Oculus Keratograph分析仪评估睑板腺功能障碍患者的眼表情况

doi:10.6040/j.issn.1671-7554.0.2020.620

摘要/Abstract

摘要： 目的探讨Oculus Keratograph分析仪评估睑板腺功能障碍(MGD)患者眼表情况的临床应用价值。方法随机选取MGD患者46例46眼作为MGD组,对照组为同期的46例健康志愿者。对每位受检者均依次进行详细的病史询问、视力、眼压等一般眼科检查;采用眼表疾病指数(OSDI)问卷调查表评估眼部症状;裂隙灯显微镜观察睑缘、睑板腺开口及眼表情况;Oculus Keratograph分析仪观察首次非侵入性泪膜破裂时间(NITBUTf)、睑板腺的形态学特征及缺失情况。OSDI分值与 NITBUT、睑板腺缺失评分的相关性采用Pearson相关进行分析。结果 MGD组和对照组的年龄分布相近(P=0.354),性别组成在两组的差异无统计学意义(P=0.288)。MGD组的眼部不适多表现为异物感、视疲劳、干涩、视物模糊、畏光等;对照组出现上述症状的情况较少、不适症状的程度较轻;MGD组的OSDI分值较对照组低,两组比较差异具有统计学意义(P<0.001)。MGD组多数患者的睑缘形态及睑板腺开口呈异常表现。对照组的泪膜图颜色比MGD组的更均一,NIBUTf较MGD组高(P<0.001)。睑板腺腺体长短不一、扩张、迂曲及腺体缺失等睑板腺异常在MGD组更常见,MGD组的睑板腺缺失评分明显高于对照组(P<0.001)。OSDI分值与NIBUTf呈负相关(r=-0.618,P<0.001),与睑板腺缺失评分呈正相关(r=0.714, P<0.001)。结论 Oculus Keratograph分析仪能客观、无创性观察泪膜稳定性及睑板腺状况,可用于MGD患者眼表情况的临床评估。

关键词: 眼表疾病, 睑板腺功能障碍, 泪膜

Abstract: Objective To explore the application value of Oculus Keratograph in evaluating the ocular surface in patients with meibomian gland dysfunction(MGD). Methods A total of 46 MGD patients(46 eyes)and 46 healthy controls were enrolled. All subjects received routine ophthalmic examinations to check vision and intraocular pressure. All subjects filled in the ocular surface disease index(OSDI)questionnaire to evaluate ocular symptoms. Eyelid margin, meibomian gland orifice and ocular surface were observed with a slit-lamp microscope. The first noninvasive tear breakup time(NIBUTf), morphological characteristics and loss of meibomian gland were checked with Oculus Keratograph. The correlation among OSDI score, NIBUTf and meibomian gland loss was analyzed with Pearson analysis. Results MGD group and control group had similar age(P=0.354)and male/female ratio(P=0.288). The MGD patients had ocular symptoms such as foreign body sensation, visual fatigue, dryness, blurred vision and photophobia, while the controls seldom had such symptoms and their discomfort was minor. MGD patients had statistically lower OSDI score than the controls(P<0.001). Most MGD patients showed abnormal morphology of eyelid margin and meibomian gland orifice, while the controls had more uniform color of tear film and longer NIBUTf(P<0.001). Common abnormalities like uneven length of meibomian gland, enlargement, tortuous, and loss of meibomian gland were more common in MGD group. MGD group had higher score of meibomian gland loss(P<0.001). OSDI score was negatively correlated with NIBUTf(r=-0.618, P<0.001), while positively correlated with score of meibomian gland loss(r=0.714, P<0.001). Conclusion Oculus Keratograph is able to observe tear film stability and meibomian gland noninvasively and objectively, and it can be used to evaluate the ocular surface in MGD patients.

Key words: Ocular surface disease, Meibomian gland dysfunction, Tear film

中图分类号:

R772.2

张京京,陈国玲,鲍印磊,马广风. Oculus Keratograph分析仪评估睑板腺功能障碍患者的眼表情况[J]. 山东大学学报 (医学版), 2020, 58(6): 87-91.

ZHANG Jingjing, CHEN Guoling, BAO Yinlei, MA Guangfeng. Oculus Keratograph in the evaluation of ocular surface in patients with meibomian gland dysfunction[J]. Journal of Shandong University (Health Sciences), 2020, 58(6): 87-91.

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