干眼仪在干眼诊断中的价值初步评价

Diagnosis of dry eye by DR-1 tear interferometry

目的 :评价干眼仪对干眼的诊断价值。方法 :对 2 5例 (2 5只眼 )正常人和 3 5例 (3 5只眼 )干眼患者分别行泪膜破裂时间 (BUT)、泪液分泌试验 (SchirmerI)、角膜荧光素染色 (FL)、干眼仪检查和泪高度测量五项检查。结果 :干眼患者的干眼仪检测等级与正常人差异显著 (χ2 =3 2 2 2 ,P =0 0 0 0 )。干眼仪诊断干眼的特异度为 80 % ,灵敏度为83 %。干眼仪检查为Ⅲ级脂质层形态图像者患干眼的机率约为 75 % (15 / 2 5 )。干眼患者的干眼仪检测等级越高 ,BUT和SchirmerI试验越短 (r =-0 783 ,-0 3 68,P =0 0 0 0 ,0 0 15 ) ,角膜荧光素染色越多 (r =0 80 6,P =0 0 0 0 ) ,而与泪河高度无相关 (P =0 178)。正常人的干眼仪检测等级也与BUT和SchirmerI试验呈负相关 (r =-0 3 98,-0 65 6,P =0 0 2 4,0 0 0 0 )。干眼患者的干眼仪显示图像的稳定性较正常人差。干眼仪的检查结果具有较高的重复性。结论 :干眼仪能较直观地观察角膜中央脂质层的光干涉图像 ,是一种快速、无创伤、重复性强、操作简单的检查方法。对干眼的诊断及客观反映病情的严重程度具有临床应用价值。

Objective: To evaluate the potential of DR-I tear interferometry in the diagnosis of dry eye. Methods: The status of pre-corneal tear lipid layer in 25 normal volunteers (25 eyes) and 35 dry eye patients (35 eyes) was estimated by DR-I tear interferometry and was termed as interference patterns of tear film in 5 grades.The break-up time (BUT) of tear film,Schirmer I-test (SIt),corneal fluorescein staining,and the height of tear meniscus were also measured. Results: The interference patterns of tear film (tear lipid layer) in control eyes were in grades 1,2 or 3;and in dry eye patients were in grades 2,3,4,and 5.The distinctive degree in the diagnosis of dry eye by DR-I tear interferometry was 80% and the sensitivity degree of that was 83%.The grade of the interference patterns,both in dry eye patients and in controls,was negatively correlated with BUT and SIt (P<0.05),but in dry eye patients it was also positively correlated with the scores of corneal fluorescein staining (r=0.806,P<0.05).Interference patterns could be observed repeatedly,although the stability of the patterns was better in controls than that in dry eye patients. Conclusions: The interference patterns of pre-corneal tear lipid layer can be observed by DR-I tear interferometry clearly.The DR-I tear interferometry examination is an effective clinical method to diagnose dry eye and the dry eye severity.