Zhou Nanyu, Edwards Katie, Colorado Luisa H, Schmid Katrina L
Centre for Vision and Eye Research, School of Optometry and Vision Science, Faculty of Health, Queensland University of Technology, Kelvin Grove, Australia.
Cornea. 2022 Jun 1;41(6):699-708. doi: 10.1097/ICO.0000000000002913. Epub 2022 Mar 4.
Although meibography provides direct evidence of gland dropout in meibomian gland dysfunction, this specialized technique is not available in most clinics. The primary aim was to determine which clinical ocular marker was most related to meibomian area loss. A secondary aim was to determine associations with confocal microscopy imaging of the lid margin.
One hundred participants from age 18 to 65 years were recruited. Measurements of the right eye and its upper eyelid, where relevant, included noninvasive tear break-up time, bulbar and limbal redness scores, blepharitis score, lipid layer thickness, number of parallel conjunctival folds, tear osmolarity, corneal fluorescein staining, phenol red thread test, lid margin score, meibography, and in vivo confocal microscopy. Participants also completed the Ocular Surface Disease Index questionnaire. The relationships between the measurements were determined using the Spearman correlation. The receiver operating characteristic curve and area under the receiver operating characteristic curve were used to determine the cutoff value of clinical markers.
Significant correlations were found between meibomian area and lid margin score (r = -0.47, P < 0.01), and meibomian tortuosity and lid signs of blepharitis (r = -0.32, P < 0.01). Area under the receiver operating characteristic curve analysis revealed that a lid margin score of ≥1.70 detected meibomian area loss with a sensitivity of 0.58 and a specificity of 0.86. There were significant correlations between meibomian area and orifice area at 30 μm depth (r = -0.25, P = 0.01).
The lid margin score was most related to the meibomian area and thus the best predictor of undiagnosed meibomian area loss.
尽管睑板腺造影术能为睑板腺功能障碍时腺体缺失提供直接证据，但这项专业技术在大多数诊所无法开展。主要目的是确定哪种临床眼部指标与睑板腺面积减少最为相关。次要目的是确定与睑缘共聚焦显微镜成像的相关性。
招募了100名年龄在18至65岁之间的参与者。对右眼及其上眼睑进行测量（如适用），包括无创泪膜破裂时间、球结膜和角膜缘充血评分、睑缘炎评分、脂质层厚度、平行结膜皱襞数量、泪液渗透压、角膜荧光素染色、酚红棉线试验、睑缘评分、睑板腺造影术以及活体共聚焦显微镜检查。参与者还完成了眼表疾病指数问卷。使用Spearman相关性分析测量指标之间的关系。采用受试者工作特征曲线及受试者工作特征曲线下面积来确定临床指标的临界值。
睑板腺面积与睑缘评分之间存在显著相关性（r = -0.47，P < 0.01），睑板腺迂曲与睑缘炎体征之间存在显著相关性（r = -0.32，P < 0.01）。受试者工作特征曲线下面积分析显示，睑缘评分≥1.70时检测睑板腺面积减少的灵敏度为0.58，特异度为0.86。睑板腺面积与30μm深度处的开口面积之间存在显著相关性（r = -0.25，P = 0.01）。
睑缘评分与睑板腺面积最为相关，因此是未诊断出的睑板腺面积减少的最佳预测指标。
