眼表综合分析仪联合角膜激光共聚焦显微镜检查对睑缘炎相关性角结膜病变 45例的价值

目的应用眼表综合分析仪和角膜激光共聚焦显微镜( IVCM)探讨睑缘炎相关性角结膜病变( BKC)病人角膜细胞密度和眼表功能的变化及与蠕形螨感染的关系。方法选取 2020年 9月至，2022年 3月就诊于沧州市中心医院的 45例 BKC病人为观察组，同期的健康志愿者 45例为对照组。根据观察组是否感染蠕形螨，分为蠕形螨感染组和未感染组。对所有研究对象使用眼表综合分析仪和 IVCM进行检查，收集观察组和对照组的非侵入式平均泪膜破裂时间( NITBUTav)、非侵入式首次泪膜破裂时间( NIBUTf)、角膜荧光素染色( FL)评分、泪液分泌试验( SⅠt)、蠕形螨感染情况和角膜细胞密度。 Pearson相关性分析蠕形螨感染数量与病人角膜细胞密度及眼表功能的相关性。结果观察组的 NITBUTav［( 6.31±2.95)s比( 14.85±3.88)s］和 NIBUTf［( 4.65±2.03)s比( 11.88±3.14)s］低于对照组， FL评分高于对照组( P<0.05)。观察组蠕形螨感染阳性率高于对照组，央角膜浅基质层的细胞密度低于对照组( P<0.05)。观察组下方角膜基底细胞层和浅基质层的细胞密度低于对照组( P<0.05)。中蠕形螨感染组的 FL评分高于未感染组，下方角膜基底细胞层、浅基质层和中央角膜浅基质层的细胞密度低于未感染组( P<0.05)。蠕形螨感染数量与 BKC病人下方角膜基底细胞层、浅基质层和中央角膜浅基质层的细胞密度呈负相关，与 FL评分呈正相关(均 P<0.05)。结论眼表综合分析仪联合 IVCM可对 BKC病人的眼表损害进行综合评价； BKC病人下方角膜基底细胞层、浅基质层和中央角膜浅基质层的细胞密度降低， FL评分增加，与蠕形螨感染数量增多有关。

Clinical application of the ocular surface analyzer and in vivo confocal microscopy in blepharokeratoconjunctivitis

Objective To explore the changes of corneal cell density and ocular surface function and the relationship with demodexinfection in Blepharokeratoconjunctivitis (BKC) patients by ocular surface analyzer and in vivo confocal microscopy (IVCM).Methods Forty-five BKC patients were collected as the observation group ,while 45 healthy volunteers in the same period were selected as thecontrol group in Cangzhou Central Hospital from September 2020 to March 2022. Patients of the observation group were assigned intoinfected group and uninfected group according to whether they were infected with demodex.All subjects were examined by ocular surface analyzer and IVCM. Average non-invasive tear break-up time (NITBUTav), non-invasive first tear break-up time (NIBUTf), fluorescein staining (FL), SchirmerⅠtest (SⅠt), demodex infection and corneal cell density were collected in both observation group and control group. Pearson correlation was used to analyze the correlation between the number of demodex infection, the density of cornealcells and ocular surface function.Results The NITBUTav [(6.31±2.95) s vs. (14.85±3.88) s] and NIBUTf [(4.65±2.03) s vs. (11.88±3.14) s] of the observation group was lower than those of the control group, and the FL score was higher in the observation group thanthe control group (P<0.05). The positive rate of demodex infection in the observation group was higher than that of the control group.Compared with the control group, the cell density in the central superficial stromal layer was lower in the observation group (P<0.05).The cell density in the basal cell layer and the superficial stromal layer of the lower cornea in the observation group was lower thanthose of the control group (P < 0.05). The FL score of the demodex infected group was higher than that of the uninfected group. The cell density in the basal cell layer and the superficial stromal layer of the lower cornea and the central superficial stromal layer in the infected group was lower than those of the uninfected group (P < 0.05). Pearson correlation analysis results showed that the number of demodex infection was negatively correlated with the cell density in the basal cell layer and the superficial stromal layer of the lower corneaand the central superficial stromal layer in BKC patients and positively correlated with FL score (both P < 0.05).Conclusions The ocular surface analyzer combined with IVCM can provide a comprehensive evaluation of the ocular surface damage in BKC patients. Thecell density in the basal cell layer and the superficial stromal layer of the lower cornea and the central superficial stromal layer are decreased and the FL score is increased in BKC patients, which is associated with the increased number of demodex infection.