there was a negative relationship between eye fatigue and vision-related QOL (r=-.55, p<.001). It was found that the final factors affecting the vision-related QOL of middle-aged patients with dry eye syndrome were the severity of dry eye syndrome symptoms (β=-0.76, p<.001) and dry eye stress (β=-0.14, p=.048). The explanatory power of vision-related QOL in the participants was 56.0%. Conclusion: To develop indices that can objectively measure patients’ subjective symptoms for improving their vision-related QOL is necessary. .

Dry Eye Assessment of Patients Undergoing Endoscopic Dacryocystorhinostomy for Nasolacrimal Duct Obstruction Combined with Dry Eye Syndrome

Min Han Kim,Kangmin Lee,Minwook Chang 대한안과학회 2023 Korean Journal of Ophthalmology Vol.37 No.5

Purpose: To evaluate the prevalence of dry eye symptoms after endoscopic dacryocystorhinostomy (EDCR) for patients with primary acquired nasolacrimal duct obstruction (PANDO) combined with dry eye syndrome. Methods: The patients diagnosed with PANDO combined with dry eye syndrome who underwent EDCR were divided into two groups according to the questionnaire about dry eye symptoms after surgery. The medical records were retrospectively analyzed. Before and after surgery, we compared the tear meniscus height, tear breakup time, and the presence of corneal punctuate epithelial erosion. The level of dry eyes of patients after surgery was assessed by using the Korean guidelines for the diagnosis of dry eye. Results: At 6 months after EDCR, the proportion of patients with dry eye symptoms was 30% in a total of 80 patients. The duration of epiphora and tear breakup time after EDCR were higher in the group without dry eye symptoms and the proportion of eyes with corneal punctuate epithelial erosion after EDCR was higher in the group with dry eye symptoms. About 15% of total patients started treatment with a dry eye of level 2 or higher. Conclusions: About 15% of patients who underwent EDCR for PANDO combined with dry eye syndrome developed significant dry eye syndrome after surgery. The short onset of epiphora was associated with the development of the dry eye symptoms. Therefore, it is necessary to evaluate dry eye syndrome before surgery, and surgeons should be careful about this.

건성안 환자에서 쇼그렌증후군의 빈도 및 임상양상

이준성,최원,이신석,윤경철.Jun Sung Lee. MD. Won Choi. MD. Shin Seok Lee. MD. Kyung Chul Yoon. MD. PhD 대한안과학회 2012 대한안과학회지 Vol.53 No.4

Purpose: To investigate the prevalence and clinical aspects of Sjögren syndrome in patients who were diagnosed with dry eye syndrome in Korea. Methods: The medical records of patients who were diagnosed with dry eye syndrome in a dry eye clinic during a 2-year period (March 2008 to March 2010) and were followed up for more than 3 months were reviewed retrospectively. Results: A total of 206 patients were included in the present study. Fifty-eight patients (28%) had Sjögren syndrome and 39 patients (19%) showed primary Sjögren syndrome. Sjögren syndrome patients showed poorer results than non-Sjögren syndrome patients in ocular surface disease index score (OSDI), tear break up time, Schirmer test score, and ocular surface staining score using the Oxford scheme (p < 0.05). Among the patients with primary Sjögren syndrome, 27 patients were SSA (anti-Ro antibodies) or SSB (anti-La antibodies) positive and 12 patients were sero-negative. There were no statistically significant differences in objective or subjective parameters between the sero-positive and sero-negative groups. Conclusions: Sjögren syndrome was observed in 28% of all dry eye patients, in two-thirds of severe dry eye patients. Sjögren syndrome patients showed more severe clinical aspects than dry eye patients with non-Sjögren syndrome. Diagnosing Sjögren syndrome through systemic evaluation is necessary in the patients with severe dry eye. J Korean Ophthalmol Soc 2012;53(4):499-504

