双通道视觉质量分析系统评价泪膜稳定性对青少年视网膜成像质量的影响

Evaluation of the Impact of Tear Film Stability on Adolescent Visual Quality by the Optical Quality Analysis System

目的:利用双通道视觉质量分析系统(OQAS-II)评价泪膜稳定性对青少年视网膜成像质量的影响,为临床研究提供相关数据。方法:系列病例研究。选取2019年3─10月在福州市中医院眼科门诊就诊的青少年患者,按泪膜破裂时间(BUT)分为研究组(BUT<10 s)32例和对照组(BUT≥10 s)30例。利用基于双通道技术的OQAS-II系统检测2组患者自然状态下的调制传递函数截止频率(MTF cutoff)、客观散射指数(OSI)、不同对比度下的OQAS-II值(OV100%、OV20%、OV9%),同时检测2组患者在20 s持续睁眼过程中的OSI动态变化,获取此动态过程的OSI均值及标准差(SD-OSI)。采用独立样本t检验比较2组各数据间的差异性,采用Spearman秩相关分析法分析数据资料间的相关性。结果:2组患者的年龄、球镜度、柱镜度比较差异均无统计学意义。研究组的BUT为(5.90±2.16)s,明显小于对照组的(11.53±2.06)s,差异有统计学意义(t=-10.473,P<0.001)。2组MTF cutoff、OSI、OV100%、OV20%、OV9%值比较,差异无统计学意义;研究组OSI均值和SD-OSI高于对照组,差异有统计学意义(t=2.259,P=0.028;t=0.359,P=0.036)。MTF cutoff、OSI、OV100%、OV20%与BUT无相关性;而OV9%值与BUT呈正相关(r=0.273,P=0.032)。20 s内的OSI均值与BUT呈负相关(r=-0.276,P=0.002),SD-OSI与BUT无相关性。结论:青少年泪膜不稳定可引起视网膜成像质量下降。OQAS-II系统在评价青少年泪膜质量中具有很高的应用价值。

Objective:To evaluate the impact of tear film stability on adolescent visual quality by using the Optical Quality Analysis System(OQAS-II),and to provide relevant data for clinical research.Methods:In this case series study,32 adolescent patients with short break-up time(BUT<10 s)and thirty control subjects(BUT≥10 s)were enrolled from the outpatient clinic of Fuzhou Hospital of Traditional Chinese Medicine from March to October 2019.The OQAS-II system was used to detect the modulation transfer function cut off frequency(MTF cutoff),objective scattering index(OSI)and OQAS values with contrasts of 100%,20%and 9%(OV100%,OV20%and OV9%)in the natural state.Meanwhile,the dynamic changes of OSI were detected during 20-second intervals with the eye open continuously,and the mean value and standard deviation of OSI(SD-OSI)in this dynamic process were obtained.Differences in the parameters were compared between the two groups using independent t test.Spearman rank correlation analysis was used to analyze the correlation between the data.Results:There were no statistically significant differences between the two groups in terms of age,spherical degree or astigmatic degree.BUT was 5.90±2.16 s in the study group,which was significantly less than that in the control group(11.53±2.06 s).This difference(t=-10.473,P<0.001)was statistically significant.MTF cutoff,OSI,OV100%,OV20%,OV9%were compared between the 2 groups,and the differences were not statistically significant.The mean values of OSI and SD-OSI in the study group were higher than those in the control group,and the difference was statistically significant(t=2.259,P=0.028;t=0.359,P=0.036).There was no correlation between MTF cutoff,OSI,OV100%,OV20%and BUT(all P>0.05)but the value of OV9%was positively correlated with BUT(r=0.273,P=0.032).The mean value of OSI in 20-second period was negatively correlated with BUT(r=-0.276,P=0.002),while SD-OSI was not correlated with BUT.Conclusions:The instability of adolescent tear films can lead to a decline in retinal image quality,and it is related to the degree of BUT.There is a high value of OQAS-II in evaluation of adolescent tear films.