Department of Ophthalmology, Seoul National University Bundang Hospital, Seongnam, South Korea.
Department of Ophthalmology, Seoul National University College of Medicine, Seoul, South Korea.
Graefes Arch Clin Exp Ophthalmol. 2021 May;259(5):1235-1241. doi: 10.1007/s00417-020-05044-5. Epub 2021 Jan 6.
To investigate the characteristics of eyes with dry eye disease (DED) whose lipid layer thickness (LLT) measured 100 nm on a LipiView II interferometer and compare the DED parameters of them to those with LLT below 100 nm.
A total of 201 eyes of 102 enrolled DED patients (mean age 56.4 ± 11.8 years) were classified into 3 groups according to their average LLT; < 60 nm as thin-LLT (n = 49), 60-99 nm as normal-LLT (n = 77), and 100 nm as thick-LLT (n = 75). LLT, meiboscore, Schirmer I test, tear film break-up time (TBUT), ocular surface staining (OSS), and ocular surface disease index (OSDI) were assessed.
The OSS and TBUT were significantly worse in the thick-LLT group than in the normal-LLT group (p = 0.020, and p = 0.028, respectively). The OSDI was significantly higher in the thick-LLT group than in the thin-LLT group (p = 0.006). However, the meiboscore was not different among the three groups (p = 0.33). Age, OSS, and OSDI showed a positive correlation with LLT (r = 0.16, p = 0.023; r = 0.213, p = 0.003; and r = 0.338, p = 0.001, respectively). In sensitivity analyses, eyes with corneal erosions had a significantly higher average LLT (p = 0.015), higher OSDI (p = 0.009), shorter TBUT (p < 0.001), and shorter Schirmer I value (p = 0.024) than those with clear corneas.
The average LLT of eyes with corneal erosions was thicker than those without erosions, suggesting that the LLT of 100 nm in the eyes with corneal erosions should not be regarded as a stable physiologic condition. Cautious interpretation of LLT along with other dry eye parameters is required.
研究脂质层厚度（LLT）在 LipiView II 干涉仪上测量为 100nm 的干眼（DED）患者的眼部特征，并将其与 LLT 低于 100nm 的 DED 患者的 DED 参数进行比较。
共纳入 201 只眼的 102 名 DED 患者（平均年龄 56.4±11.8 岁），根据其平均 LLT 将其分为 3 组；＜60nm 为薄 LLT（n=49），60-99nm 为正常 LLT（n=77），100nm 为厚 LLT（n=75）。评估 LLT、睑板腺评分、泪液分泌试验（Schirmer I 试验）、泪膜破裂时间（TBUT）、眼表面染色（OSS）和眼表疾病指数（OSDI）。
厚 LLT 组的 OSS 和 TBUT 明显差于正常 LLT 组（p=0.020 和 p=0.028）。厚 LLT 组的 OSDI 明显高于薄 LLT 组（p=0.006）。然而，三组间的睑板腺评分无差异（p=0.33）。年龄、OSS 和 OSDI 与 LLT 呈正相关（r=0.16，p=0.023；r=0.213，p=0.003；r=0.338，p=0.001）。在敏感性分析中，角膜糜烂的眼的平均 LLT 明显较高（p=0.015），OSDI 更高（p=0.009），TBUT 更短（p＜0.001），Schirmer I 值更短（p=0.024）。
角膜糜烂眼的平均 LLT 高于无糜烂眼，提示角膜糜烂眼的 100nm LLT 不应视为稳定的生理状态。需要谨慎解释 LLT 以及其他干眼参数。
