AIM： To investigate the effects of different concentrations of artificial tears on lipid layer thickness （LLT） and blink rate （BR） in dry eye patients. METHODS： This study included 106 eyes of 58 patients with ...AIM： To investigate the effects of different concentrations of artificial tears on lipid layer thickness （LLT） and blink rate （BR） in dry eye patients. METHODS： This study included 106 eyes of 58 patients with dry eye. The lipid deficiency type was defined as the LLT baseline 〈75 nm. The LLT and BR were measured at baseline and 1, 5 and 15min after the instillation of 0.1% or 0.3% sodium hyaluronate （SH） eye drops by using the LipiView ocular surface interferometer. RESULTS： In the lipid deficiency group, the LLT increased from baseline at 1rain post instillation. The LLT after the instillation of 0.1% SH was significantly higher than that after the instillation of 0.3% SH （P〈0.001）. The LLT returned to baseline at 15min post instillation of 0.1% SH and at 5min post instillation of 0.3% SH. In the non-lipid deficiency group, the LLT decreased from baseline at lmin and returned to baseline at 5rain for both treatments. The BRs were not significantly different at different time points for both treatments. CONCLUSION： SH eye drops induce a short-term increase in LLT of patients with lipid deficiency. A low concentration of artificial tears have a stronger effect than a high concentration of artificial tears on the increase in LLT. in comparison, SH eye drops induce a transient and slight decrease in LLT of patients without lipid deficiency. A low concentration of artificial tears might be better for patients with lipid deficiency.展开更多
AIM: To evaluate the quantitatively changes in lipid layer thickness(LLT) when 3% diquafosol eye drop is used for dry eye patients using the tear film interferometer. METHODS: A total 124 participants(32 males, 92 fem...AIM: To evaluate the quantitatively changes in lipid layer thickness(LLT) when 3% diquafosol eye drop is used for dry eye patients using the tear film interferometer. METHODS: A total 124 participants(32 males, 92 females;mean age, 28.9 y) diagnosed with dry eye disease(DED) received topical instillation of 4 ophthalmic solutions in one eye: diquafosol, normal saline, 0.1% sodium hyaluronate and 0.3% gatifloxacin, in a masked manner. LLT was measured using an interferometer at baseline and 20 min after the instillation of each ophthalmic solutions.RESULTS: Changes of LLT after instillation(nm, mean± standard error) were as follows: 12.6±2.0 for diquafosol(P<0.001), 1.2±2.2 for normal saline(P=0.301), 1.5±2.0 for hyaluronate(P=0.495), and 0.5±3.2 for gatifloxacin(P=0.884).CONCLUSION: Topical instillation of diquafosol increases tear film LLT in DED patients. Diquafosol 3% eye drop might be effective treatment option of evaporative DED with meibomian gland dysfunction.展开更多
AIM： To explore a new diagnostic index for differentiating the evaporative dry eye（EDE） subtypes by analysis of their respective clinical characteristics. METHODS： A cross-sectional study of 139 patients（139 eyes...AIM： To explore a new diagnostic index for differentiating the evaporative dry eye（EDE） subtypes by analysis of their respective clinical characteristics. METHODS： A cross-sectional study of 139 patients（139 eyes） with EDE who were enrolled and classified as obstructive meibomian gland dysfunction（MGD）（n=81） and non-obstructive MGD（n=58） EDE. All patients completed a Standard Patient Evaluation of Eye Dryness（SPEED） questionnaire and were evaluated for average lipid layer thickness（LLT）, tear meniscus height measurements（TMH）, tear break-up time（TBUT）, ocular surface staining score, Schirmer I test（SIT）, lid margin abnormalities, and meibomian gland function and morphology. RESULTS： Age, average LLT, TMH, scores of lid margin abnormalities, meibum quality, meibomian gland