Itoh Clinic, Saitama, Japan.
Cornea. 2010 Sep;29(9):980-4. doi: 10.1097/ICO.0b013e3181cc7b1b.
To compare clinical findings between patients with seborrheic meibomian gland dysfunction (MGD) and normal controls and to propose diagnostic criteria for seborrheic MGD.
Thirty eyes of 30 patients [13 men and 17 women; age (mean +/- SD) 73.9 +/- 9.9 years] diagnosed with seborrheic MGD and 60 eyes of 60 healthy volunteers (22 men and 38 women; age: 71.0 +/- 9.3 years) as a control group were included in this study. Ocular symptoms were scored from 0 to 14 according to the number of symptoms present. Lid margin abnormality was scored from 0 to 4 depending on the number of abnormalities present. Meibomian gland changes were scored from 0 to 6 on the basis of noncontact meibography (meiboscore). Superficial punctate keratopathy was scored from 0 to 3. Tear film production was evaluated by Schirmer test. Receiver operating characteristic curves with calculations of the area under the curve were used to describe the accuracy of each parameter to differentiate patients with seborrheic MGD from normal eyes.
Ocular symptom score and lid margin abnormality score were significantly higher in the seborrheic MGD group than in the control group (P < 0.0001 for both scores). Area under the curve values indicated that the lid margin abnormality score had the highest diagnostic power as a single parameter followed by the ocular symptom score. When the diagnosis for seborrheic MGD was made on the basis of the 2 scores (ocular symptom score and lid margin abnormality score) being abnormal, the sensitivity was 100% and the specificity was 98.3%.
On the basis of these findings, we recommend that physicians use ocular symptom score and lid margin abnormality score in the diagnosis of seborrheic MGD. Seborrheic MGD should be considered very likely when both of the 2 scores are abnormal.
比较脂溢性睑板腺功能障碍（MGD）患者与正常对照者的临床特征，并提出脂溢性 MGD 的诊断标准。
本研究纳入了 30 例（30 只眼）脂溢性 MGD 患者（13 名男性，17 名女性；年龄（均值±标准差）73.9±9.9 岁）和 60 例（60 只眼）健康志愿者（22 名男性，38 名女性；年龄：71.0±9.3 岁）作为对照组。根据存在的症状数量，将眼部症状评分从 0 到 14 分。根据存在的异常数量，将睑缘异常评分从 0 到 4 分。根据非接触式睑板腺照相术（meiboscore）将睑板腺变化评分从 0 到 6 分。浅层点状角膜病变评分从 0 到 3 分。泪膜生成通过 Schirmer 试验进行评估。使用受试者工作特征曲线计算曲线下面积，以描述每个参数区分脂溢性 MGD 患者与正常眼的准确性。
脂溢性 MGD 组的眼部症状评分和睑缘异常评分均显著高于对照组（两项评分均 P<0.0001）。曲线下面积值表明，作为单一参数，睑缘异常评分的诊断效能最高，其次是眼部症状评分。当根据 2 项评分（眼部症状评分和睑缘异常评分）异常诊断脂溢性 MGD 时，敏感性为 100%，特异性为 98.3%。
基于这些发现，我们建议医生在脂溢性 MGD 的诊断中使用眼部症状评分和睑缘异常评分。当这 2 项评分均异常时，应高度怀疑脂溢性 MGD。