Risk Factors for Inflammatory Dry Eye in Young Adults in Twenties

Jung-Eun Park,Min-Hye Park,Koon-Ja Lee 대한시과학회 2020 대한시과학회지 Vol.22 No.1

목적 : 건성안의 핵심적인 원인으로 염증이 제시됨에 따라 본 연구에서는 한국 20대 성인을 대상으로 콘택트렌즈 착용 및 각막굴절교정술이 염증성 건성안(inflammatory dry eye syndrome)에 미치는 영향을 알아보고자 하였다. 방법 : 안질환이 없는 20대 성인 81명(162안)을 대상으로 염증 생체지표인 ‘기질금속단백분해효소’(MMP-9: Matrix Metalloproteinase-9)의 활성도와 염증성 건성안 감별진단법으로 제시된 ‘안구표면질환지수(OSDI, Ocular Surface Disease Index)/결막충혈’ 검사법으로 염증성 건성안을 감별진단하였다. 각막굴절교정술 및 콘택트렌즈 착용 여부에 따른 유병률과 위험요인은 χ2-test 검정과 하였고, 위험비(odds ratio, OR)는 로지스틱 회귀분석으 로 검정하였으며 유의수준은 0.050 이하로 하였다. 결과 : 전체 대상자의 염증성 건성안 유병률은 MMP-9 검사, ’OSDI, 결막충혈’ 검사 기준 각각 77.15%, 64.31% 로 나타났다. 콘택트렌즈 착용군의 염증성 건성안 비율은 검사법 기준으로 각각 85.23%, 75.00%로 미착용군의 67.57%, 52.70% 보다 높았고, 염증성 건성안 발생 가능성이 2.77배(OR 2.77, 95% CI 1.29~5.99), 2.69배 (OR 2.69, 95% CI 1.39~5.23)로 높게 나타났다. 각막굴절교정술을 받은 군의 염증성 건성안 비율은 검사법 기준 각각 81.25%, 75.00%로 수술을 받지 않은 군의 76.71%, 63.69%보다 높았으나 통계적으로 유의한 차이는 아니 었다(p=0.682), (p=0.370). 결론 : 20대 한국 성인의 염증성 건성안 비율은 매우 높고, 콘택트렌즈를 착용한 경우에 염증성 건성안의 발병 확률은 미착용안에 비해 2배 이상 높은 것으로 나타나 콘택트렌즈 착용자의 경우 이를 예방하기 위한 콘택트렌즈 관리교육이 중요할 것으로 생각된다. Purpose : As inflammation is suggested as a core drive factor for dry eye, in this study the effects of contact lens wear and corneal refractive surgery on inflammatory dry eye were investigated in Korean twenties. Methods : Eighty-one adults (162 eyes) in their twenties who had no ocular disease were evaluated by 'Matrix Metalloproteinase-9 (MMP-9)' test as known biomarker for inflammatory dry eye and 'OSDI/conjunctival hyperemia' test for screening of inflammatory dry eye. We analyzed prevalence and risk factors of inflammatory dry eye based on two inflammatory dry eye tests, and analyzed them using Chi-square test and logistic regression. The statistical significance level was p<0.050. Results : The prevalence of inflammatory dry eye evaluated by MMP-9 and OSDI/conjunctival hyperemia tests in all subjects was shown 77.15% and 64.31%, respectively. The prevalence of inflammatory dry eye in contact lens wearer group with two tests was 85.23% and 75.00%, respectively, and that in the non-wearer group was 67.57% and 52.70%, respectively. The risk of inflammatory dry eye in contact lens wears was 2.77 times (OR 2.77, 95% CI 1.29~5.99), and 2.69 times (OR 2.69, 95% CI 1.39~5.23) higher than non contact lens wearers, respectively. The prevalence of inflammatory dry eye in corneal refractive surgery group compared with non operative group was not significantly different (p=0.682 and p=0.370, respectively). Conclusion : It was confirmed that the prevalence of inflammatory dry eye in Korean twenties was very high, and the odds ratio of inflammatory dry eye was 2 times higher than contact lens wearers. Therefore, the contact lens care education for contact lens weareres would be necessary to prevent inflammatory dry eye.

