活体共聚焦显微镜下复发与初发睑板腺囊肿患者睑板腺形态分析

Morphological analysis of meibomian glands in patients with recurrent and primary meibomian gland cyst under in vivo confocal microscope

目的:分析复发与初发睑板腺囊肿患者的睑板腺组织形态学改变在活体共聚焦显微镜(in v ivo confocal microscope,IVCM)下的表现及特点。方法:采用横断面研究方法,选取2018年10月至2019年4月在汕头大学·香港中文大学联合汕头国际眼科中心门诊就诊的10例复发性睑板腺囊肿患者、10例初发性睑板腺囊肿以及10例对照组作为观察对象。所有对象行眼科常规检查及IVCM检查。IVCM检测指标包括睑板腺开口面积、开口最短径、开口最长径、睑板腺开口附近腺管形态、睑板腺腺泡样结构形态,分析比较三组的计量指标。结果:复发性睑板腺囊肿组睑板腺开口短径(109.08±49.96)μm,开口长径(144.95±68.10)μm,开口面积为11621.62(3976.49~24828.82)μm^(2);初发性睑板腺囊肿组睑板腺开口短径(101.53±29.55)μm,开口长径(130.08±45.21)μm,开口面积10615.07(5813.29~18275.44)μm^(2);对照组睑板腺开口短径(44.14±14.37)μm,开口长径(55.98±13.46)μm,开口面积2233.29(1437.72~2945.65)μm^(2)。与对照组相比,复发性、初发性睑板腺囊肿组睑板腺开口短径、开口长径及开口面积均明显扩大,差异有统计学意义(P<0.05);复发与初发睑板腺囊肿组之间差异不具有统计学意义(P>0.05)。复发性睑板腺囊肿组睑板腺腺管扩张,周边腺泡样结构纤维组织增生,伴有炎症细胞浸润。初发性睑板腺囊肿组睑板腺腺管扩张,周边腺泡样结构未见明显纤维组织增生。结论:IVCM可在活体下观察睑板腺囊肿患者睑板腺形态学上的微观改变,复发性睑板腺囊肿睑板腺腺泡样结构形态与初发性睑板腺囊肿表现有差异。

Background:To analyze the morphological changes of meibomian glands in patients with recurrent and primary meibomian gland cyst under in vivo confocal microscope(IVCM).Methods:A cross-sectional study was performed in Shantou International Eye Center from September 2018 to April 2019.Ten patients with recurrent meibomian cyst,10 patients with primary meibomian cyst and 10 control subjects were selected in this clinical trial.All subjects received routine ophthalmologic examination and IVCM examination.IVCM examination parameters included open area of meibomian gland,and the maximum and minimum diameter of meibomian gland opening.Relevant parameters were analyzed and statistically compared among different groups.Results:The average minimum diameter of meibomian glands opening in the recurrent meibomian gland cyst group was(109.08±49.96)μm,the average maximum diameter of meibomian glands opening was(144.95±68.10)μm,and the median open area of meibomian gland was 11621.62(3976.49-24828.82)μm^(2).In the primary meibomian gland cyst group,the average minimum diameter of meibomian glands opening was(101.53±29.55)μm,the average maximum diameter of meibomian glands opening was(130.08±45.21)μm,and the median open area of meibomian gland was 10615.07(5813.29-18275.44)μm^(2).The opening of meibomian glands in both the recurrent and primary meibomian gland cyst groups was enlarged,which significantly differed from that in the control group(both P<0.05).No statistical significance was noted between the recurrent and primary meibomian gland cyst groups(P>0.05).The acinus structure around the gland tube was manifested with serious hypertrophic scar complicated with inflammatory cell infiltration.Conclusion:IVCM can detect the morphological changes of meibomian glands in meibomian gland cyst patients.The IVCM findings of recurrent and primary meibomian gland cyst are different.