睑板腺功能障碍患者的视觉质量分析

目的 运用双通道视觉质量分析仪(optical quality analysis system,OQAS-Ⅱ)观察睑板腺功能障碍(meibomian glanddysfunction,MGD)患者的视觉质量,为其临床应用提供依据.方法 50例(50眼)MGD患者按照是否伴随干眼症状分为MGD干眼组(22眼)和MGD非干眼组(28眼),同时选取25名(25眼)健康志愿者为对照组.利用OQAS-Ⅱ检测并比较3组受试者自然状态下的视觉质量:调制传递函数截止频率(modulation transfer function cutoff,MTF cutoff)、斯特列尔比值(Strehl ratio,SR)、客观散射指数(objectivescattering index,OsI).所有受试对象均行睑板腺相关检查(睑缘形态评分、睑板腺挤压评分、睑板腺分泌物性状评分)和泪液相关检查.对3组受试对象的测量结果进行比较,同时检测指标间的相关性.结果 3组受试对象的MTF cutoff、SR、OSI差异均有统计学意义(均为P＜0.05).MGD非干眼组的MTF cutoff和SR分别为(31.36±1.83)e· deg-1和0.21 +0.02,均较对照组的(35.87±1.59)c·deg-1和0.23±0.03显著降低,OSI为0.57±0.06,较对照组的0.45±0.06显著提高(均为P＜0.05);MGD干眼组的MTF cutoff和SR分别为(27.87±3.08)c·deg-1和0.16±0.02,均较MGD非干眼组显著降低,OSI为0.72±0.10,较MGD非干眼组显著提高(均为P＜0.05).MGD患者的OSI、MTF cutoff、SR与泪膜破裂时间、泪液分泌量、睑板腺相关检查数据间均无相关性(均为P＞0.05).结论 OQAS-Ⅱ检测发现MGD患者的视觉质量参数发生变化,且MGD干眼患者较MGD非干眼患者变化更明显.MGD非干眼患者视觉质量的下降应当引起临床医师的重视.

Evaluation of visual quality in patients with meibomian gland dysfunction

Objective To evaluate the optical quality in patients with meibomian gland dysfunction (MGD) by using double-pass optical quality analysis system (OQAS-Ⅱ) for offering the reference data for clinical practices.Methods A total of 50 patients with a diagnosis of MGD,who were divided into MGD with dry eye disease (DED) group (n =22) and MGD without DED group (n =28) according to the results of tear film break-up time (BUT) and Schirmer I test (SIT),and another 25 healthy subjects were enrolled in this study.Then several parameters,including modulation transfer function cutoff (MTF cutoff),Strehl ratio (SR) and objective scattering index (OSI),were measured to evaluate the optical quality by using OQAS-Ⅱ.Additional clinical examination,including meibomian gland and tear film assessment were per formed and compared between the three groups.In addition,a correlation analysis was conducted among OSI,MTF cutoff,SR,BUT,SIT and meibomian gland assessment.Results Statistical differences were approached in MTF cutoff,SR,OSI of the three groups (all P ＜ 0.05).The MTF cutoff and SR in MGD without DED group were significantly lower than those in the control group (31.36 + 1.83) c · deg-1 vs.(35.87 ± 1.59)c·deg-1,(0.21 +0.02) vs.(0.23 ±0.03)],but the OSI got higher (0.57+ 0.06) vs.(0.45 ±± 0.06)] (all P ＜ 0.05).The SR and MTF cutoff in MGD patients with DED was significantly lower than those in MGD patients without DED (27.87 ±± 3.08),c·deg-1 vs.(31.36±±1.83)c· deg-1,(0.16 ±±0.02) vs.(0.21 ± 0.02)],but OSIgot significantly higher (0.72 ± 0.10) vs.(O.57 ± 0.06)] (all P ＜ 0.05).Among the three groups,OSI,MTF cutoff and SR showed no significant correlation with BUT,SIT and meibomian gland assessment (all P ＞ 0.05).Conclusion There is changes in visual quality parameters in MGD patients by OQAS-Ⅱ,and MGD with DED patients has significant changes than MGD patients without DED.