Liang Hong, Randon Matthieu, Michee Sylvain, Tahiri Rachid, Labbe Antoine, Baudouin Christophe
Department of Ophthalmology III, Quinze-Vingts National Ophthalmology Hospital, Paris, France.
DHU View Maintain, INSERM-DHOS, Center of Clinical Investigations (CIC) 1423, Quinze-Vingts National Ophthalmology Hospital, Paris, France.
Br J Ophthalmol. 2017 Mar;101(3):268-274. doi: 10.1136/bjophthalmol-2015-308110. Epub 2016 May 24.
The physiopathology of rosacea and the correlation between ocular and cutaneous rosacea remains unclear. This study analysed ocular and cutaneous rosacea with in vivo confocal microscopy (IVCM).
Thirty-four eyes of 34 patients with confirmed rosacea-associated meibomian gland dysfunction-related evaporative dry eye were enrolled in the study. The ophthalmological investigations included dry eye ocular surface disease index (OSDI), the Schirmer test, tear osmolarity, tear break up time, the Oxford score, infrared meibography for meibomian gland (MG) analysis and IVCM investigation for cornea, MG and skin analysis (cheek, hand). Presences of in the MG and in the cheek were also investigated. We established scores for quantifying the MG alterations in the MG (IVCM-MG) and cheek (IVCM-Cheek), and scores for quantification in the MG and cheek (IVCM-MG-Dex and IVCM-Cheek-Dex).
IVCM was relevant for analysing the cornea and MG structures and was also suitable for cutaneous analysis. Exposed skin explorations presented the epidermal and dermal layers clearly. In patients with rosacea, the IVCM-MG alteration scores were correlated with IVCM-Cheek (R=0.27 and p=0.0006) and IVCM-MG-Dex was correlated with IVCM-Cheek-Dex (R=0.70 and p<0.0001). However, no correlation was found between the IVCM-MG or IVCM-Cheek and the break up time, Schirmer, Oxford and osmolarity evaluations.
IVCM could be a safe, effective and reliable tool to quantify alterations of the cornea, MG and cheek glands in patients with rosacea combined with quantification of infections. As a valuable tool for investigating the pathophysiology of the disease, it could be used to assess the effectiveness of therapy.
酒渣鼻的生理病理学以及眼部和皮肤酒渣鼻之间的相关性仍不明确。本研究采用活体共聚焦显微镜（IVCM）分析眼部和皮肤酒渣鼻。
34例确诊为酒渣鼻相关睑板腺功能障碍性蒸发型干眼的患者的34只眼睛纳入本研究。眼科检查包括干眼眼表疾病指数（OSDI）、泪液分泌试验、泪液渗透压、泪膜破裂时间、牛津评分、用于睑板腺（MG）分析的红外睑板腺造影以及用于角膜、MG和皮肤分析（脸颊、手部）的IVCM检查。还研究了MG和脸颊中[具体物质未提及]的存在情况。我们建立了用于量化MG（IVCM-MG）和脸颊（IVCM-脸颊）中MG改变的评分，以及用于MG和脸颊中[具体物质未提及]量化的评分（IVCM-MG-Dex和IVCM-脸颊-Dex）。
IVCM对于分析角膜和MG结构是相关的，并且也适用于皮肤分析。对暴露皮肤的检查清晰地呈现了表皮和真皮层。在酒渣鼻患者中，IVCM-MG改变评分与IVCM-脸颊相关（R = 0.27，p = 0.0006），IVCM-MG-Dex与IVCM-脸颊-Dex相关（R = 0.70，p < 0.0001）。然而，未发现IVCM-MG或IVCM-脸颊与泪膜破裂时间、泪液分泌试验、牛津评分和渗透压评估之间存在相关性。
IVCM可能是一种安全、有效且可靠的工具，用于量化酒渣鼻患者角膜、MG和脸颊腺体的改变以及[具体物质未提及]感染的量化。作为研究该疾病病理生理学的有价值工具，它可用于评估治疗效果。
