视屏终端的使用对人泪膜及眼表的影响及非侵人性眼表综合分析仪的应用价值  

Influence of watching video display terminal on ocular surface and application of non-invasive ocular surface analyzer

作　　者：熊婵[1] 刘珍凯 纪开宝 喻理[1] 古学军[1] 张旭[1] 

机构地区：[1]南昌大学附属眼科医院江西省眼科学和视觉科学研究所江西省眼科学重点实验室,330006

出　　处：《中华实验眼科杂志》2016年第5期443-447,共5页Chinese Journal Of Experimental Ophthalmology

基　　金：国家自然科学基金项目（81271425、81260148）

摘　　要：背景目前，视屏终端已广泛用于人们的工作和生活中，其对眼表健康的影响受到关注，而临床上对眼表的健康评估和干眼的早期诊断尚有一定的困难。以往对眼表的检查以侵入性方法为主，影响检查结果的客观性。近年来，非侵入性眼表综合分析仪已用于临床，其在对视屏终端使用者眼表健康状况的评估方面的研究尚少。目的使用Keratograph5M非侵入性眼表综合分析仪观察青年人长时间注视视屏终端对泪膜及眼表的影响。方法采用前瞻性干预性研究方法，于2015年3月1日至11月10日在南昌大学附属眼科医院纳入健康志愿者81人，其中男39人，女42人；年龄18～30岁，均取右眼为受试眼。受试者在自然光线和屈光矫正状态下观看和操作计算机上的同一个视频，距离计算机显示屏约3013m，使用Keratograph5M非侵人性眼表综合分析仪分别测定受试者计算机操作前后右眼非侵入性泪膜破裂时间（NITBUT）、泪河高度、结膜充血评分、角膜缘充血评分、睑板腺和泪膜脂质层等，比较计算机操作前后各项检查指标的差异和出现眼表异常的眼数。结果受试者持续操作计算机3h后出现视物疲劳、干涩感、眼胀痛、视物模糊和结膜充血的眼数明显多于试验前，差异均有统计学意义（均P〈0．01）。受试眼计算机操作后首次N1TBUT、平均NITBUT分别为（6．086±3．701）8和（9．103±4．680）s，明显低于试验前的（11．445±4．964）s和（14．626±4．467）s；操作后受试眼泪河高度为（0．190±0．032）mm，明显低于受试前的（0．212±0．040）mm；操作后结膜充血评分和角膜缘充血评分分别为0．869±0．311和0．572±0．276，均分别高于受试前的0．780_±0．306和0．509±0．266，差异均有统计学意义（均P〈O．01），而试验前后眼压变化及不同级别角膜荧光素染色眼数分布、不同形态睑板腺眼数分布�Background The incidence of dry eye is increasing among young adults because of wide usage of video display terminal. But the early diagnosis of dry eye still presents challenge to medical practitioners. The accurate diagnosis and treatment of the dry eye, therefore, is a topic of high interest to researchers. Previous examination outcome of dry eye is interferred primarily due to invasive procedure. It is very important to search an examination approach. Objective This study was to use Keratograph 5M,a non-invasive ocular surface analyzer to evaluate the influence of watching video display terminal on ocular surface and tear film. Methods Eighty-one eyes of 81 health volunteers among 18-30 years were enrolled in Affiliated Eye Hospital of Nanchang University from March 1,2015 to November 10,2015 under the informed consent,including 39 males and 42 females. The subjects watched the computer for continuously 3 hours under the nature light, and ocular surface related examinations were performed and compared before and after video display terminal exposure,including non-invasive tear film break-up time （NITBUT）, tear meniscus height, conjunctival hyperemia scoring,limbal congestion scoring, corneal fluoresceinstaining scoring, meibomian gland imaging and lipid layer analysis. Results The number of eyes with visual fatigue, dryness, pain, blurring and conjunctival congestion was significantly increased after 3-hour video display terminal exposure in comparison with before （all at P〈0. 01 ）. The initial NITBUT and mean NITBUT were （6. 086±3. 701）s and （9.103±0.680） s, and tear meniscus height was （0.190±0.032） mm after trail, which were significantly lower than （ 11. 445±4. 964）s, （ 14. 626±0. 467）s and （0. 212±0. 040）ram of before trail,respectively; The conjunctical hyperemia scoring and limbal congestion scoring were 0. 869±0. 311 and 0. 572±0. 276 after trial, which were significantly higher than 0. 780 ±0. 306 and 0. 509 ±0. 266 before trail, showing significant differe

关 键 词：角膜病/诊断 泪膜/生理 干眼/诊断 眼科诊断技术/仪器 人 眼表 视屏终端 

分 类 号：R77[医药卫生—眼科]