Influence of Meibomian Gland Dysfunction and Friction-Related Disease on the Severity of Dry Eye
Influence of Meibomian Gland Dysfunction and Friction-Related Disease on the Severity of Dry Eye
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DOI：
10.1016/j.ophtha.2018.01.025
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发表时间：
2018-08-01
期刊：
影响因子：
13.7
通讯作者：
Tsubota, Kazuo
中科院分区：
文献类型：
--
作者：
Chi Hoang Viet Vu;Kawashima, Motoko;Tsubota, Kazuo
目的：探讨睑板腺功能障碍（MGD）和摩擦相关疾病（FRD）对干眼病（DED）严重程度的影响。设计：横断面观察性研究。参与者：本研究纳入449例DED患者（男性63例，女性386例，平均年龄62.6±15.7岁[范围21-90岁]）进行分析。方法：观察患者的主观症状、眼表、泪液功能、MGD和FRD（上缘角膜结膜炎、结膜松弛症和眼睑湿性上皮病）的存在情况。主要观察指标：Schirmer值、泪膜破裂时间（TBUT）、角膜结膜评分。结果：我们将参与者分为缺水性干眼（ADDE; n = 231[51.4%]）和短TBUT干眼亚型（TBUT- de; n = 109[24.3%]）亚组。MGD患者TBUT短于无MGD患者，而其他眼部体征无差异（TBUT: MGD存在，1.97 +/- 1.02秒；MGD缺失，2.94 +/- 1.63秒[P < 0.001]； ADDE/MGD存在，1.94 +/- 1.08秒；ADDE/MGD缺失，2.77 +/- 1.61秒[P < 0.001]； TBUT- de /MGD存在，2.07 +/- 0.97秒；TBUT- de /MGD缺失，2.94 +/- 1.23秒[P = 0.01]）。伴有FRD的ADDE患者TBUT比无FRD的ADDE患者更差（TBUT: ADDE/FRD存在，2.08 +/- 1.39秒；ADDE/FRD不存在，2.92 +/- 1.54秒，P < 0.001）。结论：本研究显示了MGD、FRD或两者与DED的眼部体征相关。在存在MGD、FRD或两者同时存在的情况下，无论干眼状态或亚型如何，TBUT均显著缩短。(C) 2018年由美国眼科学会发布
Purpose: To evaluate the effect of meibomian gland dysfunction (MGD) and friction-related disease (FRD) on the severity of dry eye disease (DED).Design: Cross-sectional observational study.Participants: This study enrolled 449 patients with DED (63 men and 386 women; mean age, 62.6 +/- 15.7 years [range, 21-90 years]) for analysis.Methods: Subjective symptoms, the ocular surface, tear function, and the presence of MGD and FRD (superior limbic keratoconjunctivitis, conjunctivochalasis, and lid wiper epitheliopathy) were investigated.Main Outcome Measures: Schirmer value, tear film breakup time (TBUT), and keratoconjunctival score.Results: We classified the participants into aqueous-deficient dry eye (ADDE; n = 231 [51.4%]) and short TBUT dry eye subtype (TBUT-DE; n = 109 [24.3%]) subgroups. The TBUT was shorter in patients with MGD than in those without MGD, whereas other ocular signs showed no difference (TBUT: MGD present, 1.97 +/- 1.02 seconds; MGD absent, 2.94 +/- 1.63 seconds [P < 0.001]; ADDE/MGD present, 1.94 +/- 1.08 seconds; ADDE/MGD absent, 2.77 +/- 1.61 seconds [P < 0.001]; short TBUT-DE/MGD present, 2.07 +/- 0.97 seconds; short TBUT-DE/MGD absent, 2.94 +/- 1.23 seconds [P = 0.01]). The ADDE patients with FRD showed a worse TBUT than ADDE patients without FRD (TBUT: ADDE/FRD present, 2.08 +/- 1.39 seconds; ADDE/FRD absent, 2.92 +/- 1.54 seconds; P < 0.001).Conclusions: This study showed associations between MGD, FRD, or both and ocular signs in DED. In the presence of MGD, FRD, or both, TBUT was significantly shortened regardless of the dry eye status or subtype. (C) 2018 by the American Academy of Ophthalmology