Liang Q F, Du X H, Su Y D, Wang N L, Wei Z J, Labbé Antoine
Beijing Institute of Ophthalmology, Beijing TongRen Hospital, Capital Medical University, Beijing Ophthalmology&Visual Sciences Key Lab., Beijing 100005, China.
Zhonghua Yan Ke Za Zhi. 2017 Jul 11;53(7):495-501. doi: 10.3760/cma.j.issn.0412-4081.2017.07.005.
To investigate the distribution of tear film lipid layer thickness (LLT) and the relationship between symptoms and signs of dry eye and tear film LLT in the population of Taishitun Community in Beijing. A cross-sectional study. From May 2016 to August 2016, three streets of Taishitun Community were randomly selected as survey districts and 540 persons were taken as investigation subjects. Every participant completed 6 items of dry eye examinations as follows: questionnaire (Ocular Surface Disease Index, OSDI), measurement of tear film LLT, tear film break-up time (TBUT), corneal and conjunctival staining, SchirmerⅠtest and the infrared meibomian photography. According to their age, all participants were divided into four groups: junior group (<18 years old), youth group (18 to 40 years old), middle-aged group (41 to 59 years old) and the elderly group (over 60 years old). With the OSDI criteria, no dry eye symptom group (score, <12 points), mild to moderate dry eye symptom group (score, 12 to 32) and severe dry eye symptom group (score, 33-100) were included. With the statistical methods of variance analysis and multivariate Logistic regression analysis, distribution of the variables of LLT and the relationship between dry eye symptoms and LLT were studied. A total of 473 residents finally participated in this study, and the response ratio was 87.6%. The values of LLT were normally distributed. The average LLT was (59.87±18.50) nm [(60.16±19.15) nm in males and (59.67±18.57) nm in females], and the comparison of LLT with different genders was not statistically significant (0.198, 0.843). The tear film LLT of four different age groups had statistical significance (15.092, 0.05), and increased with age [(56.10±18.33) nm in the junior group, (54.60±16.29) nm in the youth group, (60.61±19.18) nm in the middle-aged group and (73.25±14.58) nm in the elderly group]. The LLT was inversely proportional to the severity of dry eye symptoms. With a thinner LLT, the symptoms of the subjects turned severe. In the elderly with different degrees of symptoms, the LLT was significantly different (0.019, 0.05), while in the youth and middle-aged groups with different degrees of symptoms, the LLT was not significantly different (0.096, >0.05. 0.538, >0.05). In the OSDI symptom questionnaire, only blurred vision and decreased visual acuity were related to the tear film LLT (0.05). There was no significant correlation between the TBUT, SchirmerⅠtest result, meibomian gland loss rate and the tear film LLT (0.05). In Taishitun Community of Beijing, the values of tear film LLT had a normal distribution. The LLT was positively correlated with age, but inversely correlated with the severity of the symptoms of dry eye. There was no significant correlation between the LLT and the TBUT, SchirmerⅠtest result and meibomian gland loss rate..
为调查北京太石屯社区人群泪膜脂质层厚度(LLT)的分布情况以及干眼症状体征与泪膜LLT之间的关系。采用横断面研究。2016年5月至2016年8月,随机选取太石屯社区3条街道作为调查区域,选取540人作为调查对象。每位参与者完成以下6项干眼检查项目:问卷调查(眼表疾病指数,OSDI)、泪膜LLT测量、泪膜破裂时间(TBUT)、角膜和结膜染色、SchirmerⅠ试验以及睑板腺红外摄影。根据年龄将所有参与者分为4组:青少年组(<18岁)、青年组(18至40岁)、中年组(41至59岁)和老年组(>60岁)。依据OSDI标准,纳入无干眼症状组(评分<12分)、轻至中度干眼症状组(评分12至32分)和重度干眼症状组(评分33 - 100分)。采用方差分析和多因素Logistic回归分析的统计方法,研究LLT变量的分布以及干眼症状与LLT之间的关系。最终共有473名居民参与本研究,应答率为87.6%。LLT值呈正态分布。平均LLT为(59.87±18.50)nm[男性为(60.16±19.15)nm,女性为(59.67±18.57)nm],不同性别间LLT比较差异无统计学意义(0.198,0.843)。4个不同年龄组的泪膜LLT有统计学意义(15.092,0.05),且随年龄增加而升高[青少年组为(56.10±18.33)nm,青年组为(54.60±16.29)nm,中年组为(60.61±19.18)nm,老年组为(73.25±14.58)nm]。LLT与干眼症状严重程度呈负相关。LLT越薄,受试者症状越严重。不同症状程度的老年人中,LLT差异有统计学意义(0.019,0.05),而不同症状程度的青年组和中年组中,LLT差异无统计学意义(0.096,>0.05;0.538,>0.05)。在OSDI症状问卷中,仅视力模糊和视力下降与泪膜LLT有关(0.05)。TBUT、SchirmerⅠ试验结果、睑板腺缺失率与泪膜LLT之间无显著相关性(0.05)。在北京太石屯社区,泪膜LLT值呈正态分布。LLT与年龄呈正相关,但与干眼症状严重程度呈负相关。LLT与TBUT、SchirmerⅠ试验结果及睑板腺缺失率之间无显著相关性。