原发性泪点狭窄的前节OCT特征及其与溢泪相关性的初步研究  

Preliminary study on the correlation between primary lacrimal punctal stenosis and epiphora by using AS-OCT

作　　者：王菲 卢珊珊 王朋 王海彬[2] 陶海 王英爽 白芳 Fei Wang;Shan-Shan Lu;Peng Wang;Hai-Bin Wang;Hai Tao;Ying-Shuang Wang;Fang Bai(The Senior Department of the Ophthalmology,the Third Medical Center of PLA General Hospital,Beijing 100039,China;Department of Ophthalmology,Affiliated Hospital of Chengde Medical College,Chengde 067000,Hebei Province,China)

机构地区：[1]中国人民解放军总医院第三医学中心眼科医学部,北京市100039 [2]承德医学院附属医院眼科,河北省承德市067000

出　　处：《国际眼科杂志》2022年第10期1603-1607,共5页International Eye Science

基　　金：Capital’s Funds for Health Improvemen and Research(No.CFH.2020-2Z-5132)。

摘　　要：目的:应用眼前节光学相干断层扫描(AS-OCT)对原发性泪点狭窄患者的泪点进行量化,并分析其与溢泪的相关性。方法:横断面研究。共纳入2020年9月至2021年1月于解放军总医院第三医学中心泪器病中心就诊的44例(62眼)原发性泪点狭窄伴溢泪的患者为观察组,对照组为43例(57眼)健康志愿者。对所有受试者的下泪点进行AS-OCT扫描,并对泪点图像进行量化,以观察其AS-OCT图像特征,测量参数包括泪点外径、泪点深度、泪点内残留泪液的液面直径及深度,根据以上参数计算泪点储备量及比率。结果:1)符合正态分布的各测量参数用均数±标准差表示,结果如下,观察组:泪点外径458.19±63.58μm、泪点内残留泪液的直径200.34±84.69μm、泪点内残留泪液的深度188.95±87.50μm、泪点储备比率0.32±0.18;正常对照组各测量参数为:泪点外径655.53±82.62μm、泪点内残留泪液的直径230.26±107.02μm、泪点内残留泪液的深度275.30±144.34μm、泪点储备比率0.46±0.23,观察组各参数均小于正常组(P<0.05);2)不符合正态分布的参数数据则用中位数及四分位数表示,结果如下,观察组:泪点深度265.50μm (四分位间距204.25-328.77)μm、泪点储备量71.53μm (四分位间距46.12-111.37)μm,对照组:泪点深度468.76μm(四分位间距420.50-588.88)μm、泪点储备量182.16μm (四分位间距131.36-309.84)μm,观察组各参数数据均小于正常对照组(P<0.05);3)观察组测量数据显示,溢泪程度与泪点外径呈负相关(相关系数r=-0.448,P<0.05)、与泪点内残留泪液的深度呈正相关(相关系数r=0.335,P<0.05)、与泪点储备量及其比率呈负相关(相关系数r=-0.520、-0.566,P<0.05)。结论:AS-OCT的使用可以帮助提高对泪点形态的认知;泪点内残留泪液的深度以及泪点外径的大小与溢泪相关;原发性泪点狭窄者中泪点储备泪液的潜在能力越强,溢泪程度越弱,且泪点外径小者相对于泪点外径大者�·AIM:To quantify the lacrimal punctum using anterior segment optical coherence tomography(AS-OCT) and analyze the correlation between the epiphora and primary punctal stenosis.·METHODS:A cross-sectional study.There were 43 healthy volunteers(57 eyes) and 44 patients(62 eyes)with primary lacrimal punctal stenosis and epiphora enrolled in the Lacrimal Center of the Third M edical Center of PLA General Hospital from September 2020 to January2021.The inferior punctum of all subjects were scanned by AS-OCT,and the images were quantified in order to observe the AS-OCT image features.The outer punctal diameter,punctal depth,tear well diameter and tear well depth were all measured simultaneously.The inferior punctum ’ s punctal reserve and punctal reserve ratio were estimated according to the available parameter data.·RESULTS:1) The measured parameters conforming to normal distribution were expressed as mean ± standard deviation.The observation group’ s outer punctal diameter,tear well diameter,tear well depth,and punctal reserve ratio were 458.19±63.58,m,200.34±84.69μm,188.95±87.50μ m and 0.32±0.18,respectively,while the control group’ s outer punctal diameter,tear well diameter,tear well depth and punctal reserve ratio were655.53±82.62μ m,230.26±107.02μ m,275.30±144.34μ m,0.46±0.23,respectively.The parameters in observation group were all lower than those of control group(P<0.05);2) Parameter data that did not conform to normal distribution were expressed as medians and quartiles,and the results were as follows:the punctal depth in the observation group was 265.50μm(interquartile range 204.25-328.77) μm and the punctal reserve was 71.53μ m(interquartile range 46.12-111.37)μm,respectively,while the punctal depth in the control group was 468.76μ m(interquartile range 420.50-588.88)μm and the punctal reserve was 182.16μ m(interquartile range 131.36-309.84) μm.This difference was statistically significant(P<0.05);3) In the observation group,there was a negative correlation between the epiphor

关 键 词：泪点狭窄 原发性 溢泪 光学相干断层扫描 

分 类 号：R777.2[医药卫生—眼科]