Meibomian Gland Dropout in Patients with Dry Eye Disease in China
Meibomian Gland Dropout in Patients with Dry Eye Disease in China
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中国干眼病患者睑板腺脱落
DOI：
10.3109/02713683.2014.891748
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发表时间：
2014-10-01
影响因子：
2
通讯作者：
Hong, Jing
中科院分区：
文献类型：
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作者：
Feng, Yun;Gao, Ziqing;Hong, Jing
摘要目的：应用非接触式红外微影仪检测干眼症患者眼部睑板腺的形态学变化，探讨其与睑板脱落、体征及泪膜功能的关系。方法：随机选取干眼症患者264例（528只眼），其中男性95例，女性169例，年龄7 ~ 85岁，男性平均39.83±19.17岁，女性平均46.16±17.38岁。测定了泪膜破裂时间（BUT），并通过Schirmer试验（SIT）评价了泪膜的生成。主观症状也被评分。上下眼睑翻转，采用非接触式睑板记录仪观察睑板腺。每个眼睑的睑板腺部分或完全丧失（睑板脱落）评分从0级（无丧失）到3级（丧失面积为睑板腺总面积的2/3）。结果：SIT结果平均为6.71±6.13 mm（范围0 ~ 30 mm）， BUT结果平均为3.13±2.39 s（范围0 ~ 10 s）。平均荧光素染色评分为4.25±4.05（范围0-12）。平均睑板腺照相评分为4.35±1.39。睑板腺摄影评分与各种眼表检查的相关性采用肯德尔相关法进行评估。SIT和BUT与睑板腺照相评分呈显著负相关，而角膜荧光素染色呈显著正相关。结论：研究结果提示在干眼病患者中睑板脱落病例占很大比例，提示针对睑板腺的治疗将成为治疗干眼病的重要方向。推荐将Meibography作为干眼症的常规检查。
Abstract Purpose: To examine the morphological changes in the meibomian glands of eyes of patients with dry eye disease using the non-contact infrared meibography system and to assess their relationship with meibomian dropout, signs, and tear-film function. Methods: Subjects included 264 randomly selected patients (528 eyes) suffering from dry eye disease (95 males, 169 females; age range, 7–85 years; mean male age, 39.83 ± 19.17 years; mean female age, 46.16 ± 17.38 years). Tear-film break-up time (BUT) was measured and tear-film production was evaluated by the Schirmer test I (SIT). Subjective symptoms were also scored. The upper and lower eyelids were turned over, and the meibomian glands were observed using the non-contact meibography system. Partial or complete loss of the meibomian glands (meibomian dropout) was scored for each eyelid from grade 0 (no loss) through grade 3 (lost area was >2/3 of the total meibomian gland area). Results: The average SIT result was 6.71 ± 6.13 mm (range 0–30 mm) and that for BUT was 3.13 ± 2.39 s (range 0–10 s). The average fluorescein staining score was 4.25 ± 4.05 (range 0–12). In addition, the mean meibomian gland photographic score was 4.35 ± 1.39. The correlation between the meibomian gland photographic scores and various ocular surface examinations were evaluated using Kendall’s correlation. SIT and BUT were significantly negatively correlated with the meibomian gland photographic score, whereas corneal fluorescein staining was positively correlated. Conclusions: The results suggest a large proportion of meibomian dropout cases among patients with dry eye disease, indicating that treatment targeted at the meibomian gland will become an important direction for treating dry eye disease. Meibography is recommended as a routine test for dry eye disease.