아이라인 문신이 마이봄샘 기능이상 및 안구 표면에 미치는 영향 = The Effect of Eyeliner Tattoo on Meibomian Gland Dysfunction and the Ocular Surface

다국어 초록 (Multilingual Abstract)

Purpose: To determine whether eyeliner tattoo affects the meibomian gland (MG) and ocular surface.
Methods: The medical charts of an eyeliner tattoo group (16 eyes of 8 patients) and a control group (16 eyes of 18 patients) were retrospectively reviewed. The ocular surface disease index questionnaire, ocular surface staining score, tear film break-up time (TBUT), upper eyelid abnormality, meibum expressibility and quality, and MG loss and tear film lipid layer thickness (LLT) which measured with LipiView® (TearScience, Morrisville, NC, USA) were compared. In the tattoo group, the correlation between the distance from the MG orifice to the tattoo pigment and other indices were analyzed.
Results: Compared to controls, the tattoo group had a significantly higher ocular surface disease index (p = 0.002), shorter TBUT (p < 0.001), higher vessel engorgement of the upper lid (p = 0.016), poorer meibum expressibility and quality (p = 0.006 and p < 0.001, respectively), higher MG loss (p < 0.001), and thinner LLT (p = 0.024). In the tattoo group, the closer the tattoo was to the MG orifice, the more the upper lid vessel was engorged and the more MG loss occurred (rs = -0.560, p = 0.024; rs = -0.563, p = 0.023, respectively), and a thinner LLT was observed (rs = 0.567, p = 0.022).
Conclusions: Eyeliner tattoos may be related to changes in the lid margin, loss of the MG, and thinning of the LLT.

국문 초록 (Abstract)

목적: 아이라인 문신이 마이봄샘 기능이상 및 안구 표면에 미치는 영향을 알아보고자 한다.
대상과 방법: 아이라인 문신군 16안(8명)과 대조군 18안(16명)의 의무기록을 후향적으로 분석하였다. 안구표면질환지수를 이용한 설문조사, 안구표면 염색정도, 눈물막파괴시간, 상안검연의 이상 여부, 마이붐의 배출 및 성상, LipiView® (TearScience, Morrisville, NC, USA)로 측정한 마이봄샘의 손실 정도 및 눈물 지질층 두께를 비교하였다. 또한, 마이봄샘 개구부로부터 문신까지의 거리와 지표들 간의 상관관계를 분석하였다.
결과: 아이라인 문신군의 경우 대조군에 비해 안구표면질환지수가 더 높았으며(p=0.002), 눈물막파괴시간은 더 짧았다(p<0.001). 아이라인 문신군에서 상안검연의 혈관 확장이 있는 경우가 유의하게 많았으며(p=0.016), 마이붐은 배출이 덜 되고 더 불투명하였다(p=0.006, p<0.001). 마이봄샘 손실 비율은 문신군에서 더 높았으며(p<0.001), 눈물 지질층 두께는 문신군에서 더 낮았다(p=0.024). 아이라인 문신이 마이봄샘 개구부에 가까울수록 상안검연의 혈관 확장 및 마이봄샘의 손실 정도는 심하였고(rs=-0.560, p=0.024; rs=-0.563, p=0.023), 눈물 지질층의 두께는 얇았다(rs=0.567, p=0.022).
결론: 아이라인 문신은 안검연의 변화, 마이봄샘의 손실의 증가 및 눈물 지질층의 얇아짐과 관련이 있을 수 있다.

참고문헌 (Reference)

1 김은철, "안구건조증의 진단과 치료" 대한의사협회 61 (61): 352-364, 2018

2 Kim HM, "The relationship between morphology and function of the meibomian glands" 44 : 1-5, 2018

3 Tomlinson A, "The international workshop on meibomian gland dysfunction: report of the diagnosis subcommittee" 52 : 2006-2049, 2011

4 Nelson JD, "The international workshop on meibomian gland dysfunction: report of the definition and classification subcommittee" 52 : 1930-1937, 2011

5 Kojima T, "Tear film and ocular surface abnormalities after eyelid tattooing" 21 : 69-71, 2005

6 Gomes JAP, "TFOS DEWS II iatrogenic report" 15 : 511-538, 2017

7 Craig JP, "TFOS DEWS II Definition and Classification Report" 15 : 276-283, 2017

8 Goldman A, "Severe unexpected adverse effects after permanent eye makeup and their management by Q-switched Nd : YAG laser" 9 : 1305-1309, 2014

9 Arita R, "Proposed diagnostic criteria for obstructive meibomian gland dysfunction" 116 : 2058-2063.e1, 2009

10 Morrison C, "My tattoos caused my dry eye? A new way to look at diagnosis and treatment for patients with tattoo eyeliner" 78 : 6-15, 2016

11 Foulks GN, "Meibomian gland dysfunction : a clinical scheme for description, diagnosis, classification, and grading" 1 : 107-126, 2003

12 Bron AJ, "Meibomian gland disease. Classification and grading of lid changes" 5 (5): 395-411, 1991

13 Liao JC, "Late-onset melanopenic hypomelanosis as a complication of cosmetic eyeliner tattoo" 69 : e144-e146, 2013

14 Wojtowicz JC, "Historical brief on composition of human meibum lipids" 7 : 145-153, 2009

15 Bron AJ, "Grading of corneal and conjunctival staining in the context of other dry eye tests" 22 : 640-650, 2003

16 Lee YB, "Eyelid tattooing induces meibomian gland loss and tear film instability" 34 : 750-755, 2015

17 Wolfley DE, "Eyelid pigment implantation : early and late histopathology" 82 : 770-774, 1988

18 Finis D, "Evaluation of lipid layer thickness measurement of the tear film as a diagnostic tool for Meibomian gland dysfunction" 32 : 1549-1553, 2013

19 Eom Y, "Correlation between quantitative measurements of tear film lipid layer thickness and meibomian gland loss in patients with obstructive meibomian gland dysfunction and normal controls" 155 : 1104-1110, 2013

20 Tse DT, "Clinicopathologic correlate of a fresh eyelid pigment implantation" 103 : 1515-1517, 1985

21 Shams PN, "Clinical anatomy of the periocular region" 29 : 255-263, 2013

22 Takahashi Y, "Anatomy of secretory glands in the eyelid and conjunctiva : a photographic review" 29 : 215-219, 2013