近视未矫正儿童的眼表异常评估

Consideration of Ocular Surface Abnormalities in Children with Uncorrected Myopia

目的:通过临床检查分析评估近视未矫正儿童的眼表异常。方法:病例对照研究。选取于洛阳市妇女儿童医疗保健中心眼科体检且首次发现近视的30例(60眼)儿童患者为观察组,裸眼视力正常儿童30例(60眼)为对照组,通过裂隙灯显微镜眼前节检查评估2组间的眼表和睑板腺功能状况差异。使用Spearman秩相关性分析评估观察组眼表参数间的相关性,使用秩和检验比较2组间的差异。结果:2组间年龄、性别组成和泪液分泌试验(SⅠT)的差异均无统计学意义,2组间睑板腺开口状况(Z=-4.08,P<0.001)及分泌物性状评分(Z=-2.99,P=0.003)、角膜荧光素染色(FL)评分(Z=-2.65,P=0.008)、泪膜破裂时间(BUT)(Z=-7.09,P<0.001)差异均有统计学意义。观察组的BUT值与睑板腺开口形态、分泌性状评分及Marx线位置评分呈负相关性(rs=-0.501,P<0.001;rs=-0.400,P=0.002;rs=-0.557,P<0.001),而FL评分与睑板腺分泌性状评分、Marx线位置评分无相关性,与睑板腺开口形态评分呈弱正相关性(rs=0.332,P=0.012)。结论:近视未矫正儿童可能是睑板腺功能异常的高发人群,同时也是睑板腺功能障碍发病的危险群体。

Objective:To evaluate the ocular surface condition of children with uncorrected myopia by clinical examinations.Methods:This was a case control study.Thirty children with uncorrected myopia(60 eyes)were randomly selected as the study group and 30 normal children(60 eyes)as the control group.The ocular surface and meibomian gland condition were compared and evaluated with a slit lamp microscope.The observed data was evaluated by a non-parametric test.A spearman rank correlation analysis was used to evaluate the correlation between the ocular surface parameters in the observation group.Results:There was no significant difference in age,sex or lacrimal secretion between the two groups.There were statistically significant differences between the two groups in meibomian gland orifice scores(Z=-4.08,P<0.001),meibomian gland secretion scores(Z=-2.99,P=0.003),corneal fluorescein scores(Z=-2.65,P=0.008)and BUT(Z=-7.09,P<0.001).Negative correlations were found between BUT and meibomian gland orifice scores(rs=-0.501,P<0.001),meibomian gland secretion scores(rs=-0.400,P=0.002),and Marx's line scores(rs=-0.557,P<0.001),and there were no correlations between Marx's line scores,meibomian gland secretion scores with corneal fluorescein scores and a positive correlation was found between corneal fluorescein scores and meibomian gland orifice scores in children with uncorrected myopia(rs=0.332,P=0.012).Conclusions:The children with uncorrected myopia may have a high incidence of impairment in the meibomian gland and are a risk group for meibomian gland dysfunction.