Department of Ophthalmology, University of Health Sciences, Ankara Training and Research Hospital, Ankara, Turkey.
Department of Ophthalmology, University of Health Sciences, Bursa Yüksek Ihtisas Training and Research Hospital, Bursa, Turkey.
Indian J Ophthalmol. 2022 Aug;70(8):2922-2928. doi: 10.4103/ijo.IJO_6_22.
To compare findings in specular microscopy, corneal topography, and noncontact meibography in polycystic ovary syndrome (PCOS) patients with healthy controls.
A total of 40 women with PCOS and 32 healthy controls were enrolled in the study. Schirmer's test, Ocular Surface Disease Index (OSDI), noninvasive tear break-up time (NITBUT), the mean keratometry (Km), maximum keratometry (Kmax), central (CCT), thinnest (TCT) and apical (ACT) corneal thicknesses, meibomian gland (MG) loss, meiboscores, morphology of MGs, endothelial cell density (ECD), coefficient of variation (CV), and percentage of hexagonal cells (PHEX) were analyzed. Correlations between anti-Mullerian hormone (AMH) and sex hormones and the findings of PCOS patients were evaluated.
Mean OSDI score, intraocular pressure, Km and Kmax values, the mean MG loss of upper and lower eyelids, lower eyelid meiboscore, and degree of morphological abnormalities of MGs were higher in cases with PCOS than healthy controls. There were no significant differences between groups in Schirmer results, first and average NITBUT, mean values of TCT, ACT, CCT, ECD, CV, and PHEX (P > 0.05, for all). There were correlations between plasma AMH level and Kmax, back Km and PHEX, and between estradiol (E2) and PHEX; there were negative correlations between E2 and total MG loss and CV and between total testosterone and ACT.
Loss and morphological deterioration of the MGs are observed in PCOS patients, even if the tear parameters are not impaired yet. In eyes with PCOS, keratometry values become steeper in proportion to AMH levels. The PCOS patients should be followed carefully for the development of corneal ectasia.
比较多囊卵巢综合征（PCOS）患者和健康对照者在共焦显微镜、角膜地形图和非接触式睑板腺成像方面的检查结果。
本研究共纳入 40 名 PCOS 患者和 32 名健康对照者。检测 Schirmer 试验、眼表疾病指数（OSDI）、非侵入性泪膜破裂时间（NITBUT）、平均角膜曲率（Km）、最大角膜曲率（Kmax）、中央角膜厚度（CCT）、最薄角膜厚度（TCT）、顶点角膜厚度（ACT）、睑板腺缺失、睑板腺评分、睑板腺形态、内皮细胞密度（ECD）、变异系数（CV）和六边形细胞百分比（PHEX）。评估抗苗勒管激素（AMH）和性激素与 PCOS 患者检查结果的相关性。
PCOS 组的平均 OSDI 评分、眼内压、Km 和 Kmax 值、上睑和下睑平均睑板腺缺失、下睑睑板腺评分和睑板腺形态异常程度均高于健康对照组。两组间 Schirmer 试验结果、首次和平均 NITBUT、TCT、ACT、CCT、ECD、CV 和 PHEX 平均值无显著差异（P > 0.05，均为 P）。AMH 水平与 Kmax、后 Km 与 PHEX，以及雌二醇（E2）与 PHEX 之间存在相关性；E2 与总睑板腺缺失和 CV 呈负相关，总睾酮与 ACT 呈负相关。
即使泪膜参数没有受损，PCOS 患者仍存在睑板腺缺失和形态恶化。在 PCOS 患者中，角膜曲率值随 AMH 水平的升高而变得更陡峭。应密切随访 PCOS 患者角膜扩张的发生。
