CAJ | 학술논문

目的比较干眼患者与健康人眼视网膜成像质量的差异.方法前瞻性队列研究.连续收集北京同仁医院眼科门诊无眼部器质性病变的轻度于眼患者22例(22眼),对照组20例(20眼),进行视觉相关生存质量[眼表疾病指数(OSDI)问卷]、基础泪液分泌(Schirmer Ⅰ)试验、角膜荧光染色、泪膜破裂时间(BUT)等检查.使用双通道客观视觉质量分析系统(OQASⅡ)以0.5 s为时间间隔,在6 mm瞳孔直径下测量患者自然瞬目后10 s的调制传递函数(MTF)截止频率动态变化.对于同一组患者不同时间点的数据通过Greenhouse-Geisser(G-G)法校正后,采用重复测量方差分析比较.比较干眼组与对照组瞬目后10 s不同时间段的MTF截止频率均值和MTF截止频率进展指数并作Spearman相关性分析.结果对照组/干眼组的平均BUT为(10.80±1.61)s/(3.36±1.26)s (t=-12.27,P＜0.01);Schirmer Ⅰ试验为(12.75±3.89)mm/(7.95±2.52)mm(t=-2.74,P＜0.01);OSDI评分为12.86±9.71/30.96±15.45(t=4.42,P＜0.01).2组瞬目后0.0～2.5 s、＞2.5～5.0 s、＞5.0～7.5 s、＞7.5～10.0 s MTF截止频率均值分别为对照组(21.23±9.38)、(20.98±8.72)、(21.12±9.38)、(20.11±8.28)c/d,干眼组(26.20±16.09)、(24.60±15.99)、(24.24±15.83)、(23.20±15.05)c/d,组间比较结果显示,2组患者在瞬目后相同时间段的MTF截止频率均值差异均无统计学意义;重复测量方差分析结果显示干眼组瞬目后4个时间段的组内MTF截止频率均值差异具有统计学意义(F=14.49,P＜0.01),对照组结果差异无统计学意义.MTF截止频率进展指数与性别(r=0.46,P＜0.01)、logMAR最佳矫正视力(r=0.33,P＜O.05)、BUT(r=0.34,P＜0.05)呈正相关;与OSDI功能影响(r=-0.36,P＜0.05)和OSDI总得分呈负相关(r=-0.31,P＜0.05).结论干眼患者与正常人相比,瞬目后单位时间内的视网膜成像质量下降幅度较大,并与患者的BUT和对日常活动影响程度相关.
목적 비교간안환자여건강인안시망막성상질량적차이.방법 전첨성대렬연구.련속수집북경동인의원안과문진무안부기질성병변적경도우안환자22례(22안),대조조20례(20안),진행시각상관생존질량[안표질병지수(OSDI)문권]、기출루액분비(Schirmer Ⅰ)시험、각막형광염색、루막파렬시간(BUT)등검사.사용쌍통도객관시각질량분석계통(OQASⅡ)이0.5 s위시간간격,재6 mm동공직경하측량환자자연순목후10 s적조제전체함수(MTF)절지빈솔동태변화.대우동일조환자불동시간점적수거통과Greenhouse-Geisser(G-G)법교정후,채용중복측량방차분석비교.비교간안조여대조조순목후10 s불동시간단적MTF절지빈솔균치화MTF절지빈솔진전지수병작Spearman상관성분석.결과 대조조/간안조적평균BUT위(10.80±1.61)s/(3.36±1.26)s (t=-12.27,P＜0.01);Schirmer Ⅰ시험위(12.75±3.89)mm/(7.95±2.52)mm(t=-2.74,P＜0.01);OSDI평분위12.86±9.71/30.96±15.45(t=4.42,P＜0.01).2조순목후0.0～2.5 s、＞2.5～5.0 s、＞5.0～7.5 s、＞7.5～10.0 s MTF절지빈솔균치분별위대조조(21.23±9.38)、(20.98±8.72)、(21.12±9.38)、(20.11±8.28)c/d,간안조(26.20±16.09)、(24.60±15.99)、(24.24±15.83)、(23.20±15.05)c/d,조간비교결과현시,2조환자재순목후상동시간단적MTF절지빈솔균치차이균무통계학의의;중복측량방차분석결과현시간안조순목후4개시간단적조내MTF절지빈솔균치차이구유통계학의의(F=14.49,P＜0.01),대조조결과차이무통계학의의.MTF절지빈솔진전지수여성별(r=0.46,P＜0.01)、logMAR최가교정시력(r=0.33,P＜O.05)、BUT(r=0.34,P＜0.05)정정상관;여OSDI공능영향(r=-0.36,P＜0.05)화OSDI총득분정부상관(r=-0.31,P＜0.05).결론 간안환자여정상인상비,순목후단위시간내적시망막성상질량하강폭도교대,병여환자적BUT화대일상활동영향정도상관.
Objective To compare the dynamic ocular modulation transfer function (MTF) between normal and dry eye disease (DED) patients, to determine the associations between dry eye related examinations and ocular optical performance.Methods In a prospective cohort study, 22 eyes of 22 dry eye patients (DED group) and 20 eye of 20 normal subjects (control group) were consecutively enrolled from outpatient clinic in Beijing Tongren Hospital.Series of consecutive MTFcutoff frequency at 6-mm pupil was derived from dynamic retinal images obtained by a double-pass system (OQAS Ⅱ, Spain, Visiometrics) after a blink (0-10 s).Vision-related quality of life was evaluated using the ocular surface disease index (OSDI) questionnaire.The clinical examination included tear film assessment [tear film break-up time (BUT) and Schirmer Ⅰ test] and corneal fluorescence staining.Mean value of MTFcutoff in different time stages after blink and MTFcutoff progress index were compared between groups and analyzed the related factors.Results The BUT of DED/control group were 3.36±1.26 s/10.80±1.61 s (t=-12.27, P＜0.01).Schirmer Ⅰ test were 7.95±2.52 mm/12.75±3.89 mm (t=-2.74, P＜0.01);OSDI score were 30.96±15.45/12.86±9.71 (t=4.42, P＜0.01).The mean MTFcutoff values of 0.0-2.5 s, ＞2.5-5 s, ＞5.0-7.5 s, ＞7.5-10 s after blink were 26.20±16.09, 24.60±15.99, 24.24±15.83, 23.20±15.05 (F=14.49, P＜0.01) in DED group, 21.23±9.38, 20.98±8.72, 21.12±9.38, 20.11±8.28 (F=1.54, P＞0.05) in control group.The MTFcutoff progression index of DED/control group were-0.36±0.38/-0.10±0.37 (t=-2.16, P＜0.05).MTFcutoff progression index was statistically significant positive correlative with gender (r=0.46, P＜0.01), BCVA (r=0.33, P＜0.05), and BUT (r=0.34, P＜ 0.05), negative correlative with OSDI vision-related activities of daily living (r=-0.36, P＜0.05) and OSDI overall averaged score (r=-0.31, P＜0.05).Conclusion Progressive degradation of retinal image quality is significant worse in DED eyes compared with normal, which is related with both the BUT and vision-related quality of life.