干眼仪在干眼诊断中的价值初步评价

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1、·358·中国实用眼科杂志第21卷(2003)第5期干眼仪在干眼诊断中的价值初步评价刘祖国罗丽辉程冰张振平张梅肖启国王智崇黄挺陈家祺张志红中山大学中山眼科中心510060目的:评价干眼仪对干眼的诊断价值。方法:对25例(25只眼)正常人和35例(35只眼)干眼患者分别行泪膜破裂时间(BUT)、泪液分泌试验(SchirmerI)、角膜荧光素染色(FL)、干眼仪检查和泪高度测量五项检查。2结果:干眼患者的干眼仪检测等级与正常人差异显著(χ=32.22,P=0.000)。干眼仪诊断干眼的特异度为80%

2、,灵敏度为83%。干眼仪检查为Ⅲ级脂质层形态图像者患干眼的机率约为75%(15/25)。干眼患者的干眼仪检测等级越高,BUT和SchirmerI试验越短(r=-0.783,-0.368,P=0.000,0.015),角膜荧光素染色越多(r=0.806,P=0.000),而与泪河高度无相关(P=0.178)。正常人的干眼仪检测等级也与BUT和SchirmerI试验呈负相关(r=-0.398,-0.656,P=0.024,0.000)。干眼患者的干眼仪显示图像的稳定性较正常人差。干眼仪的检查结果具有

3、较高的重复性。结论:干眼仪能较直观地观察角膜中央脂质层的光干涉图像,是一种快速、无创伤、重复性强、操作简单的检查方法。对干眼的诊断及客观反映病情的严重程度具有临床应用价值。关键词:干眼仪诊断干眼DiagnosisofdryeyebyDR-1tearinterferometryLIUZuguo,LUOLihui,CHENGBingZhongshanOphthalmicCenter,ZhongshanUniversity,Guangzhou510060,ChinaObjective:Toevalua

4、tethepotentialofDR-Itearinterferometryinthediagnosisofdryeye.Methods:Thestatusofpre-cornealtearlipidlayerin25normalvolunteers(25eyes)and35dryeyepatients(35eyes)wasestimatedbyDR-Itearinterferometryandwastermedasinterferencepatternsoftearfilmin5grades.

5、Thebreak-uptime(BUT)oftearfilm,SchirmerI-test(SIt),cornealfluoresceinstaining,andtheheightoftearmeniscuswerealsomeasured.Results:Theinterferencepatternsoftearfilm(tearlipidlayer)incontroleyeswereingrades1,2or3;andindryeyepatientswereingrades2,3,4,and

6、5.ThedistinctivedegreeinthediagnosisofdryeyebyDR-Itearinterferometrywas80%andthesensitivityde-greeofthatwas83%.Thegradeoftheinterferencepatterns,bothindryeyepatientsandincontrols,wasnegativelycorrelatedwithBUTandSIt(P<0.05),butindryeyepatientsitwasal

7、sopositivelycorrelatedwiththescoresofcornealfluoresceinstaining(r=0.806,P<0.05).Interferencepatternscouldbeobservedrepeatedly,althoughthestabilityofthepatternswasbetterincontrolsthanthatindryeyepatients.Conclusions:Theinterferencepatternsofpre-cornea

8、ltearlipidlayercanbeobservedbyDR-Itearinterferometryclearly.TheDR-Itearinterferometryexaminationisaneffectiveclinicalmethodtodiagnosedryeyeandthedryeyeseverity.Keywords:Tearinterferometry,Dryeye干眼(DryEye)主要是由于泪膜的质和量异常teardeficiency,LTD)越来越多,因而寻找新的能客而