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使用新开发的指标评估干眼症的角膜地形图仪。

Evaluation of Dry Eye With Videokeratographer Using a Newly Developed Indicator.

机构信息

From the Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan.

From the Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan.

出版信息

Am J Ophthalmol. 2023 Aug;252:135-146. doi: 10.1016/j.ajo.2023.03.023. Epub 2023 Mar 25.

Abstract

PURPOSE

To analyze the effectiveness of a newly developed indicator that quantitatively assesses disturbance in Meyer-ring (MR) images obtained via videokeratographer and assess its usefulness for the clinical evaluation of dry eye (DE).

DESIGN

Cross-sectional study.

METHODS

This study involved 79 eyes of 79 DE patients (10 males and 69 females; mean age: 62.7 years). After MR images were obtained via videokeratographer, the degree of blur was quantified at multiple points on the ring, with the total value across the cornea being defined as the disturbance value (DV). Correlations between total DV (TDV; the sum of DV for 5 seconds after eye opening) and 12 DE symptoms, Dry Eye-Related Quality of Life Score (DEQS), tear meniscus radius (mm), tear film (TF) lipid-layer spread grade (SG; grades 1-5, 1 = best), TF noninvasive breakup time (NIBUT, seconds), fluorescein breakup time (FBUT, seconds), corneal epithelial damage score (CEDS; maximum: 15 points), conjunctival epithelial damage score (CjEDS; maximum: 6 points), and Schirmer 1 test value (mm) were analyzed via univariate and multivariate analyses.

RESULTS

No significant correlations were found between TDV and each DE symptom or DEQS, yet significant correlations were found between TDV and SG, NIBUT, FBUT, CEDS, and CjEDS (r = 0.56, -0.45, -0.45, 0.72, and 0.62, respectively, all P < .01). TDV was found to be described as 2334 + (412.1 × CEDS) - (302.0 × FBUT) (R = 0.593, P < .0001).

CONCLUSIONS

Our newly developed indicator, DV, reflecting TF dynamics and stability and corneoconjunctival epithelial damage, may be useful for quantitatively assessing DE ocular-surface abnormalities.

摘要

目的

分析一种新开发的指标在评估眼干症(DED)方面的临床应用价值,该指标用于定量评估角膜知觉仪获取的梅耶环(MR)图像的干扰程度。

设计

横断面研究。

方法

本研究共纳入 79 例 DED 患者(10 名男性,69 名女性;平均年龄:62.7 岁)的 79 只眼。通过角膜知觉仪获取 MR 图像后,在环上的多个点量化模糊程度,角膜总模糊值定义为干扰值(DV)。分析总干扰值(TDV;睁眼后 5 秒的 DV 总和)与 12 个 DED 症状、眼表疾病指数(DEQS)、泪膜月牙半径(mm)、泪膜脂质层铺展分级(TF-SG;1-5 级,1 级最佳)、泪膜非侵入性破裂时间(NIBUT,秒)、荧光素破裂时间(FBUT,秒)、角膜上皮损伤评分(CEDS;最大值:15 分)、结膜上皮损伤评分(CjEDS;最大值:6 分)和泪液分泌试验值(Schirmer 1 试验,mm)之间的相关性,采用单变量和多变量分析。

结果

TDV 与各 DED 症状或 DEQS 之间无显著相关性,但与 SG、NIBUT、FBUT、CEDS 和 CjEDS 之间呈显著相关性(r=0.56、-0.45、-0.45、0.72 和 0.62,均 P<0.01)。TDV 可以用 2334+(412.1×CEDS)-(302.0×FBUT)表示(R2=0.593,P<0.0001)。

结论

我们新开发的指标 DV 反映了泪膜的动态和稳定性以及角结膜上皮损伤,可能有助于定量评估 DED 眼表异常。

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