Thermographic Assessment in Dry Eye Syndrome, Compared with Normal Eyes by Using Thermography

Purpose: The purpose of this study was to compare and analyze the ocular surface and the palpebral conjunctiva of categorized subjects, which were divided into normal eye group and dry eye group, by using a thermal camera. Methods: Subjects were 144 eyes of 72 normal university students, who didn't have any corneal disease, abnormal lacrimal ducts, medical records regarding ocular surgeries, or experience of using contact lens. Subjects were divided into two groups, which were normal eye group and dry eye group, based on the results of TBUT, Schirmer I test, and McMonnies test. After categorizing the subjects, the temperature of the subjects' ocular surface and the palpebral conjunctiva were measured and analyzed by using a thermal camera (Cox CX series, Answer co., Korea). Results: In the normal eye group's Central Ar.1, Nasal Ar.2, Temporal Ar.3, Superior Ar.4, Inferior Ar.5, the measured amount of temperature change on each area was $-0.13{\pm}0.08$, $-0.14{\pm}0.08$, $-0.12{\pm}0.08$, $-0.14{\pm}0.08$, $-0.10{\pm}0.09(^{\circ}C/sec)$. The dry eye group's results were $-0.17{\pm}0.08$, $-0.16{\pm}0.07$, $-0.16{\pm}0.08$, $-0.17{\pm}0.09$, $-0.15{\pm}0.08(^{\circ}C/sec)$. When compared with the normal eye group, the values of Ar.1, Ar.3, Ar.5 were significantly different in the dry eye group(p<0.05). The amount of temperature change, which was observed on the palpebral conjunctiva(Ar.1:central, Ar.2: nasal, Ar.3: temporal) of the normal eyes, measured by thermography, was $34.36{\pm}1.12$, $34.17{\pm}1.10$, $34.07{\pm}1.12^{\circ}C$ on each area. Same values taken from the dry eye group was $33.55{\pm}0.94$, $33.43{\pm}0.97$, $33.51{\pm}1.06^{\circ}C$ on each area. The values of Ar.1, taken from the dry eye group, had a significant difference, compared to the values of the normal eye group(p=0.05). Conclusion: The temperature of the ocular surface decreased faster on the dry eyes, compared to the normal eyes. The temperature measured on the palpebral conjunctiva of the dry eyes were also lower than the normal eyes. The temperature changes on the ocular surface, observed with a thermal camera, were objective values to assess the stability of tear films, and might provide useful data for studies related to dry eye syndrome.

열화상카메라를 이용한 정상안과 건성안의 서모그래피 비교

목적: 열화상카메라를 이용하여 정상안 군과 건성안 군의 검결막과 안구표면의 서모그래피를 객관적으로 알아보고자 하였다. 방법: 각막질환, 안외상, 누도이상자, 안과수술 병력 등 안구표면의 눈물막에 영향을 주는 질환이 없고 콘택트렌즈를 사용하지 않는 대학생 72명(144안)을 대상으로 하였다. TBUT, Schirmer I test, McMonnies test를 시행하여 정상안 군과 건성안 군으로 분류하고 열화상카메라(Cox CX series, Answer co., Korea)를 이용하여 안구표면과 검결막의 온도변화를 분석하였다. 결과: 정상안 군에서 안구표면 눈물막의 중심부, 코방향, 귀방향, 위, 아래방향에서 온도변화량은 $-0.13{\pm}0.08$, $-0.14{\pm}0.08$, $-0.12{\pm}0.08$, $-0.14{\pm}0.08$, $-0.10{\pm}0.09(^{\circ}C/sec)$이었고 건성안군에서는 $-0.17{\pm}0.08$, $-0.16{\pm}0.07$, $-0.16{\pm}0.08$, $-0.17{\pm}0.09$, $-0.15{\pm}0.08(^{\circ}C/sec)$로 중심부, 귀방향, 아래방향에서 유의성을 띠었다(p<0.05). 정상안 군으로 분류된 대상자의 중심부, 코방향, 귀방향의 검결막 온도는 $34.36{\pm}1.12$, $34.17{\pm}1.10$, $34.07{\pm}1.12^{\circ}C$였고, 건성안 군은 $34.17{\pm}1.10$, $33.43{\pm}0.97$, $33.51{\pm}1.06^{\circ}C$로 중심부에서 유의한 차이를 보였다(p=0.05). 결론: 건성안 군에서 정상안 군보다 안구표면의 온도 감소가 빠르게 나타났고 검결막의 온도도 낮은 것으로 관찰되었다. 열화상카메라를 활용한 안구표면의 온도변화는 눈물막의 안정성을 평가하는데 객관적이었으며 건성안 연구에 유용할 것으로 기대된다.