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影响 MGD 患者的睑板腺长期变化的因素。

Factors affecting long-term changes of meibomian gland in MGD patients.

机构信息

Department of Ophthalmology, Eye, Ear, Nose and Throat Hospital of Fudan University, Shanghai, China.

Institutes of Biomedical Sciences of Fudan University, Shanghai, China.

出版信息

Graefes Arch Clin Exp Ophthalmol. 2024 Feb;262(2):527-535. doi: 10.1007/s00417-023-06210-1. Epub 2023 Aug 31.

Abstract

PURPOSE

To explore the long-term course of patients with meibomian gland dysfunction (MGD), and to analyse potential factors affecting the recovery of meibomian gland (MG) dropout.

METHODS

Seventy-nine MGD patients (79 eyes) aged 36.03±15.78 years old who underwent more than one year of follow-up were enrolled in this retrospective study. Corneal fluorescein staining (CFS), tear meniscus height (TMH), noninvasive breakup time (NIBUT), and noncontact meibography at baseline and last visit were collected and analysed. Then an automatic MG analyzer was used to measure the morphological and functional parameters of MGs, including their area ratio (AR), tortuosity index (TI), and signal index (SI). The patients whose AR increased by more than 5% were defined as MG improvement, and AR decreased by more than 5% was MG worsening.

RESULTS

A total of 79 patients (79 eyes) were assessed with at least 1-year of follow-up. More than 1/3 of MGD patients (27 eyes, 34.2%) underwent MG improvement, and 30.4% of MGs became worsened. Age (P=0.002), gender (P<0.001), IPL treatment (P=0.013), the change of CFS (P=0.0015), and the recovery of SI (P=0.035) showed significant differences among different recovery groups. Age(P<0.001), female sex (P=0.003), ΔCFS (P<0.001), AR at baseline (P<0.001) were negative correlation with AR recovery, and the change of SI (P=0.003) and IPL treatment (P=0.003) had a positive correlation with it. Among them, age (P=0.038), the change of CFS (P=0.004), and AR at baseline (P=0.007) were confirmed as negatively correlated factors predicting the long-term change of the MG.

CONCLUSION

Although the MGD treatment has continued for more than 1 year, only 34.2% of MGD patients were observed to undergo MG improvement. Younger patients and patients with better CFS recovery seem to have more opportunities to improve their MGs.

摘要

目的

探讨睑板腺功能障碍(MGD)患者的长期病程,并分析影响睑板腺缺失恢复的潜在因素。

方法

本回顾性研究纳入了 79 名(79 只眼)年龄为 36.03±15.78 岁、随访时间超过 1 年的 MGD 患者。收集并分析患者基线和末次就诊时的角膜荧光素染色(CFS)、泪膜新月高度(TMH)、非侵入性泪膜破裂时间(NIBUT)和非接触式睑板腺照相。然后使用自动睑板腺分析器测量睑板腺的形态和功能参数,包括其面积比(AR)、扭曲指数(TI)和信号指数(SI)。AR 增加超过 5%的患者被定义为睑板腺改善,AR 减少超过 5%的患者被定义为睑板腺恶化。

结果

共有 79 名患者(79 只眼)接受了至少 1 年的随访。超过 1/3 的 MGD 患者(27 只眼,34.2%)出现了睑板腺改善,30.4%的睑板腺恶化。年龄(P=0.002)、性别(P<0.001)、 IPL 治疗(P=0.013)、CFS 变化(P=0.0015)和 SI 恢复(P=0.035)在不同恢复组之间存在显著差异。年龄(P<0.001)、女性(P=0.003)、ΔCFS(P<0.001)、基线 AR(P<0.001)与 AR 恢复呈负相关,而 SI 变化(P=0.003)和 IPL 治疗(P=0.003)与 AR 恢复呈正相关。其中,年龄(P=0.038)、CFS 变化(P=0.004)和基线 AR(P=0.007)被证实为预测睑板腺长期变化的负相关因素。

结论

尽管 MGD 治疗已经持续了 1 年以上,但只有 34.2%的 MGD 患者观察到睑板腺改善。年轻患者和 CFS 恢复较好的患者似乎有更多机会改善他们的睑板腺。

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