loss（MGL）（all P≤0.001）, and TBUT（P=0.03） were all significantly different between obstructive MGD EDE patients and nonobstructive MGD EDE patients. Average LLT in obstructive MGD EDE was correlated with meibomian expressibility（r=-0.541, P≤0.001）, lid margin abnormalities were marginally not significant（r=0.197, P=0.077）, and TMH was correlated with MGL（total MGL： r=0.552, P≤0.001; upper MGL： r=0.438, P≤0.001; lower MGL： r=0.407, P≤0.001）. Average LLT in non-obstructive MGD EDE, was correlated with meibomian expressibility and Oxford staining（r=-0.396, P=0.002; r=-0.461, P≤0.001）. The efficiency of combining average LLT and TMH was optimal, with a sensitivity of 80.2% and a specificity of 74.1%. Obstructive MGD EDE patients had an average LLT≥69 nm and TMH≥0.25 mm, while non-obstructive MGD EDE patients had an average LLT〈69 nm and TMH〈0.25 mm.CONCLUSION： Obstructive MGD EDE and nonobstructive MGD EDE have significantly different clinical characteristics. Combining average LLT and TMH measurements enhanced their reliability for differentiating these two subtypes and provided guidance for offering more precise treatments for EDE subtypes.展开更多
目的:探讨干眼患者角膜荧光素染色后泪膜破裂动态变化和泪膜脂质层动态变化的图像特征及其对干眼的诊断价值。方法:前瞻性研究。选取我院2019-09/2020-12收治的干眼患者66例132眼,根据荧光素染色后泪膜破裂形态的不同分为片状破裂组(17...目的:探讨干眼患者角膜荧光素染色后泪膜破裂动态变化和泪膜脂质层动态变化的图像特征及其对干眼的诊断价值。方法:前瞻性研究。选取我院2019-09/2020-12收治的干眼患者66例132眼,根据荧光素染色后泪膜破裂形态的不同分为片状破裂组(17例28眼)、类圆形破裂组(20例27眼)、线状破裂组(25例28眼)、点状破裂组(21例24眼)和不规则破裂组(20例25眼),比较各组患者泪膜破裂动态变化图像特征、泪膜脂质层动态变化图像特征及泪膜首次破裂时间(NIBUTf)、泪膜平均破裂时间(NIBUTav)、泪河高度(TMH)、角膜荧光素染色(FL)评分的差异。结果:各组患者NIBUTf有差异(P<0.001),除点状破裂组和不规则破裂组间无差异(7.56±1.54s vs 8.02±1.86s,P=0.881),其余各组两两比较均有差异(P<0.05)。各组间NIBUTav有差异(P<0.001),除点状破裂组和不规则破裂组间无差异(9.54±2.12s vs 9.73±1.94s,P=0.997),其余各组两两比较均有差异(P<0.05)。各组间TMH比较有差异(P<0.001),除类圆形破裂组和线状破裂组间无差异(0.16±0.03mm vs 0.17±0.03mm,P=0.986)、点状破裂组和不规则破裂组间无差异(0.22±0.03mm vs 0.21±0.05mm,P=0.993),其余各组两两比较均有差异(P<0.05)。各组患者FL评分和泪膜脂质层分级均有差异(P<0.001)。结论:通过分析荧光素染色泪膜破裂的动态图像和脂质层扩散的动态图像特征,并结合其他泪膜静态检查参数,发现不同荧光素染色泪膜破裂形态可以直观反映干眼患者泪膜各层结构的变化,有助于临床医生识别干眼亚型,这对于干眼的诊断和分类具有潜在的临床价值。展开更多
基金Supported by Provincial Frontier and Key Technology Innovation Special Fund of Guangdong Province(No.2015B020227001)Guangzhou Science and Technology Plan Scientific Research Projects(No.201504010023)Fundamental Research Funds of State Key Laboratory of Ophthalmology of China,and Five Five Cultivation Project of Ophthalmic Center,Sun Yat-sen University
文摘AIM： To investigate the effects of different concentrations of artificial tears on lipid layer thickness （LLT） and blink rate （BR） in dry eye patients. METHODS： This study included 106 eyes of 58 patients with dry eye. The lipid deficiency type was defined as the LLT baseline 〈75 nm. The LLT and BR were measured at baseline and 1, 5 and 15min after the instillation of 0.1% or 0.3% sodium hyaluronate （SH） eye drops by using the LipiView ocular surface interferometer. RESULTS： In the lipid deficiency group, the LLT increased from baseline at 1rain post instillation. The LLT after the instillation of 0.1% SH was significantly higher than that after the instillation of 0.3% SH （P〈0.001）. The LLT returned to baseline at 15min post instillation of 0.1% SH and at 5min post instillation of 0.3% SH. In the non-lipid deficiency group, the LLT decreased from baseline at lmin and returned to baseline at 5rain for both treatments. The BRs were not significantly different at different time points for both treatments. CONCLUSION： SH eye drops induce a short-term increase in LLT of patients with lipid deficiency. A low concentration of artificial tears have a stronger effect than a high concentration of artificial tears on the increase in LLT. in comparison, SH eye drops induce a transient and slight decrease in LLT of patients without lipid deficiency. A low concentration of artificial tears might be better for patients with lipid deficiency.
