背景 干眼是常见的眼表疾病,光学相干断层扫描(OCT)前节模块可实现对泪河进行直接和精确的检测. 目的 用OCT前节模块对上下泪河进行测量,并分析测量结果与干眼症状和体征的相关性.方法 采用回顾性系列病例观察方法,收集2010年9-10月在北京大学第一医院眼科就诊的符合眼表疾病指数问卷(OSDI)评分＞20分的干眼患者36例,使用OCT前节模块测量平视状态时上下泪河的高度(U/LTMH,μm)、深度(U/LTMD,μm)和泪三角面积(U/LMA,mm2);对患者行泪膜干涉成像仪、泪膜破裂时间(BUT)、角膜荧光素钠(Fl)染色、结膜丽丝胺绿染色、Schirmer Ⅰ试验(SⅠt)检查.采用Spearman秩相关分析法评估OCT前节模块测量的泪河参数与患者干眼相关症状体征之间的相关性. 结果 本组患者平均UTMH为(232±56) μm,平均UTMD(156±53)μm,平均UMA为(0.021±0.008) mm2,LTMH平均为(222±72) μm,平均LTMD为(163±65) μm,平均LMA为(0.020±0.006) mm2,测量的上下泪河高度、深度接近,差异均无统计学意义(目河高度:t=0.530,P＞0.05;泪河深度:t=0.650,P＞0.05;泪河高度:t=1.010,P＞0.05).泪河各参数与OSDI评分、泪膜干涉分析成像仪分析结果间无明显相关性;UTMH、UTMD、UMA与BUT均呈正相关(r=0.46,P=0.01;r=0.40,P=0.02;r=0.43,P=0.01);LTMH、LTMD、LMA与BUT均呈正相关(r=0.61,P=0.00;r=0.64,P=0.00;r=0.64,P=0.00),与SⅠt结果均呈正相关(r=0.54,P=0.02;r=0.46,P=0.01;r=0.55,P=0.01),而与角膜荧光素染色评分均呈负相关(r=-0.37,P=0.04;r=-0.37,P=0.04;r=-0.41,P=0.05),与结膜染色评分亦均呈负相关(r=-0.56,P=0.01;r=-0.37,P=0.04;r=-0.47,P=0.00).结论 OCT前节模块可用于对上下泪河进行客观和非侵入性测量,其测量结果与BUT、角膜荧光素钠染色、结膜丽丝胺绿染色和SⅠt结果均有相关性,可作为干眼诊断的有效辅助工具.
揹景 榦眼是常見的眼錶疾病,光學相榦斷層掃描(OCT)前節模塊可實現對淚河進行直接和精確的檢測. 目的 用OCT前節模塊對上下淚河進行測量,併分析測量結果與榦眼癥狀和體徵的相關性.方法 採用迴顧性繫列病例觀察方法,收集2010年9-10月在北京大學第一醫院眼科就診的符閤眼錶疾病指數問捲(OSDI)評分＞20分的榦眼患者36例,使用OCT前節模塊測量平視狀態時上下淚河的高度(U/LTMH,μm)、深度(U/LTMD,μm)和淚三角麵積(U/LMA,mm2);對患者行淚膜榦涉成像儀、淚膜破裂時間(BUT)、角膜熒光素鈉(Fl)染色、結膜麗絲胺綠染色、Schirmer Ⅰ試驗(SⅠt)檢查.採用Spearman秩相關分析法評估OCT前節模塊測量的淚河參數與患者榦眼相關癥狀體徵之間的相關性. 結果 本組患者平均UTMH為(232±56) μm,平均UTMD(156±53)μm,平均UMA為(0.021±0.008) mm2,LTMH平均為(222±72) μm,平均LTMD為(163±65) μm,平均LMA為(0.020±0.006) mm2,測量的上下淚河高度、深度接近,差異均無統計學意義(目河高度:t=0.530,P＞0.05;淚河深度:t=0.650,P＞0.05;淚河高度:t=1.010,P＞0.05).淚河各參數與OSDI評分、淚膜榦涉分析成像儀分析結果間無明顯相關性;UTMH、UTMD、UMA與BUT均呈正相關(r=0.46,P=0.01;r=0.40,P=0.02;r=0.43,P=0.01);LTMH、LTMD、LMA與BUT均呈正相關(r=0.61,P=0.00;r=0.64,P=0.00;r=0.64,P=0.00),與SⅠt結果均呈正相關(r=0.54,P=0.02;r=0.46,P=0.01;r=0.55,P=0.01),而與角膜熒光素染色評分均呈負相關(r=-0.37,P=0.04;r=-0.37,P=0.04;r=-0.41,P=0.05),與結膜染色評分亦均呈負相關(r=-0.56,P=0.01;r=-0.37,P=0.04;r=-0.47,P=0.00).結論 OCT前節模塊可用于對上下淚河進行客觀和非侵入性測量,其測量結果與BUT、角膜熒光素鈉染色、結膜麗絲胺綠染色和SⅠt結果均有相關性,可作為榦眼診斷的有效輔助工具.
