Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing, 100005, China.
Quinze-Vingts National Ophthalmology Hospital, IHU FOReSIGHT Paris and Versailles Saint-Quentin-en-Yvelines University, Versailles, France.
BMC Ophthalmol. 2022 Feb 10;22(1):64. doi: 10.1186/s12886-022-02280-7.
In clinical practice, fluctuating vision or decreased quality of vision is a common complaint in DED patients. Our study was designed to investigate the change in dynamic optical quality in dry eye patients after the use of artificial tears.
Fifty-nine patients with dry eye disease (DED) and 31 control subjects were included in this prospective case-control study. There was no significant difference in age and sex between these two groups (P = 0.342, P = 0.847, respectively). Clinical evaluation of the ocular surface included Ocular Surface Disease Index (OSDI), tear film break-up time (TBUT), lipid layer thickness (LLT), and Schirmer I test. DED patients were divided into two groups, mild (31 patients) and severe (28 patients). The optical quality of the tear film was measured with the Optical Quality Analysis System (OQAS) using the mean objective scatter index (mean OSI), standard deviation of objective scatter index (SD-OSI) and modulation transfer function cut-off (MTF cut-off). After baseline examinations, one drop of artificial tears (ATs, carboxymethylcellulose ophthalmic solution, 0.5%) was instilled in both eyes, and optical quality parameters were measured again at 5 and 30 min following application of ATs.
At baseline, the mean OSI was higher in the DED group (0.95 ± 0.54) than in controls (0.54 ± 0.23, P < 0.001). The SD-OSI was also significantly increased in DED patients (0.44 ± 0.71) compared to control subjects (0.12 ± 0.06, P = 0.003). Five minutes after AT instillation, mean OSI and SD-OSI decreased significantly in severe DED patients (P = 0.044; P = 0.018), remained unchanged in mild DED patients, and increased in the control group (P = 0.019; P < 0.001). Thirty minutes after AT instillation, no significant difference in optical quality parameters was observed among the three groups.
The effect of ATs on optical quality in patients with DED may differ according to the severity of the disease. Measurement of optical quality might be a promising tool to evaluate the effects of various ATs and possibly individualize treatment in DED patients.
在临床实践中，波动的视力或视力质量下降是干燥性角结膜炎（DED）患者常见的主诉。我们的研究旨在调查人工泪液使用后干燥性角结膜炎患者动态光学质量的变化。
本前瞻性病例对照研究纳入了 59 例干燥性角结膜炎患者（DED 组）和 31 例对照者。两组间年龄和性别无显著差异（P=0.342，P=0.847）。眼部表面的临床评估包括眼表疾病指数（OSDI）、泪膜破裂时间（TBUT）、脂质层厚度（LLT）和 Schirmer I 试验。DED 患者分为轻度（31 例）和重度（28 例）两组。采用光学质量分析系统（OQAS）测量泪膜光学质量，测量指标包括平均客观散射指数（mean OSI）、客观散射指数标准差（SD-OSI）和调制传递函数截止值（MTF cutoff）。基线检查后，双眼滴羧甲基纤维素钠眼用溶液（人工泪液）1 滴，滴入人工泪液后 5 分钟和 30 分钟再次测量光学质量参数。
基线时，DED 组的 mean OSI（0.95±0.54）高于对照组（0.54±0.23，P<0.001）。DED 患者的 SD-OSI 也明显高于对照组（0.44±0.71 对 0.12±0.06，P=0.003）。人工泪液滴入后 5 分钟，重度 DED 患者的 mean OSI 和 SD-OSI 显著降低（P=0.044；P=0.018），轻度 DED 患者无变化，对照组升高（P=0.019；P<0.001）。人工泪液滴入后 30 分钟，三组间光学质量参数无显著差异。
人工泪液对 DED 患者的光学质量的影响可能因疾病的严重程度而异。光学质量的测量可能是一种有前途的工具，可以评估各种人工泪液的效果，并可能在 DED 患者中实现个体化治疗。