文摘AIM: To evaluate the quantitatively changes in lipid layer thickness(LLT) when 3% diquafosol eye drop is used for dry eye patients using the tear film interferometer. METHODS: A total 124 participants(32 males, 92 females;mean age, 28.9 y) diagnosed with dry eye disease(DED) received topical instillation of 4 ophthalmic solutions in one eye: diquafosol, normal saline, 0.1% sodium hyaluronate and 0.3% gatifloxacin, in a masked manner. LLT was measured using an interferometer at baseline and 20 min after the instillation of each ophthalmic solutions.RESULTS: Changes of LLT after instillation(nm, mean± standard error) were as follows: 12.6±2.0 for diquafosol(P<0.001), 1.2±2.2 for normal saline(P=0.301), 1.5±2.0 for hyaluronate(P=0.495), and 0.5±3.2 for gatifloxacin(P=0.884).CONCLUSION: Topical instillation of diquafosol increases tear film LLT in DED patients. Diquafosol 3% eye drop might be effective treatment option of evaporative DED with meibomian gland dysfunction.
基金Supported by the Provincial Frontier and Key Technology Innovation Special Fund of Guangdong Province(No.2015B020227001)the Guangzhou Science and Technology Plan Scientific Research Projects(No.201504010023)
文摘AIM： To explore a new diagnostic index for differentiating the evaporative dry eye（EDE） subtypes by analysis of their respective clinical characteristics. METHODS： A cross-sectional study of 139 patients（139 eyes） with EDE who were enrolled and classified as obstructive meibomian gland dysfunction（MGD）（n=81） and non-obstructive MGD（n=58） EDE. All patients completed a Standard Patient Evaluation of Eye Dryness（SPEED） questionnaire and were evaluated for average lipid layer thickness（LLT）, tear meniscus height measurements（TMH）, tear break-up time（TBUT）, ocular surface staining score, Schirmer I test（SIT）, lid margin abnormalities, and meibomian gland function and morphology. RESULTS： Age, average LLT, TMH, scores of lid margin abnormalities, meibum quality, meibomian gland loss（MGL）（all P≤0.001）, and TBUT（P=0.03） were all significantly different between obstructive MGD EDE patients and nonobstructive MGD EDE patients. Average LLT in obstructive MGD EDE was correlated with meibomian expressibility（r=-0.541, P≤0.001）, lid margin abnormalities were marginally not significant（r=0.197, P=0.077）, and TMH was correlated with MGL（total MGL： r=0.552, P≤0.001; upper MGL： r=0.438, P≤0.001; lower MGL： r=0.407, P≤0.001）. Average LLT in non-obstructive MGD EDE, was correlated with meibomian expressibility and Oxford staining（r=-0.396, P=0.002; r=-0.461, P≤0.001）. The efficiency of combining average LLT and TMH was optimal, with a sensitivity of 80.2% and a specificity of 74.1%. Obstructive MGD EDE patients had an average LLT≥69 nm and TMH≥0.25 mm, while non-obstructive MGD EDE patients had an average LLT〈69 nm and TMH〈0.25 mm.CONCLUSION： Obstructive MGD EDE and nonobstructive MGD EDE have significantly different clinical characteristics. Combining average LLT and TMH measurements enhanced their reliability for differentiating these two subtypes and provided guidance for offering more precise treatments for EDE subtypes.
文摘目的:探讨干眼患者角膜荧光素染色后泪膜破裂动态变化和泪膜脂质层动态变化的图像特征及其对干眼的诊断价值。方法:前瞻性研究。选取我院2019-09/2020-12收治的干眼患者66例132眼,根据荧光素染色后泪膜破裂形态的不同分为片状破裂组(17例28眼)、类圆形破裂组(20例27眼)、线状破裂组(25例28眼)、点状破裂组(21例24眼)和不规则破裂组(20例25眼),比较各组患者泪膜破裂动态变化图像特征、泪膜脂质层动态变化图像特征及泪膜首次破裂时间(NIBUTf)、泪膜平均破裂时间(NIBUTav)、泪河高度(TMH)、角膜荧光素染色(FL)评分的差异。结果:各组患者NIBUTf有差异(P<0.001),除点状破裂组和不规则破裂组间无差异(7.56±1.54s vs 8.02±1.86s,P=0.881),其余各组两两比较均有差异(P<0.05)。各组间NIBUTav有差异(P<0.001),除点状破裂组和不规则破裂组间无差异(9.54±2.12s vs 9.73±1.94s,P=0.997),其余各组两两比较均有差异(P<0.05)。各组间TMH比较有差异(P<0.001),除类圆形破裂组和线状破裂组间无差异(0.16±0.03mm vs 0.17±0.03mm,P=0.986)、点状破裂组和不规则破裂组间无差异(0.22±0.03mm vs 0.21±0.05mm,P=0.993),其余各组两两比较均有差异(P<0.05)。各组患者FL评分和泪膜脂质层分级均有差异(P<0.001)。结论:通过分析荧光素染色泪膜破裂的动态图像和脂质层扩散的动态图像特征,并结合其他泪膜静态检查参数,发现不同荧光素染色泪膜破裂形态可以直观反映干眼患者泪膜各层结构的变化,有助于临床医生识别干眼亚型,这对于干眼的诊断和分类具有潜在的临床价值。
