应用Keratograph眼表综合分析仪分析老年人干眼症状与体征的相关性
摘要
目的应用新型眼表综合分析仪对老年人进行干眼相关检查,结合眼表疾病指数(OSDI)问卷评分,探讨体征与老年人干眼症状的相关性。方法选取在干眼门诊就诊的老年患者,利用Keratograph 5M进行非侵入性干眼相关检查(包括非侵入性泪膜破裂时间、泪河高度、脂质层评级、睑板腺评分、眼红分析),并进行OSDI问卷评分,将干眼检查结果与OSDI评分进行相关性分析。结果患者OSDI问卷评分(24.24±12.08)分,平均泪河高度(0.17±0.05)mm,首次非侵入性泪膜破裂时间(6.14±3.39)s,平均非侵入性泪膜破裂时间为(8.04±3.63)s,脂质层评级(1.56±0.64)级,睑板腺评分(2.19±1.47)分,眼红分析评分(1.38±0.57)分。OSDI问卷评分与泪河高度、眼红分析无相关性(P=0.679;P=0.143),与非侵入性泪膜破裂时间、脂质层评级呈显著负相关(均P<0.01),与睑板腺评分呈显著正相关(P<0.01)。无干眼及轻、中、重度干眼组间非侵入性泪膜破裂时间、脂质层评级、睑板腺评分的差异有统计学意义(均P<0.01);4个组间泪河高度、眼红分析差异无统计学意义(P=0.499;P=0.384)。重测信度(ICC值)在0.855～0.890。结论 Keratograph 5M可以客观、准确、高效地获得老年人眼表状况相关参数,在老年人干眼检测中具有一定的优势和临床应用价值。老年人干眼症状与体征存在一定的相关性。
引文
1 中华医学会眼科学分会角膜病学组.干眼临床诊疗专家共识(2013年)[J].中华眼科杂志,2013;49(1):73-5.
2 张梅,陈家祺,刘祖国,等.干眼患者115例的临床特点分析[J].中华眼科杂志,2003;39(1):5-9.
3 Ozcura F,Aydin S,Helvaci MR.Ocular surface disease index for the diagnosis of dry eye syndrome[J].Ocul Immunol Inflamm,2007;15:389-93.
4 Wolffsohn JS,Arita R,Chalmers R,et al.TFOS DEWS Ⅱ Diagnostic methodology report[J].Ocul Surf,2017;15:539-74.
5 Arita R,Itoh K,Inoue K,et al.Noncontact infrared meibography to document age--related changes of the meibomian glands in anormalpopulation[J].Ophthalmology,2008;115(5):911-5.
6 No authors listed.The definition and classification of dry eye disease:report of the definition and classification subcommittee of the international dry eye WorkShop(2007)[J].Ocul Surf,2007;5(2):75-92.
7 阎慧,赵少贞.干眼症临床检查的新进展[J].眼科新进展,2008;28(9):711-4.
8 Nichols KK,Nichols JJ,Mitchell GL.The lack of association between signs and symptoms in patients with dry eye diseasel[J].Cornea,2004;23(8):762-70.
9 Schein OD,Tielsch JM,Munoz B,et al.Relation between signs and symptoms of dry eye in the elderly.A population-based perspective[J].Ophthalmology,1997;104(9):1395-401.
10 田磊,宋文秀,王智群,等.Keratograph 5M眼表综合分析仪在干眼诊断中的应用研究[J].首都医科大学学报,2017;38(1):11-6.
11 沈沛阳,陈海波,刘红山,等.Keratograph 眼表综合分析仪与传统方法对泪膜功能评价的一致性分析[J].国际眼科杂志,2015;15(5):846-9.
12 Vitale S,Goodman LA,Reed GF,et al.Comparison of the NEI-VFQ and OSDI questionnaires in patients with Sjogren′s syndrome-related dry eye[J].Health Qnal Life Outcomes,2004;2:44.
13 Blackie CA,Solomon JD,Scaffidi RC,et al.The relationship between dry eye symptoms and lipid layer thickness[J].Cornea,2009;28(7):789-94.
14 Eom Y,Lee JS,Kang SY,et al.Correlation between quantitative measurements of tear film lipid layer thickness and Meibomian gland loss in patients with obstructive meibomian gland dysfunction and normal controls[J].Am J Ophthalmol,2013;155(6):1104-10.
15 Finis D,Pischel N,Scherader S,et al.Evaluation of lipid layer thickness measurement of the tear film as a diagnostic tool for meibomian gland dysfunction[J].Cornea,2013;32(12):1549-53.