Evaluating the Effects of Dry Eye Syndrome on Ocular Fatigue and Attentiveness

Kyung-Hee Hong,Hyun-Joo Lee,Se-Jin Kim 대한시과학회 2017 대한시과학회지 Vol.19 No.4

목적: 본 연구는 건성안 증후군이 눈 피로도와 주의집중력에 미치는 영향을 알아보고자 한다. 방법: 시기능 이상이 없고 콘택트렌즈를 착용하지 않으며 양안 교정시력이 0.8 이상인 19 ~ 83세(평균 연령 40.27세)의 512명을 대상으로 하였다. 일반적인 특성(성별, 연령, 음주 및 흡연 여부), 건성안증후군, 눈 피로도 검사의 설문점수 및 주의집중력의 하위요인별로 검사하여 분석하였다. 결과: 대상자 중 여자가 312명(60.9%)으로 남자보다 많았고 평균 나이는 40.27세이었다. 음주를 하는 응답자가 260명(50.8%)으로 하지 않는 응답자보다 많았으며, 비흡연자가 438명(85.5%)으로 흡연자보다 많 았다. 건성안증후군은 나이, 성별, 흡연, 음주, 눈 피로도와 정적상관을 나타냈으며, 주의집중력의 하위요인 BET, NAR, OET, RED에서 유의한 차이를 나타내었다. 결론: 건성안증후군은 그렇지 않은 사람보다 주의집중력이 낮았고, 건성안증후군이 증가하면 눈 피로도 가 높아졌다. Purpose: This study was aimed to evaluate the effects of dry eye syndrome on ocular fatigue and attentiveness. Methods: This study targeted 512 subjects who did not have an abnormal visual function, did not wear contact lens, had corrective eyesight over 0.8, and were between 19 and 83 year olds (mean age of 40.27 years). General characteristics (i.e., sex, age, drinking, and smoking status), dry eye syndrome, the score of a survey on ocular fatigue, and sub-factors of attentiveness were tested and analyzed. Results: Among the subjects, 312 were women and the mean age of them was 40.27 years. The number of drinkers was 260 and there were more drinkers than non-drinkers. There were 438 non-smokers, which was more than smokers. Dry eye syndrome showed positive correlations with age, sex, smoking, drinking, and eye fatigue. Attentiveness showed significant differences with BET, NAR, OET, and RED, which were sub-factors, had significant effects on dry eye syndrome. Conclusion: People with dry eye syndrome showed lower attentiveness than those who without it and higher dry eye syndrome increased ocular fatigue.

