双通道技术评估睑板腺功能障碍性干眼患者的视觉质量

A double-pass method of evaluating the optical quality of dry eye caused by meibomian gland dysfunction

目的利用双通道技术动态监测睑板腺功能障碍（MGD）性干眼患者眼球散射情况，来客观评价MGD性干眼患者的视觉质量。方法横断面研究。选取MGD性干眼患者56例（74眼，干眼组）及正常人31例（53眼，对照组）。对2组对象进行相关检查，包括泪液分泌试验（Sehirmer Ⅰ test，SIT）、泪膜破裂时间（BUT）、睑板腺分泌物评分、睑板腺缺失面积评分，以及利用双通道技术-OQAS-Ⅱ系统检测调制传递函数截止频率（MTFcutoff）、斯特列尔比（SR）、客观散射指数（OSD等参数。采用独立样本t检验分析MGD干眼组与对照组之间各参数的差异性，采用Pearson相关分析OSI均值与MTFcutoff、SR的相关性。结果干眼组SIT、BUT、睑板腺分泌物评分、睑板腺缺失面积评分、MTFcutoff、SR、OSI均值及标准差分别为（4．7±2．8）mm、（4．9±2．1）S、（3．0±1．2）分、（3．2±1．3）分、（24．41±9．12）c／deg、0．13±0．06、2．26±1．08、0．61±0．68，与对照组[（15．7±5．1）mm、（13.2±2．0）s、（0．5±0．2）分、（0．6±0．1）分、（37．24±7．04）c／deg、0．23±0．06、0．71±0．18、0．11±0．09]相比，差异有统计学意义（t=-15．815、-22．399、9．925、6．965、-8．574、-9．752、10．341、5．315，P〈0．05）。OSI均值与MTFcutoff、SR均呈负相关（r=-0．67、-0．60，P〈0．05）。结论双通道技术可用于客观评估MGD性干眼患者的视觉质量，表明泪膜改变造成的散射对MGD性干眼患者视网膜成像及视觉质量影响明显。

Objective To use double-pass technology to evaluate optical quality by dynamically analyzing the ocular light scatter of dry eye caused by meibomian gland dysfunction （MGD）. Methods In a noninterventional, cross-sectional study, results of the following tests were recorded in 56 patients （74 eyes） with dry eye caused by MGD and a control group of 31 participants （53 healthy eyes）： Schirmer Ⅰ test, tear film break-up time （BUT）, meibomiau gland grade, modulation transfer function cutoff （MTF cut off）, Strehl ratio （SR）, and objective scatter index （OSI）. The differences between the two groups were compared for the MTF eutoff, SR, the average value of OSI and the corresponding standard deviation （SD-OSI）. The correlations of OSI with MTF cut off and SR were analyzed. Results The result of Schirmer Ⅰ test, BUT, meibomian secretion score, miss rate of meibomian glands, MTF cut off, SR, OSI and SD-OSI in MGD dry eye group were as follows： 4.7±2.8, 4.9±2.1, 3.0±1.2, 3.2±1.3, 24.41±9.12, 0.13±0.06, 2.26±1.08 and 0.61±0.68. The corresponding results for the control group were： 15.7±5.1, 13.2±2.0, 0.5±0.2, 0.6±0.1, 37.24±7.04, 0.23±0.06, 0.71±0.18 and 0.11±0.09. There were statistically significant differences between the two groups （t=-15.815, -22.399, 9.925, 6.965, -8.574, -9.752, 10.341, 5.315, P〈0.05）. Both the MTF cut off and SR were negatively correlated with OSI （r=-0.67, -0.60, P〈0.05）. Conclusion Ocular light scatter in MGD dry eye patients greatly influences retinal images and optical quality.The double-pass technology, which is an objective method for evaluating optical quality, may play an important guidance role in the diagnosis and treatment of dry eye.