眼表综合分析仪和活体共聚焦显微镜观察干眼患者干眼程度和睑板腺形态

An observation of dry eye degree and meibomian gland morphology by ocular surface analyzer and in vivo confocal microscopy in patients with dry eye

目的分析眼表综合分析仪和活体共聚焦显微镜(IVCM)观察干眼患者干眼程度及睑板腺形态。方法干眼患者54例(72眼),根据IVCM对螨虫检出情况分为两组:上眼睑6个毛囊中3个或大于3个毛囊有螨虫为A组(28例36眼),上眼睑6个毛囊中3个以下毛囊有螨虫为B组(26例36眼),比较两组的IVCM及眼表综合分析仪检查相关指标。结果A组非侵入性首次泪膜破裂时间(NITBUTf)和非侵入性平均泪膜破裂时间(NITBUTav)稍大于B组,但差异无统计学意义(P>0.05);两组下泪河高度(LTHM)和睑板腺缺失率比较无统计学差异(P>0.05)。两组睑板腺腺泡最长径(MGALD)、睑板腺腺泡最短径(MGASD)、睑板腺腺泡单元密度(MGAUD)、睑板腺腺泡单元面积(MGAUA)和炎症细胞密度比较均无统计学差异(P>0.05)。尚未发现睑板腺缺失率与MGALD、MGASD、MGAUD、MGAUA、NITBUTf、NITBUTav、LTHM存在相关关系(P>0.05)。结论眼表综合分析仪和IVCM能够对干眼患者的干眼程度和睑板腺形态进行评估。螨虫感染并不一定会引起睑板腺结构的形态学改变,与干眼严重程度也无明显关系。

Objective To analyze the results of observing dry eye degree and meibomian gland morphology by ocular surface analyzer and in vivo confocal microscopy(IVCM)in the patients with dry eye.Methods A total of 54 patients(72 eyes)with dry eye were divided into two groups according to the detection of mite by IVCM.The mites were seen in 3 or more of the 6 hair follicles in the upper eyelid in group A(28 cases).The mites were seen in less than 3 out of 6 hair follicles in the upper eyelid in group B(26 cases).The related indicators of ocular surface analyzer and IVCM were compared between the two groups.Results The non-invasive first tear film break-up time(NITBUTf)and non-invasive average tear film break-up time(NITBUTav)were sightly higher in group A than those in group B(P>0.05).The low tear meniscus height(LTHM)and meibomian gland deletion rate were not significantly different between the two groups(P>0.05).The longest diameter of meibomian gland acus(MGALD),shortest diameter of meibomian gland acus(MGASD),meibomian gland acinus unit density(MGAUD),meibomian gland acinus unit area(MGAUA)and inflammatory cell density were not significantly different between the two groups(P>0.05).The meibomian gland deletion rate was not correlated to MGALD,MGASD,MGAUD,MGAUA,NITBUTf,NITBUTav and LTHM(P>0.05).Conclusion The ocular surface analyzer and IVCM can be used to evaluate the degree of dry eye and meibomian gland morphology in the patients with dry eye.Mite infection does not necessarily cause morphological changes of meibomian gland structure,which has no significant relationship with the severity of dry eye.