스마트폰 사용여부에 따른 온도와 상대습도 변화가 건성안 유발에 미치는 영향

김대종,차정원,박문찬,이화자 대한시과학회 2014 대한시과학회지 Vol.16 No.3

Purpose: This study was to measure and asses for confirming whether the use of smart phone was related to dry eye or not under various temperature and humidity. Methods: Undergraduate applicants 30 subjects were studied under constant temperature and constant humidity for 2hr. who were divided into two groups: smart phone user group and non-user group. They were checked at 9 times in a person, whether they have dry eye or not, by using 4 kinds of dry eye examination which were questionnaire, Non invasive break up time, tear film Break-Up Time and Schirmer test. Results: In McMonnies dry eye symptom questionnaire, we analyzed that low humidity and smart phone user group had 1.27 times (95% CI : 1.201-1.348) and 0.43 times (95% CI : 0.211-0.886) higher risk of dry eye than non-user group. And, in Schirmer test, low humidity and smart phone user group had 1.36 times(95% CI : 1.264-1.478) and 0.19 times (95% CI : 0.080-0.465) higher risk of dry eye than non-user group, which showed significant result. In tear film Break-Up Time examination, low humidity and smart phone user group had 1.23 times(95% CI : 1.176-1.303) and 0.15 times(95% CI : CI : 0.075-0.330) higher risk of dry eye than high humidity and non-user group. In non-invasive break up time examination, also it was investigated that low humidity and smart phone user group had 1.20 times(95% CI : 1.149-1.258) and 0.27 times(95% CI : 0.141-0.528) higher risk of dry eye. Conclusions: We knew that low humidity and smart phone users were related in dry eye, but temperature was not related in dry eye. 목 적: 본 연구의 목적은 스마트폰의 사용여부에 따른 온도와 상대습도의 변화가 건성안에 영향을 미치는지 파악하기 위하여 측정 평가하였다. 방 법: 실험은 온도와 습도의 조건을 설정하여 총 9회 측정을 실시하였다. 대상자는 건성안과 관련이 없는 지원자 30명을 스마트폰 사용 군과 사용하지 않는 군으로 분류하였으며, 1회 측정 시 같은 실험공간과 환경조건에서 동일하게 2시간동안 지내게 한 후 설문과 Non invasive break up time, tear film Break-Up Time, Schirmer test의 4가지 건성안검사를 실시해 건성안의 유무를 파악하였다. 결 과: McMonnies dry eye symptom questionnaire에서는 상대습도가 낮을 때와 스마트폰을 사용하는 군에서 안구 건조의 발생 가능성이 각각 1.27배(95% CI: 1.201-1.348) 및 0.43배(95% CI: 0.211-0.886) 높은 것으로 분석되었으며, Schirmer test에서도 상대습도가 낮을 때와 스마트폰을 사용하는 군에서 각각 건성안의 발생 가능성이 1.36배(95% CI: 1.264-1.478) 및 0.19배(95% CI: 0.080-0.465)로 유의한 결과를 나타내었다. tear film Break-Up Time의 검사에서의 건성안에 대한 발생 가능성은 상대습도가 낮을 때 1.23배(95% CI: 1.176-1.303), 스마트폰을 사용하는 군에서 0.15배(95% CI: 0.075-0.330)로 높아졌으며, Non invasive break up time검사에서도 건성안의 발생 가능성이 상대습도가 낮을 때 1.20배(95% CI: 1.149-1.258), 스마트폰을 사용할 때 0.27배(95% CI: 0.141-0.528)로 높아지는 것으로 측정 분석되었다. 결 론: 상대습도가 낮을 때와 스마트폰 사용자에서 건성안의 영향이 있는 것을 알 수 있었으며, 온도의 변화는 건성안에 영향을 미치지 않았다.

건성안 환자의 광학적 특성에 대한 객관적인 분석

전혜민,이동준,Hye Min Jeon,Dong Jun Lee 대한안과학회 2014 대한안과학회지 Vol.55 No.11

Purpose: To evaluate the efficacy of Optical Quality Analysis System (OQAS<SUP>Ⓡ) instrument for the assessment of dry eye syndrome. Methods: Dynamic recording of double-pass (DP) retinal images was performed in 1 eye dry eye patients (20 eyes) and in healthy controls (20 eyes) for 20 seconds after eye blinking. Results: The mean objective scatter Index (OSI) value was 4.53 in dry eyes, 0.67 in healthy eyes and the standard deviation of OSI was 1.20 in dry eyes and 1.18 in healthy eyes. The patients with dry eyes showed significantly higher mean OSI and standard deviation values. Ocular scatter increased over time and significant changes occurred 13.5 seconds after blinking. The difference in OSI value between 0 second and 20 seconds was significantly greater in dry eye patients (4.15) than in controls (0.32). Conclusions: Ocular scatter increased over time after blinking. The dry eye patients had larger and more variable ocular scatter index than the controls. OQAS<SUP>Ⓡ may be useful to detect and follow-up tear film-related patient complaints in dry eye syndrome. J Korean Ophthalmol Soc 2014;55(11):1600-1605

