不同程度及类型干眼症患者视觉质量的改变及其相关因素  

Changes in the quality of vision in pationts with different degrees of dry eye and their associated factors

作　　者：罗丽 李华[1] 宋胜仿[1] 刘世纯[1] 徐霁[1] LUO LI;LI Hua;SONG Shengfang;LIU Shichun;XU Ji(Department of Ophthalmology,Yongchuan Hospital,Chongqing Medical University,Chongqing 402160,China)

机构地区：[1]重庆医科大学附属永川医院眼科,重庆永川402160

出　　处：《中国临床医生杂志》2022年第5期535-539,共5页Chinese Journal For Clinicians

基　　金：重庆市科卫联合项目(2021MSXM199)。

摘　　要：目的 研究不同严重程度及类型的干眼症患者角膜高阶像差和对比敏感度的变化,探讨干眼症患者视觉质量的改变及其相关因素。方法 选取2021年1月至2021年7月于重庆医科大学附属永川医院就诊的84例干眼症患者作为干眼组,选取同期在医院体检的30例健康者作为对照组。收集患者基本信息及眼表疾病指数调查问卷结果 ,所有患者进行基本眼部检查、对比敏感度检测,采用依据Scheimpflug原理的眼前节成像系统测量角膜高阶像差,采用非侵入性的方法 检测非接触泪膜破裂时间、泪河高度,检测角膜荧光素染色和泪液分泌试验;分析上述干眼相关指标与对比敏感度及角膜高阶像差的相关性。结果 不同严重程度的干眼症患者在空间频率为1.5、3.0、6.0、12.0c/d时的对比敏感度均低于正常者(P<0.001),且水液缺乏型干眼患者的对比敏感度低于蒸发过强型干眼患者的对比敏感度(P<0.001);不同严重程度的干眼症患者慧差、三叶草差均高于正常者(P<0.001),且水液缺乏型干眼患者的慧差、三叶草差高于蒸发过强型干眼患者(P<0.001)。对比敏感度及角膜高阶像差与泪膜破裂时间、泪液分泌呈正相关(P<0.001),与角膜荧光素染色呈负相关(P<0.001),与OSDI评分及泪河高度无相关性(P>0.05)。结论 干眼症患者角膜高阶像差增加、对比敏感度降低,并且与严重程度及类型相关,干眼症患者诊疗过程中应重视视觉质量的改变。Objective The purpose of this study was to research the changes of corneal higher order aberration and contrast sensitivity of dry eye patients with different severity degrees and types and to discuss the changes of visual quality of dry eye patients and its relevant factors.Method 84 dry eye patients from Department of Ophthalmology of Yongchuan Hospital of Chongqing Medical University from January 2021 to July 2021 were selected for the research,and 30 healthy collators were studied as well.Basic information of patients and the ocular surface disease index questionnaire results were collected.Standardized procedures were used to obtain results on the basic eye examination and the contrast sensitivity detectionin which the corneal higher order aberration was measured with the anterior segment imaging system based on Scheimpflug principle,and the noninvasive tear brokeup time and tear meniscus height were detected in the nonintrusive method,and Cornea Fluorescein Staining and Schirmer I test(Schirmer and Cornea Fluorescein Staining were invasive)were detected;The correlation of the above dry eye-related indicators and contrast sensitivity and corneal higher order aberration was analyzed.Result The contrast sensitivity of dry eye patients was lower than that of the normal individualsat the spatial frequency of 1.5,3.0,6.0 and 12.0 c/d(P<0.001),and the contrast sensitivity of aqueous deficiency dry eye patients was lower than those of evaporative dry eye patients(P<0.001);The coma aberration and trefoil aberration of dry eye patients were higher than those of the normal individual(P<0.001),and the coma aberration and trefoil aberration of aqueous deficiency dry eye patients were higher than those of evaporative dry eye patients(P<0.001).A positive correlation existed between contrast sensitivity,corneal higher order aberration and brokeup time of tear film,lacrimal secretion(P<0.001),while negative correlation for cornea Fluorescein Staining(P<0.001),and no correlation for ocular surface disease index grading and t

关 键 词：干眼症 视觉质量 对比敏感度 角膜高阶像差 

分 类 号：R657.31[医药卫生—外科学]