Department of Ophthalmology, Yonsei University College of Medicine, Seoul, South Korea.
Department of Ophthalmology, Yonsei University College of Medicine, Seoul, South Korea; Corneal Dystrophy Research Institute, Yonsei University College of Medicine, Seoul, South Korea.
Ocul Surf. 2022 Oct;26:295-299. doi: 10.1016/j.jtos.2022.02.002. Epub 2022 Feb 24.
To evaluate the effects of meibomian gland dysfunction (MGD) and aqueous deficiency (AD) on friction-related disease (FRD).
Cross-sectional comparative study. This study included 550 eyes (550 patients) with dry eye disease (DED). The DED subtype and dynamic tear-film parameters by automated assessments were investigated for the analysis of FRD (superior limbic keratoconjunctivitis, conjunctivochalasis, and lid wiper epitheliopathy).
Patients with FRD had a higher proportion of moderate-to-severe MGD and AD (p < 0.001 and p < 0.001, respectively). The dropout rate of the meibomian gland was higher (30.5 ± 31.8 and 14.1 ± 25.0%, p < 0.001), tear meniscus height (TMH) was lower (227.8 ± 60.4 and 241.7 ± 55.6 μm, p = 0.008), and he first non-invasive keratographic tear break-up time (NIKBUT-1) was shorter (5.9 ± 3.5 and 7.3 ± 3.7 s, p < 0.001) in patients with FRD than in those without FRD. In the logistic regression analysis with clinical manifestation, both moderate-to-severe MGD and AD were associated with FRD (odds ratios [OR] 12.27, 95% confidence interval [CI] 7.72-19.50, and 2.31, 95% CI 1.43-3.71], p < 0.001 and p < 0.001, respectively). The dropout rate was positively associated with FRD (OR 1.017, 95% CI 1.010-1.023, p < 0.001). TMH and NIKBUT-1 were negatively associated with FRD (OR 0.995, 95% CI 0.991-0.999, and 0.90, 95% CI 0.85-0.95, p = 0.039 and p < 0.001, respectively).
This study showed that FRD was highly associated with MGD and meibomian gland dropout rate, suggesting that FRD may be mainly affected by lipid components. AD and TMH also had a good but relatively lower association with FRD, compared to MGD and meibomian gland dropout rate.
评估睑板腺功能障碍（MGD）和水样液缺乏（AD）对摩擦相关疾病（FRD）的影响。
横断面对比研究。本研究纳入 550 只眼（550 例患者）的干眼疾病（DED）患者。通过自动评估分析 DED 亚型和动态泪膜参数，以分析 FRD（上睑边缘性角膜结膜炎、结膜松弛症和睑板腺擦拭上皮病）。
FRD 患者中中重度 MGD 和 AD 的比例更高（p<0.001 和 p<0.001）。睑板腺缺失率更高（30.5±31.8 和 14.1±25.0%，p<0.001），泪膜新月高度（TMH）更低（227.8±60.4 和 241.7±55.6μm，p=0.008），首次非侵入性泪膜破裂时间（NIKBUT-1）更短（5.9±3.5 和 7.3±3.7s，p<0.001）。多变量逻辑回归分析显示，中重度 MGD 和 AD 均与 FRD 相关（比值比 [OR] 12.27，95%置信区间 [CI] 7.72-19.50 和 2.31，95% CI 1.43-3.71，p<0.001 和 p<0.001）。睑板腺缺失率与 FRD 呈正相关（OR 1.017，95% CI 1.010-1.023，p<0.001）。TMH 和 NIKBUT-1 与 FRD 呈负相关（OR 0.995，95% CI 0.991-0.999 和 0.90，95% CI 0.85-0.95，p=0.039 和 p<0.001）。
本研究表明 FRD 与 MGD 和睑板腺缺失率高度相关，提示 FRD 可能主要受脂质成分影响。AD 和 TMH 与 FRD 的关联虽然不如 MGD 和睑板腺缺失率，但也有较好的关联。