안구건조증의 병인(病因)에 대한 문헌적 고찰

윤성식,서형식,Yoon, Seong-Sik,Seo, Hyung-Sik 대한한방안이비인후피부과학회 2009 한방안이비인후피부과학회지 Vol.22 No.3

Objective : The object of this literatual study is to investigate the etiology of dry eye syndrome Methods : We have selected data related to etiology of dry eye syndrome on the literature of Oriental Medicine. And we analyzed the study. Results : Treatment and etiology concerning dry eye syndrome derived diverse opinion according to medical era and practitioner. It was a good opportunity to speculate the etiology and similar symptoms of dry eye syndrome. Conclusions : Through literatual Study, we basically understood the etiology of dry eye syndrome. In the study of the etiology, it seems that further clinical studies on treatment of dry eye syndrome via oriental medicine.

한국 성인에서의 커피 섭취 빈도와 건성안의 연관성 분석: 2010– 2011년 국민건강영양조사 자료 이용

정진이,최영제,장수영,이성화,김혜원,손효림 대한가정의학회 2019 Korean Journal of Family Practice Vol.9 No.5

Background: Dry eye is a common disease, and coffee is a popular beverage that is heavily consumed in Korea and worldwide. We examined the correlation between coffee consumption and dry eye. Methods: This study was performed using data from the 5th Korean National Health and Nutrition Examination Survey, which was a cross-sectional study of the Korean population conducted from 24 months. We included adults aged ≥19 years who underwent ophthalmologic examination and excluded those who had comorbid conditions with dry eye. The subjects were divided into dry eye and control groups. The dry eye group consisted of those who had been clinically diagnosed with dry eye. A multiple logistic regression analysis was conducted to determine the correlation between coffee consumption and dry eye. Results: An inverse correlation was found between coffee consumption and dry eye in the group that consumed 3 cups of coffee a day (P=0.001). However, after multivariate adjustment, the statistical significance of the correlation disappeared (P=0.283). Conclusion: Consumption of 3 cups of coffee a day in comparison to non-consumption group was negatively correlated with dry eye in an univariate analysis model, but the correlation was not statistically significant after adjusting for age, sex, body mass index, smoking, binge drinking, sun exposure time and history of eye surgery. 연구배경: 카페인 섭취는 건성안에 연관이 있는 인자로 알려져 있다. 그러나 국내에는 카페인 섭취와 건성안에 관한 연구가 부족한실정이다. 이에 본 연구를 통하여 한국 성인에서 커피 섭취 빈도와건성안의 연관성을 평가해보았다. 방법: 본 연구는 2010년과 2011년 국민건강영양조사 자료를 이용하였다. 조사 참여자 중에서 안과적 면담을 받은 만 19세 이상 성인7,630명을 대상으로 하였고, 건성안과 관련된 질환(류머티즘 관절염,갑상선 질환, 만성 신장 질환 또는 우울증)이 있는 자들은 분석에서제외하였다. 카이제곱 검정과 로지스틱 회귀분석을 사용하여 커피섭취 빈도와 건성안의 연관성을 평가하였고 연령, 성별, 체질량 지수, 흡연, 음주, 햇볕 노출시간, 과거 안과시술 여부를 혼란 변수로통제하였다. 결과: 커피 섭취 빈도와 건성안 진단을 교차 분석한 결과 통계적으로 유의한 연관성을 보였다(P=0.002). 다른 변수를 보정하지 않고 커피 섭취 빈도와 건성안과의 관계를 보기 위해 실행한 로지스틱 회귀분석 결과 커피를 하루 3잔 마시는 군이 건성안과 유의한 역의 상관관계를 보였으나(P=0.001) 혼란변수를 보정한 후에는 통계적 유의성이 보이지 않았다(P=0.310). 결론: 단변량 분석에는 하루 커피 3잔 섭취는 건성안과 역의 상관관계가 있었으나, 혼란변수를 보정한 후에는 통계적 유의성이 없었다.