Please wait a minute...
浙江大学学报（医学版）
Journal of ZheJiang University(Medical Science)  2016, Vol. 45 Issue (4): 422-428    DOI: 10.3785/j.issn.1008-9292.2016.07.14
    
Evaluation of tear film and meibomian gland function in dry eye patients using Keratograph 5M
ZHU Kexuan, XIE Wenjia, YING Jinglu, YAO Yufeng
Department of Ophthalmology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China
Download:   PDF(1048KB)
Export: BibTeX | EndNote (RIS)      

Abstract  

Objective: To assess the application of Keratograph 5M in evaluating tear film and meibomian gland function in patients with dry eye. Methods: A total of 144 eyes were recruited in the study, in which 72 eyes were from patients diagnosed with dry eye and 72 eyes were from healthy subjects. All subjects finished following tests or examinations:ocular surface disease index (OSDI) to evaluate eye symptoms; Keratograph 5M examination to obtain tear meniscus height (TMH), noninvasive tear break-up time (NIBUT) including first NIBUT (NIBUT-Fir) and average NIBUT (NIBUT-Ave), and infrared meibography; and fluorescein sodium staining to obtain fluorescein tearbreak-up time (FBUT). Results: Dry eye group had higher OSDI score than healthy control group, but its TMH, NIBUT-Fir and NIBUT-Ave were lower than those in healthy control group (all P<0.01). Total meiboscore in dry eye group was higher than that in healthy control group (P<0.01), and it showed a significant correlation with NIBUT-Fir and NIBUT-Ave (r=-0.449 and -0.398, P<0.01), but no correlation with ages was observed (r=0.031, P>0.05). The NIBUT-Fir and NIBUT-Ave showed a significant correlation with FBUT (r=0.833 and 0.727, P<0.01). Conclusion: Keratograph 5M is a convenient, accurate and non-invasive method to assess the function of tear film and meibomian gland, and the new meibography scoring system can evaluate the function of meibomian gland objectively and succinctly.

Key words： Xerophthalmia/diagnosis      Diagnostic techniques, ophthalmological/instrumentation      Meibomian glands      Questionnaires     
Received: 10 March 2016     
CLC:  R770.4  
Service
E-mail this article
Add to my bookshelf
Add to citation manager
E-mail Alert
RSS
Articles by authors
Cite this article:

ZHU Kexuan, XIE Wenjia, YING Jinglu, YAO Yufeng. Evaluation of tear film and meibomian gland function in dry eye patients using Keratograph 5M. Journal of ZheJiang University(Medical Science), 2016, 45(4): 422-428.

URL:

http://www.zjujournals.com/xueshu/med/10.3785/j.issn.1008-9292.2016.07.14     OR     http://www.zjujournals.com/xueshu/med/Y2016/V45/I4/422


运用Keratograph 5M眼表综合分析仪评价干眼患者的泪膜及睑板腺功能

目的：使用Keratograph 5M眼表综合分析仪测定干眼患者的泪膜功能，并运用睑板腺照相评分系统评估睑板腺功能。方法：选取干眼患者及健康对照组各72只眼，所有检查者均先后完成以下检查：眼表疾病指数（OSDI）问卷评估眼部症状；Keratograph 5M测量下睑中央泪河高度（TMH）、非侵袭泪膜破裂时间（NIBUT）包括首次NIBUT和平均NIBUT、上下睑板腺红外线照相评分；传统荧光素钠染色方法测量荧光素钠泪膜破裂时间（FBUT）。结果：干眼组OSDI问卷评分高于健康对照组，而TMH、首次NIBUT、平均NIBUT值均低于健康对照组，差异均有统计学意义（均P<0.01）。干眼组的睑板腺照相评分总分高于健康对照组，差异均有统计学意义（均P<0.01）；上下睑总分与首次NIBUT、平均NIBUT显著相关（r=-0.449、-0.398，均P<0.01），与年龄无相关性（r=0.031，P>0.05）。首次NIBUT、平均NIBUT与FBUT均显著相关（r=0.833、0.727，均P<0.01）。结论：使用Keratograph 5M眼表综合分析仪能简便、准确、非侵袭性地评价干眼患者的泪膜及睑板腺功能；睑板腺照相评分系统能较全面、客观、简便地评价睑板腺功能。


