난치성 지속각막상피결손에서 양막추출물 점안액의 임상효과

Effects of Amniotic Membrane Extract Eye Drops on Persistent Epithelial Defects of the Cornea

목적: 난치성 지속각막상피결손 환자에서 양막추출물 점안액의 임상적 효과를 알아보고자 하였다. 대상과 방법: 지속적인 치료에도 불구하고 지속각막상피결손이 적어도 4주 이상 지속된 환자 16명, 16안을 대상으로 추가적으로 양막추출물 점안액을 하루 6회 점안하여 치료를 시작하였다. 양막추출물 점안액 치료 전, 치료 1개월째 그리고 치료 2개월째 최대교정시력, 안구통증점수, 각막지각점수, 각막상피결손 면적을 측정하였다. 치료 2개월 후 각막상피결손 면적이 모두 호전된 경우 효과적, 각막상피결손 면적이 감소하였으나, 남아있는 경우 부분 효과적, 각막상피결손 면적이 증가하여 추가적인 치료가 시행된 경우 효과 없음으로 판정하였다. 결과: 양막추출물 점안액 치료 전과 비교하여 치료 2개월째 최대교정시력(0.8 ± 0.5 vs. 0.6 ± 0.3 LogMAR, p=0.03)의 증가, 안구통증점수(4.3 ± 1.0 vs. 2.8 ± 0.7, p=0.04)의 감소, 각막상피결손 면적(5.2 ± 3.1 vs. 0.1 ± 0.1 mm2, p=0.01)의 감소를 보였다. 양막추출물 점안액 치료는 13안(81.3%)에서 효과적이었으며, 3안(18.8%)에서 일부 효과적이었다. 결론: 양막추출물 점안은 난치성 지속각막상피결손 환자에서 안구 증상을 완화시키고 각막상피회복을 촉진하는 효과적인 치료 방법으로 사용될 수 있다.

Purpose: To evaluate the clinical efficacy of amniotic membrane extract eye drops (AMEEDs) in patients with persistent epithelial defects (PEDs) of the cornea. Methods: Sixteen patients with PEDs refractory to the conventional treatment were further treated with AMEEDs six times a day. Visual acuity, visual analog scale (VAS), esthesiometer score, and areas of the epithelial defects before and after 1 and 2 months of treatment were evaluated. After 2 months, AMEEDs were considered effective if all epithelial defects were healed, partially effective if the epithelial defects decreased in size compared with the baseline, and ineffective if the epithelial defects increased in size and required additional treatment. Results: After 2 months of treatment with AMEEDs, there was a reduction in the area of epithelial defects (5.2 ± 3.1 mm2 vs. 0.1 ± 0.1 mm2, respectively, p = 0.01), as well as a significant improvement in best-corrected visual acuity (0.8 ± 0.5 logarithm of minimal angle of resolution [LogMAR] vs. 0.6 ± 0.3 LogMAR, respectively, p = 0.03), and VAS scores (4.3 ± 1.0 vs. 2.8 ± 0.7, respectively, p = 0.04) compared with the baseline values. Treatment with AMEEDs was effective in 13 (81.3%) patients and partially effective in three (18.8%) patients. Conclusions: AMEEDs could stimulate epithelial wound healing and improve ocular symptoms in patients with refractory PED. Therefore, AMEEDs could be considered an effective treatment option for refractory PEDs. J Korean Ophthalmol Soc 2021;62(10):1340-1347