[1]席雷,张琛,赵少贞. 视频终端干眼患者眼表及睑板腺的分析[J].眼科新进展,2015,35(7):670-673.[doi:10.13389/j.cnki.rao.2015.0183]
　XI Lei,ZHANG Chen,ZHAO Shao-Zhen. Analysis of ocular surface and meibomian glands in visual display terminal dry eye patients[J].Recent Advances in Ophthalmology,2015,35(7):670-673.[doi:10.13389/j.cnki.rao.2015.0183]
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 视频终端干眼患者眼表及睑板腺的分析
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《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
35卷
期数:
2015年7期
页码:
670-673
栏目:
应用研究
出版日期:
2015-07-05

文章信息/Info

Title:
 Analysis of ocular surface and meibomian glands in visual display terminal dry eye patients
作者:
 席雷; 张琛; 赵少贞
 300384　天津市，天津医科大学眼科医院，天津医科大学眼科研究所，天津医科大学眼视光学院
Author(s):
 XI Lei; ZHANG Chen ; ZHAO Shao-Zhen
 Eye Hospital of Tianjin Medical University,Tianjin Medical University Eye Institute,School of Optometry and Ophthalmology, Tianjin Medical University,Tianjin 300384,China
关键词:
 ; 视频终端; 干眼; 睑板腺; 眼表
Keywords:
 ; visual display terminal;  dry eye ; meibomian gland ;  ocular surface
DOI:
10.13389/j.cnki.rao.2015.0183
文献标志码:
A
摘要:
 目的　探讨睑板腺腺体缺失和睑板腺脂质排出难易程度在年轻视频终端干眼患者眼部不适症状中的作用。方法　选择２０１４年１０月至２０１５年１月就诊于天津医科大学眼科医院屈光角膜门诊临床诊断为视频终端干眼的患者５０例（１００眼）。根据视频时间分为２组：短视频组（每天≤４ｈ）２８例、长视频组（每天＞４ｈ）２２例。根据眼表疾病评分指数（ｏｃｕｌａｒｓｕｒｆａｃｅｄｉｓ-ｅａｓｅｉｎｄｅｘ，ＯＳＤＩ）分为２组：轻、中度症状组（１３．０≤ＯＳＤＩ≤３２．５）３０例，重度症状组（３２．５＜ＯＳＤＩ≤１００．０）２０例。利用眼表分析仪及裂隙灯显微镜分别进行泪河高度、泪膜破裂时间、睑板腺、角膜荧光素染色及睑板腺脂质排出状况的评估。根据数据的正态分布和方差齐性，采用两独立样本ｔ检验。结果　长视频组与短视频组ＯＳＤＩ分别为２８．１５±１１．２８、２２．９３±９．７５，泪膜破裂时间分别为（５．８４±１．９５）ｓ、（４．７５±１．５９）ｓ，角膜荧光素染色评分分别为３．０８±１．７０、２．２１±２．０２，睑板腺缺失等级分别为２．５０±１．１１、１．８９±０．９１，睑板腺脂质排出难易度评分分别为２．１１±０．８０、１．７５±０．８６，两组间差异均有统计学意义（均为Ｐ＜０．０５）。长视频组与短视频组泪河高度分别为（０．１９±０．０４）ｍｍ、（０．２０±０．０４）ｍｍ，差异无显著性（Ｐ＝０．０６９）。严重症状组与轻、中度症状组的泪膜破裂时间［（４．６８±１．７７）ｓ、（５．６１±１．８１）ｓ］、角膜荧光素染色评分（３．５０±１．５０、２．１０±２．０１）、睑板腺缺失等级（２．４８±１．０１、２．０５±１．０３）及睑板腺脂质排出难易度评分（２．２３±０．６２、１．８０±０．９０）相比差异均有统计学意义（均为Ｐ＜０．０５），严重症状组与轻、中度症状组的泪河高度分别为（０．１９±０．０５）ｍｍ、（０．２０±０．０４）ｍｍ，差异无显著性（Ｐ＝０．４２８）。睑板腺缺失与ＯＳＤＩ评分及角膜荧光素染色评分呈正相关（ｒ＝０．２２２，Ｐ＝０．０２６；ｒ＝０．２４１，Ｐ＝０．０１６）；睑板腺脂质排出难易程度与ＯＳＤＩ评分及角膜荧光素染色评分呈正相关（ｒ＝０．２０５，Ｐ＝０．０４１；ｒ＝０．３１１，Ｐ＝０．００２）。结论　视频终端干眼患者泪液量与视频时间和眼部症状严重程度无显著相关性。睑板腺缺失及睑板腺脂质排出难度增加可能是引起视频终端干眼眼部不适的重要因素。
Abstract:
 Objective To evaluate the role of meibomian gland dropout and expression of meibum in symptoms of young visual display terminal ( VDT) dry eye patients. Methods Fifty clinically diagnosed VDT dry eye patients (100 eyes) were enrolled between October 2014 and January 2015 in refractive and corneal outpatient of Tianjin Medical University Eye Hospital. All volunteers were divided into two groups ,28 volunteers of short time VDT group ( per day《 4 hours) and 22 volunteers of long time VDT group ( per day > 4 hours ) . All volunteers were further classified into two groups according to the ocular surface disease index ( OSDI) score,30 volunteers of mild to moderate symptomatic ( 13. 0≤ OSDI≤ 32. 5 ) group ,20 volunteers of severe symptomatic ( 32. 5 < OSDI≤ 100. 0) group. Tear river height , tear film break-up time .meibonuan gland dropout , corneal fluorescein staining and expression of meibum were visualized by meibography and slit lamp microscope. Results OSDI in long time VDT group and short time VDT group were 28. 15 + 11. 28 ,22. 93 + 9. 75 . tear film break-up time were (5. 84 + 1. 95 ) s, (4. 75 + 1. 59) s, corneal fluorescein staining score were 3. 08 + 1. 70. 2. 21+ 2. 02. meibonuan gland dropout degree were 2. 50 + 1. 11, 1. 89 + 0. 91, and meibum expression assessment score were 2. 11 +0. 80 . 1. 75 + 0. 86 ( all P < 0. 05 ) . The tear river height in long time VDT group and short time VDT group were (0. 19 +0. 04 ) mm and (0. 20 +0. 04) mm (P = 0. 069) . BUT in severe symptomatic group and mild to moderate symptomatic group were ( 4. 68 + 1. 77 ) s . ( 5. 61 + 1. 81 ) s . corneal fluorescein staining score were 3. 50 + 1. 50 ,2. 10 + 2. 01 . meibomian gland dropout degree were 2. 48 + 1. 01 .2. 05 + 1. 03 , and meibum expression assessment score were 2. 23 +0. 62 . 1. 80 +0. 90 ( all P < 0. 05 ) , while the tear river height were ( 0. 19 + 0. 05 ) mm , ( 0. 20 + 0. 04 ) mm ( P = 0. 428 ) . Meibomian gland dropout degree was positively correlated with OSDI score ( r = 0. 222 . P = 0. 026) and corneal fluorescein staining score ( r = 0. 241 .P = 0. 016 ) . Meibum expression was positively correlated with OSDI score ( r = 0. 205 ,P = 0. 041 ) and corneal fluorescein stairung score ( r = 0. 311 ,P = 0. 002 ) . Conclrision There is no significant correlation between tear volume and degree of ocular surface symptoms in VDT dry eye patients. Meibomian gland dropout and increased difficulty of meibum expression might be important factors in causing dry eye discomfort.

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更新日期/Last Update: 2015-07-03