Wu Huping, Wang Yuqian, Dong Nuo, Yang Fan, Lin Zhirong, Shang Xumin, Li Cheng
Xiamen Eye Center of Xiamen University, Xiamen, Fujian, China.
PLoS One. 2014 Aug 21;9(8):e105575. doi: 10.1371/journal.pone.0105575. eCollection 2014.
To explore meibomian gland dysfunction (MGD) may determine the severity of dry eye conditions in visual display terminal (VDT) workers.
Prospective, case-control study carried out in China.106 eyes of 53 patients (VDT work time >4 hour per day) were recruited as the Long time VDT group; 80 eyes of 40 control subjects (VDT work time ≤ 4 hour per day) served as the Short time VDT group. A questionnaire of Ocular Surface Disease Index (OSDI) and multiple tests were performed. Three dry eye tests: tear film breakup time (BUT), corneal fluorescein staining, Schirmer I test; and three MGD parameters: lid margin abnormality score, meibum expression assessment (meibum score), and meibomian gland dropout degree (meiboscore) using Keratograph 5 M.
OSDI and corneal fluorescein score were significantly higher while BUT was dramatically shorter in the long time VDT group than the short time VDT group. However, the average of Schirmer tear volumes was in normal ranges in both groups. Interestingly, the three MGD parameters were significantly higher in the long time VDT group than the short time one (P<0.0001). When 52 eyes with Schirmer <10 mm and 54 eyes with Schirmer ≥ 10 mm were separated from the long time VDT workers, no significant differences were found between the two subgroups in OSDI, fluorescein staining and BUT, as well as the three MGD parameters. All three MGD parameters were positively correlated with VDT working time (P<0.0001) and fluorescein scores (P<0.0001), inversely correlated with BUT (P<0.05), but not correlated with Schirmer tear volumes in the VDT workers.
Our findings suggest that a malfunction of meibomian glands is associated with dry eye patients in long term VDT workers with higher OSDI scores whereas some of those patients presenting a normal tear volume.
探讨睑板腺功能障碍(MGD)是否会决定视觉显示终端(VDT)工作者干眼状况的严重程度。
在中国进行的前瞻性病例对照研究。招募53例患者(每天VDT工作时间>4小时)的106只眼作为长时间VDT组;40例对照者(每天VDT工作时间≤4小时)的80只眼作为短时间VDT组。进行了眼表疾病指数(OSDI)问卷调查和多项检查。三项干眼检查:泪膜破裂时间(BUT)、角膜荧光素染色、Schirmer I试验;以及三项MGD参数:睑缘异常评分、睑脂排出评估(睑脂评分)和使用角膜地形图仪5M的睑板腺缺失程度(睑板腺评分)。
长时间VDT组的OSDI和角膜荧光素评分显著高于短时间VDT组,而BUT显著短于短时间VDT组。然而,两组的Schirmer泪液量平均值均在正常范围内。有趣的是,长时间VDT组的三项MGD参数显著高于短时间VDT组(P<0.0001)。当从长时间VDT工作者中分离出52只Schirmer<10mm的眼和54只Schirmer≥10mm的眼时,两个亚组在OSDI、荧光素染色和BUT以及三项MGD参数方面均未发现显著差异。三项MGD参数均与VDT工作时间(P<0.0001)和荧光素评分(P<0.0001)呈正相关,与BUT呈负相关(P<0.05),但与VDT工作者的Schirmer泪液量无关。
我们的研究结果表明,睑板腺功能障碍与长期VDT工作者中OSDI评分较高的干眼患者有关,而这些患者中的一些人泪液量正常。