배경 간안시상견적안표질병,광학상간단층소묘(OCT)전절모괴가실현대루하진행직접화정학적검측. 목적 용OCT전절모괴대상하루하진행측량,병분석측량결과여간안증상화체정적상관성.방법 채용회고성계렬병례관찰방법,수집2010년9-10월재북경대학제일의원안과취진적부합안표질병지수문권(OSDI)평분＞20분적간안환자36례,사용OCT전절모괴측량평시상태시상하루하적고도(U/LTMH,μm)、심도(U/LTMD,μm)화루삼각면적(U/LMA,mm2);대환자행루막간섭성상의、루막파렬시간(BUT)、각막형광소납(Fl)염색、결막려사알록염색、Schirmer Ⅰ시험(SⅠt)검사.채용Spearman질상관분석법평고OCT전절모괴측량적루하삼수여환자간안상관증상체정지간적상관성. 결과 본조환자평균UTMH위(232±56) μm,평균UTMD(156±53)μm,평균UMA위(0.021±0.008) mm2,LTMH평균위(222±72) μm,평균LTMD위(163±65) μm,평균LMA위(0.020±0.006) mm2,측량적상하루하고도、심도접근,차이균무통계학의의(목하고도:t=0.530,P＞0.05;루하심도:t=0.650,P＞0.05;루하고도:t=1.010,P＞0.05).루하각삼수여OSDI평분、루막간섭분석성상의분석결과간무명현상관성;UTMH、UTMD、UMA여BUT균정정상관(r=0.46,P=0.01;r=0.40,P=0.02;r=0.43,P=0.01);LTMH、LTMD、LMA여BUT균정정상관(r=0.61,P=0.00;r=0.64,P=0.00;r=0.64,P=0.00),여SⅠt결과균정정상관(r=0.54,P=0.02;r=0.46,P=0.01;r=0.55,P=0.01),이여각막형광소염색평분균정부상관(r=-0.37,P=0.04;r=-0.37,P=0.04;r=-0.41,P=0.05),여결막염색평분역균정부상관(r=-0.56,P=0.01;r=-0.37,P=0.04;r=-0.47,P=0.00).결론 OCT전절모괴가용우대상하루하진행객관화비침입성측량,기측량결과여BUT、각막형광소납염색、결막려사알록염색화SⅠt결과균유상관성,가작위간안진단적유효보조공구.
Background Dry eye is the most common ocular surface disease.Anterior segment pattern of optical coherent tomography (OCT) is able to be used to assess the tear meniscus directly and accurately.Objective This study was to evaluate the correlation between measuring outcomes of tear meniscus by anterior segment module of OCT with signs and symptoms of dry eye.Methods A retrospective serial cases-observational study was designed.Thirty-six patients who completed Ocular Surface Disease Index (OSDI) and got a score more than 20 were enrolled in the First Hospital of Peking University from September to October,2010 under the informed consent.The upper and lower tear meniscus height (U/LTMH,μm),depth (U/LTMD,μm) and cross sectional area (U/LMA,mm2) were measured with the anterior segment module of OCT (RTVue.pitch).A series of clinical tests were performed,including tear film interferometry,break-up time (BUT),fluorescein corneal staining,lissamine green conjunctival staining and Schirmer Ⅰ test (S Ⅰ t).The correlations of measuring outcomes of tear meniscus by anterior segment module of OCT with dry eye-related examinations were analyzed with Spearman correlation coefficients.Results The values of UTMH,UTMD,UMA were (232±56) μm,(156±53) μm,(0.021 ±0.008) mm2,respectively,and the values of LTMH,LTMD,LMA were (222 ± 72) μm,(163 ± 65) μm,(0.020 ± 0.006) mm2,respectively.No significant differences were found in the measuring values between the upper and the lower tear meniscus (all at P＞0.05).The quantitative values of tear meniscus were not significantly correlated with the OSDI scores or tear film interferometry grade.Significant correlations were seen between UTMH,UTMD,UMA and BUT (r=0.46,P=0.01 ;r=0.40,P=0.02;r=0.43,P=0.01).LTMH,LTMD,LMA were positively correlated with BUT (r=0.61,P=0.00;r=0.64,P=0.00;r=0.64,P=0.00) and S Ⅰ t (r=0.54,P=0.02 ;r=0.46,P=0.01;r=0.55,P=0.01) as well as negatively correlated with fluorescein cornealstaining (r=-0.37,P=0.04;r=-0.37,P=0.04;r=-0.41,P =0.05) and lissamine green conjunctival staining (r =-0.56,P =0.01 ; r =-0.37,P =0.04 ; r =-0.47,P =0.00).Conclusions Anterior segment module of OCT is an effective approach to the measurement of tear meniscus.The measuring outcomes of anterior segment of OCT are associated with dry eye-related signs.