16 吴元,吴海龙,李海丽,等.OCT前节模块测量的上下泪河数值与干眼的相关性[J].中华实验眼科杂志,2014;32(6):541-5.
17 Koh S,Ikeda C,Watanabe S,et al.Effect of non-invasive tear stability assessment on tear meniscus height[J].Acta Ophthalmol,2015;93(2):e135-e139.
18 Heiligenhaus A,Koch JM,Kemper D,et al.Therapy of dry eye disorders[J].Klinische Monatsblatter fur Augenheilkunde,1994;204(3):162-8.
19 Horwalh-Winter J,Berghold A,Schmut O,et al.Evaluation of the clinical course of dry eye syndrome[J].Arch Ophthalmol,2003;121(10):1364-8.
20 谢立信.临床角膜病学[M].北京:人民卫生出版社,2014:126.
21 No authors listed.The epidemiology of dry eye disease:report of the Epidemiology Subcommittee of the International Dry Eye Work Shop[J].Ocul Surf,2007;5(2):93-107.
2 张梅,陈家祺,刘祖国,等.干眼患者115例的临床特点分析[J].中华眼科杂志,2003;39(1):5-9.
3 Ozcura F,Aydin S,Helvaci MR.Ocular surface disease index for the diagnosis of dry eye syndrome[J].Ocul Immunol Inflamm,2007;15:389-93.
4 Wolffsohn JS,Arita R,Chalmers R,et al.TFOS DEWS Ⅱ Diagnostic methodology report[J].Ocul Surf,2017;15:539-74.
5 Arita R,Itoh K,Inoue K,et al.Noncontact infrared meibography to document age--related changes of the meibomian glands in anormalpopulation[J].Ophthalmology,2008;115(5):911-5.
6 No authors listed.The definition and classification of dry eye disease:report of the definition and classification subcommittee of the international dry eye WorkShop(2007)[J].Ocul Surf,2007;5(2):75-92.
7 阎慧,赵少贞.干眼症临床检查的新进展[J].眼科新进展,2008;28(9):711-4.
8 Nichols KK,Nichols JJ,Mitchell GL.The lack of association between signs and symptoms in patients with dry eye diseasel[J].Cornea,2004;23(8):762-70.
9 Schein OD,Tielsch JM,Munoz B,et al.Relation between signs and symptoms of dry eye in the elderly.A population-based perspective[J].Ophthalmology,1997;104(9):1395-401.
10 田磊,宋文秀,王智群,等.Keratograph 5M眼表综合分析仪在干眼诊断中的应用研究[J].首都医科大学学报,2017;38(1):11-6.
11 沈沛阳,陈海波,刘红山,等.Keratograph 眼表综合分析仪与传统方法对泪膜功能评价的一致性分析[J].国际眼科杂志,2015;15(5):846-9.
12 Vitale S,Goodman LA,Reed GF,et al.Comparison of the NEI-VFQ and OSDI questionnaires in patients with Sjogren′s syndrome-related dry eye[J].Health Qnal Life Outcomes,2004;2:44.
13 Blackie CA,Solomon JD,Scaffidi RC,et al.The relationship between dry eye symptoms and lipid layer thickness[J].Cornea,2009;28(7):789-94.
14 Eom Y,Lee JS,Kang SY,et al.Correlation between quantitative measurements of tear film lipid layer thickness and Meibomian gland loss in patients with obstructive meibomian gland dysfunction and normal controls[J].Am J Ophthalmol,2013;155(6):1104-10.
15 Finis D,Pischel N,Scherader S,et al.Evaluation of lipid layer thickness measurement of the tear film as a diagnostic tool for meibomian gland dysfunction[J].Cornea,2013;32(12):1549-53.
16 吴元,吴海龙,李海丽,等.OCT前节模块测量的上下泪河数值与干眼的相关性[J].中华实验眼科杂志,2014;32(6):541-5.
17 Koh S,Ikeda C,Watanabe S,et al.Effect of non-invasive tear stability assessment on tear meniscus height[J].Acta Ophthalmol,2015;93(2):e135-e139.
18 Heiligenhaus A,Koch JM,Kemper D,et al.Therapy of dry eye disorders[J].Klinische Monatsblatter fur Augenheilkunde,1994;204(3):162-8.
19 Horwalh-Winter J,Berghold A,Schmut O,et al.Evaluation of the clinical course of dry eye syndrome[J].Arch Ophthalmol,2003;121(10):1364-8.
20 谢立信.临床角膜病学[M].北京:人民卫生出版社,2014:126.
21 No authors listed.The epidemiology of dry eye disease:report of the Epidemiology Subcommittee of the International Dry Eye Work Shop[J].Ocul Surf,2007;5(2):93-107.