不同年龄段正常人下泪新月的参考值范围

目的：初步估算不同年龄段正常人的下泪新月参数的参考值范围。方法：系列病例研究。收集2015年5月至2016年10月在山西省眼科医院及太原市各大高校学生占职工群体的健康受试者206例（410眼），以每10 岁一个年龄段分为4 组，采用前节光学相干断层扫描（OCT）进行下泪新月参数、中央角膜上皮厚度及中央角膜厚度的测量。采用Spearman秩相关分析下泪新月参数与传统干眼诊断方法之间的相关性，采用95%医学参考值范围的估算确定不同年龄段正常人的下泪新月参数参考值范围。结果：除中央角膜厚度与其他指标无相关性外，其他指标两两之间均存在相关性。其中，下泪新月高度（LTMH）与下泪新月面积（LTMA）和下泪新月深度（LTMD）、LTMA与LTMD之间均呈强正相关性（r=0.981、0.983、0.990，P < 0.001），远高于下泪新月参数与基础泪液分泌试验（SⅠT）、非侵入性平均泪膜破裂时间（NIBUTav）、中央角膜上皮厚度（CCET）之间的相关性（r=2.261～0.409，P < 0.05）。4个年龄组各自的LTMH参考值范围分别为：21～30岁356～441 μm，31～40岁323～378 μm，41～50 岁274～332 μm，51～60 岁232～319 μm；LTMD参考值范围分别为：21～30 岁161～188 μm，31～40 岁139～166 μm，41～50 岁114～138 μm，51～60 岁85～115 μm；LTMA参考值范围分别为：21～30 岁0.031～0.038 mm2，31～40 岁0.027～0.033 mm2，41～50 岁0.023～0.028 mm2，51～60 岁0.013～0.018 mm2。结论：前节OCT测得的下泪新月参数与SⅠT、NIBUTav、CCET之间存在一定的相关性。各个年龄段的下泪新月参数的参考值范围随年龄段递增呈递减趋势。

Application of Anterior Segment OCT in the Measurement of Lower Tear Meniscus Parameters in Different Age Groups of Healthy Individuals

Objective: To estimate a preliminary reference range for lower tear meniscus parameters that apply to different ages of individuals. Methods: A total of 206 healthy subjects (410 eyes) at Shanxi Eye Hospital and Universities were enrolled in this serial-case study. The subjects were divided into 4 groups at ten-year intervals that included all ages of the participants (21 to 60 years of age). The parameters for the lower tear meniscus, central corneal epithelial thickness and central corneal thickness were measured by anterior segment OCT. A Spearman rank correlation analysis was used to analyze the correlation between traditional dry eye diagnostic methods. The values of the reference range of the lower tear meniscusparameters in normal people at different ages were estimated by using the range of 95% medical reference values. Results: Spearman rank correlation analysis showed that there was no correlation between the central corneal thickness and other indicators, but other indicators were correlated with each other. Among them, there was a positive correlation between the and lower tear meniscus height (LTMH) and lower tearmeniscus area (LTMA) (r=0.981, P<0.001), LTMH and lower tear meniscus depth (LTMD) (r=0.983,P<0.001), LTMA and LTMD (r=0.990, P<0.001), and were significantly higher than that of SIT, NIBUTav and central corneal epithelial thickness (r=2.261-0.409, P<0.05). The LTMH reference values of the 4 age groups were: 21-30 years old: 356-441 μm; 31-40 years old: 323-378 μm; 41-50 years old: 274-332 μm; 51-60 years old: 232-319 μm, respectively. The reference range of LTMD were: 21-30 years old: 161-188 μm; 31-40 years old: 139-166 μm; 41-50 years old: 114-138 μm; 51-60 years old: 85-115 μm. The LTMA reference values were 21-30 years old: 0.031-0.038 mm2; 31-40 years old: 0.027-0.033 mm2; 41-50 years old:0.023-0.028 mm2; 51-60 years old: 0.013-0.018 mm2. Conclusions: There is a certain correlationbetween the parameters of SⅠT, NIBUTav and central corneal thickness measured by anterior segment OCT. The reference value range of the lower tear meniscus parameters in different age groups showed a decreasing trend with an increase in age.