National Centre for Optics, Vision and Eye Care, Department of Optometry, Radiography and Lighting Design, Faculty of Health and Social Sciences, University of South-Eastern Norway, Notodden, Norway.
Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway.
Sci Rep. 2021 Dec 3;11(1):23412. doi: 10.1038/s41598-021-02738-6.
To investigate the prevalence of meibomian gland dysfunction (MGD) in patients presenting with subjective dry eye-related symptoms at their first-time consultation in a Norwegian specialized ocular surface clinic. Additionally, to explore the accuracy of the ocular surface disease index score (OSDI) as an extensively applied tool to assess the severity of dry eye symptoms and MGD diagnosis. Patients with subjective dry eye-related complaints (n = 900) attending the clinic for the first time, from 2012 to 2016, were included in the study. At the baseline, patients completed the OSDI questionnaire. Subsequently, objective clinical tests, including fluorescein break-up time (FBUT), Schirmer-I test, ocular surface staining (OSS), and meibomian gland function assessment using gland expressibility and meibum quality were performed. The association between MGD and its severity in relation to symptom severity defined by OSDI-score was examined. MGD was found in 93.8% of the study group. MGD prevalence was not significantly different between groups based on age (p = 0.302) or sex (p = 0.079). There was a significant association between severity of MGD and dry eye-related symptoms (p = 0.014). OSS was significantly higher in patients with severe symptoms (p = 0.031). Sensitivity and specificity of positive symptom-score (OSDI ≥ 13) for disclosing MGD were 85.5% and 30.4%, respectively. MGD was highly prevalent, not associated with age and sex. OSDI ≥ 13 had high sensitivity and high positive predictive value (PPV), but low specificity and negative predictive value (NPV) for disclosing MGD. This underscores the importance of meibomian gland assessment in patients with dry eye-related symptoms.
调查在挪威一家专门的眼表诊所首次就诊时出现主观干眼相关症状的患者中，睑板腺功能障碍（MGD）的患病率。此外，探讨眼表疾病指数评分（OSDI）作为一种广泛应用的评估干眼症状严重程度和 MGD 诊断的工具的准确性。
纳入 2012 年至 2016 年期间首次就诊于该诊所的 900 例主观干眼相关抱怨的患者。在基线时，患者完成了 OSDI 问卷。随后，进行了客观临床检查，包括泪膜破裂时间（FBUT）、泪液分泌试验（Schirmer-I 试验）、眼表面染色（OSS）和睑板腺功能评估，包括腺泡表达力和睑脂质量。研究了 MGD 及其严重程度与 OSDI 评分定义的症状严重程度之间的关系。
研究组中 93.8%的患者存在 MGD。MGD 的患病率在年龄（p=0.302）或性别（p=0.079）方面无显著差异。MGD 严重程度与干眼相关症状之间存在显著相关性（p=0.014）。在症状严重的患者中，OSS 显著升高（p=0.031）。阳性症状评分（OSDI≥13）显示 MGD 的敏感性和特异性分别为 85.5%和 30.4%。
MGD 患病率较高，与年龄和性别无关。OSDI≥13 对揭示 MGD 具有较高的敏感性和阳性预测值（PPV），但特异性和阴性预测值（NPV）较低。这突显了对干眼相关症状患者进行睑板腺评估的重要性。
