干眼对视网膜成像质量的影响  

Impact of dry eye disease on the dynamic retinal image quality

作　　者：胡爱莲[1] 蔡啸谷[1] 万修华[1] 乔利亚[1] 梁庆丰[1] 林仲[1] 管征[1] 谭家璿[1] 王宁利[1] 

机构地区：[1]首都医科大学附属北京同仁医院北京同仁眼科中心北京市眼科研究所眼科学与视觉科学北京市重点实验室,100730

出　　处：《中华眼视光学与视觉科学杂志》2015年第9期533-537,共5页Chinese Journal Of Optometry Ophthalmology And Visual Science

摘　　要：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 imag

关 键 词：干眼病 泪膜 调制传递函数 视觉质量 视觉相关生存质量 

分 类 号：R777.34[医药卫生—眼科]