轻中度睑板腺功能障碍患者的视觉质量分析

Evaluation of visual quality in patients with mild or moderate meibomian gland dysfunction

目的用双通道视觉质量分析仪(OQASⅡ),观察分析轻中度睑板腺功能障碍(MGD)患者的视觉质量,为临床治疗时机的选择提供参考依据。方法选择2018年4月至2019年1月于东部战区总医院眼科门诊就诊确诊为轻度MGD(30例,30眼)、中度MGD(30例,30眼)患者。同时随机选择30例无任何眼表疾病的健康人的30眼作为对照组。每位受试对象填写眼表疾病指数量表(OSDI),进行睑板腺相关检查,泪膜破裂时间测定,泪液分泌功能测定,利用OQAS-Ⅱ系统检测自然状态下的调制传递函数截止频率(MTF cut off)、斯特列尔比(SR)、客观散射指数(OSI),同时检测受试对象20 s不眨眼过程中的视觉质量动态变化,获取OSI均值及标准差(SD-OSI)。比较各组间检查数据的差异。结果轻度MGD组的SR为(0.24±0.06),MTF cut off为(39.88±6.92)c/deg,OSI为(0.44±0.11),OSI均值为(0.894±0.331),SD-OSI为(0.113±0.041)。中度MGD组SR为(0.18±0.04),MTF cut off为(32.27±8.53)c/deg,OSI为(0.71±0.23),OSI均值为(1.574±0.554),SD-OSI为(0.246±0.157)。轻度MGD组SR、MTF cut off、OSI与对照组比较差异均无统计学意义(P>0.05),OSI均值、SD-OSI显著高于对照组(P<0.01)。中度MGD组SR、MTF cut off显著低于对照组(P<0.01),OSI、OSI均值和SD-OSI显著高于对照组(P<0.01)。结论轻中度MGD患者的动态视觉质量下降明显。OQAS可以有效地评估轻中度MGD患者的视觉质量。

Objective To evaluate the optical quality in patients with mild or moderate meibomian gland dysfunction(MGD)by using double-pass optical quality analysis system(OQAS Ⅱ),and offer the reference data for clinical application.Methods We recruited 30 participants with mild MGD,30 participants with moderate MGD,and 30 healthy subjects.Ocular surface disease index scores,meibomian gland correlation examination,tear film breakup time(BUT),Schirmer test(SIT)value,the modulation transfer function(MTF)cutoff frequency,the Strehl ratio(SR),and the objective scattering index(OSI)were quantitatively assessed using OQAS Ⅱ.The mean OSI and OSI standard deviation(SD-OSI)were performed over 20 seconds without blinking to evaluate the dynamic alterations of optical quality.Differences between both groups were analyzed statistically.Results In the mild MGD group,SR was(0.24±0.06),MTF cut off was(39.88±6.92)c/deg,OSI was(0.44±0.11),the mean OSI was(0.894±0.331)and SD-OSI was(0.113±0.041).In the moderate MGD group,SR was(0.18±0.04),MTF cut off was(32.27±8.53)c/deg,OSI was(0.71±0.23),the mean OSI was(1.574±0.554)and SD-OSI was(0.246±0.157).There was no significant difference in MTF cutoff,SR and OSI between the mild MGD group and the control group(P>0.05).The mean OSI and SD-OSI in mild MGD group were significantly higher than that in the control group(P<0.01).The SR and MTF cutoff were significantly lower and the OSI,the mean OSI and SD-OSI were significantly higher in the moderate MGD patients than controls(P<0.01).Conclusion The dynamic alterations of optical quality in patients with mild-moderate MGD is lower than that of normal persons.The OQAS could be a useful tool to preferably evaluate visual function in patients with mild or moderate MGD.