Rashid Mamunur Akm, Teo Calesta Hui Yi, Mamun Sumaiya, Ong Hon Shing, Tong Louis
Al Noor Eye Hospital, 1/9 E, Satmasjid Road, Lalmatia, Dhaka 1207, Bangladesh.
Singapore Eye Research Institute, The Academia, 20 College Road, Disovery Tower Level 6, Singapore 169856, Singapore.
Diagnostics (Basel). 2020 Aug 26;10(9):634. doi: 10.3390/diagnostics10090634.
This study sought to evaluate the prevalence of dry eye and meibomian gland dysfunction (MGD) and the associated factors of severe dry eye symptoms (SDES) among garments worker of Gazipur, Bangladesh. We prospectively collected cross-sectional data for 1050 garments workers of a factory (70% response). All participants had an evaluation of the Ocular Surface Disease Index (OSDI), and a detailed ophthalmic examination including tear breakup time (TBUT), ocular surface fluorescein staining, and Schirmer's I test. MGD grading was based on the viscosity/color and ease of manual expression of meibum. Mean age of participants was 35.5 ± 12.1 years; 53.8% were women. The prevalence of dry eye (OSDI > 12) was 64.2% (95% CI 61.2-67.1%). OSDI was not significantly different between sex or age-groups but associated with increasing MGD grade ( < 0.001), reduced TBUT (<5 s) [ < 0.001], and reduced Schirmer's test (<5 mm) [ < 0.001]. Thirty-five percent had SDES (OSDI > 32). Using univariate logistic regressions, SDES was associated with older age (Odds Ratio (OR) 1.01, 95% Confidence Interval [1.005-1.03] per year increase) and male sex (OR 1.76, 95% CI: 1.36-2.27). When adjusted for age and sex, SDES were strongly associated with increase in MGD severity grading (OR 188, 95% CI: 91-390). However, in multivariate regression, TBUT, but not MGD severity, became the only significant determinant of SDES (OR 13.0, 95% CI: 6.3-27.0, for every 1 s decrease in TBUT). MGD is common in garments workers, contributing to dry eye symptoms in addition to other tear parameters. Reduced tear stability is associated with SDES.
本研究旨在评估孟加拉国加济布尔服装厂工人中干眼和睑板腺功能障碍（MGD）的患病率以及严重干眼症状（SDES）的相关因素。我们前瞻性地收集了一家工厂1050名服装厂工人的横断面数据（应答率为70%）。所有参与者均接受了眼表疾病指数（OSDI）评估以及包括泪膜破裂时间（TBUT）、眼表荧光素染色和Schirmer I试验在内的详细眼科检查。MGD分级基于睑脂的粘度/颜色和手动挤压的难易程度。参与者的平均年龄为35.5±12.1岁；53.8%为女性。干眼（OSDI>12）的患病率为64.2%（95%CI 61.2 - 67.1%）。OSDI在性别或年龄组之间无显著差异，但与MGD分级增加（<0.001）、TBUT降低（<5秒）[<0.001]和Schirmer试验降低（<5毫米）[<0.001]相关。35%的人有SDES（OSDI>32）。使用单因素逻辑回归分析，SDES与年龄较大（优势比（OR）1.01，每年增加95%置信区间[1.005 - 1.03]）和男性性别（OR 1.76，95%CI：1.36 - 2.27）相关。在对年龄和性别进行调整后，SDES与MGD严重程度分级增加密切相关（OR 188，95%CI：91 - 390）。然而，在多变量回归中，TBUT而非MGD严重程度成为SDES的唯一显著决定因素（TBUT每降低1秒，OR 13.0，95%CI：6.3 - 27.0）。MGD在服装厂工人中很常见，除了其他泪液参数外，还会导致干眼症状。泪液稳定性降低与SDES相关。
