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泪膜客观散射指数在干眼诊断中的价值研究

[A study on the diagnostic value of tear film objective scatter index in dry eye].

作者信息

Su Y D, Liang Q F, Wang N L, Antoine Labbè

机构信息

Beijing Institute of Ophthalmology, Beijing TongRen Hospital, Capital Medical University, Beijing Ophthalmology&Visual Sciences Key Lab., Beijing 100005, China.

出版信息

Zhonghua Yan Ke Za Zhi. 2017 Sep 11;53(9):668-674. doi: 10.3760/cma.j.issn.0412-4081.2017.09.007.

Abstract

To study the sensitivity and specificity of tear film objective scatter index to the diagnosis dry eye disease (DED). A prospective case-controlled study. Fifty-three patients with DED and 32 healthy age- and sex-matched control subjects were included from July to October 2016. All subjects underwent the examinations sequentially as follows: evaluation of ocular surface disease symptoms using the Ocular Surface Disease Index, optical quality detection, lipid layer thickness, tear film breakup time and SchirmerⅠtest. With Optical Quality Analysis SystemⅡ, the values of modulation transfer function cut off, basic objective scatter index (OSI) and total OSI were measured. To eliminate the influence of other refractive media, the tear film OSI (TF-OSI) was calculated, and the difference in TF-OSI between two groups was analyzed with the independent-samples test. Spearman's correlation analysis was used to detect the correlation of each parameter in the DED group. With the receiver operating characteristic curve and the area under the curve (AUC), the specificity and sensitivity of TF-OSI and other parameters were described to differentiate DED from normal eyes. In the dry eye group, the value of modulation transfer function cut off (32.07±11.95) was significantly lower than the normal group (39.38±9.44, 3.096, 0.003) , and the mean value and dispersion of TF-OSI (0.50±0.43, 0.52±0.81) were higher than the normal group (0.21±0.16, 0.12±0.01) (4.300, 0.000, 3.546, 0.001) . The mean value of TF-OSI had a positive correlation with lipid layer thickness (0.365, 0.007) and dispersion of TF-OSI (0.581, 0.000), and a negative correlation with MTF cut off (0.368, 0.007). To the diagnostic value of DED, the mean value of TF-OSI had a sensitivity of 0.736, a specificity of 0.762, and the AUC was 0.764. The dispersion of TF-OSI had a sensitivity of 0.811 and a specificity of 0.810, and the AUC was 0.900. In the DED group, the mean value and dispersion of TF-OSI were higher than the normal group. With its advantages, the TF-OSI may be a new method for the auxiliary diagnosis of dry eye. .

摘要

探讨泪膜客观散射指数对干眼疾病(DED)诊断的敏感性和特异性。一项前瞻性病例对照研究。2016年7月至10月纳入了53例DED患者和32例年龄及性别匹配的健康对照者。所有受试者依次进行如下检查:使用眼表疾病指数评估眼表疾病症状、光学质量检测、脂质层厚度、泪膜破裂时间和SchirmerⅠ试验。使用光学质量分析系统Ⅱ测量调制传递函数截止值、基础客观散射指数(OSI)和总OSI值。为消除其他屈光介质的影响,计算泪膜OSI(TF - OSI),并采用独立样本检验分析两组间TF - OSI的差异。采用Spearman相关分析检测DED组各参数间的相关性。通过绘制受试者工作特征曲线及计算曲线下面积(AUC),描述TF - OSI和其他参数区分DED与正常眼的特异性和敏感性。在干眼组中,调制传递函数截止值(32.07±11.95)显著低于正常组(39.38±9.44,3.096,0.003),TF - OSI的平均值(0.50±0.43)和离散度(0.52±0.81)高于正常组(0.21±0.16,0.12±0.01)(4.300,0.000,3.546,0.001)。TF - OSI的平均值与脂质层厚度呈正相关(0.365,0.007),与TF - OSI离散度呈正相关(0.581,0.000),与MTF截止值呈负相关(0.368,0.007)。对于DED的诊断价值,TF - OSI平均值的敏感性为0.

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