关键词： 干眼病/诊断,  诊断技术,眼科/仪器和设备,  睑板腺,  问卷调查 
[[1]]   中华医学会眼科学分会角膜病学组. 干眼临床诊疗专家共识(2013年)[J]. 中华眼科杂志,2013,49(1):73-75. Cornea Group, Ophthalmology Branch of Chinese Medical Association. Experts consensus on diagnosis and treatment of xerophthalmia(2013 version)[J]. Chinese Journal of Ophthalmology, 2013, 49(1):73-75.(in Chinese)
[[2]]   MCCARTY C A, BANSAL A K, LIVINGSTON P M, et al. The epidemiology of dry eye in Melbourne, Australia[J]. Ophthalmology, 1998, 105(6):1114-1119.
[[3]]   MOSS S E, KLEIN R, KLEIN B E. Prevalence of and risk factors for dry eye syndrome[J]. Arch Ophthalmol, 2000, 118(9):1264-1268.
[[4]]   SCHEIN O D, MUNOZ B, TIELSCH J M, et al. Prevalence of dry eye among the elderly[J]. Am J Ophthalmol, 1997, 124(6):723-728.
[[5]]   GEERLING G, TAUBER J, BAUDOUIN C, et al. The international workshop on meibomian gland dysfunction: report of the subcommittee on management and treatment of meibomian gland dysfunction[J]. Invest Ophthalmol Vis Sci, 2011, 52(4):2050-2064.
[[6]]   NICHOLS K K, FOULKS G N, BRON A J, et al. The international workshop on meibomian gland dysfunction: executive summary[J]. Invest Ophthalmol Vis Sci, 2011, 52(4):1922-1929.
[[7]]   FINIS D, SCHRADER S, GEERLING G. Meibomian gland dysfunction[J]. Klin Monbl Augenheilkd, 2012, 229(5):506-513.
[[8]]   SCHAUMBERG D A, NICHOLS J J, PAPAS E B, et al. The international workshop on meibomian gland dysfunction: report of the subcommittee on the epidemiology of, and associated risk factors for, MGD[J]. Invest Ophthalmol Vis Sci, 2011, 52(4):1994-2005.
[[9]]   BAUDOUIN C, ARAGONA P, VAN SETTEN G, et al. Diagnosing the severity of dry eye: a clear and practical algorithm[J]. Br J Ophthalmol, 2014, 98(9):1168-1176.
[[10]]   SCHIFFMAN R M, CHRISTIANSON M D, JACOBSEN G, et al. Reliability and validity of the ocular surface disease index[J]. Arch Ophthalmol, 2000, 118(5):615-621.
[[11]]   MILLER K L, WALT J G, MINK D R, et al. Minimal clinically important difference for the ocular surface disease index[J]. Arch Ophthalmol, 2010, 128(1):94-101.
[[12]]   GOTO E, TSENG S C. Kinetic analysis of tear interference images in aqueous tear deficiency dry eye before and after punctal occlusion[J]. Invest Ophthalmol Vis Sci, 2003, 44(5):1897-1905.
[[13]]   GOTO E, TSENG S C. Differentiation of lipid tear deficiency dry eye by kinetic analysis of tear interference images[J]. Arch Ophthalmol, 2003, 121(2):173-180.
[[14]]   MENGHER L S, BRON A J, TONGE S R, et al. A non-invasive instrument for clinical assessment of the pre-corneal tear film stability[J]. Curr Eye Res, 1985, 4(1):1-7.
[[15]]   WANG J, PALAKURU J R, AQUAVELLA J V. Correlations among upper and lower tear menisci, noninvasive tear break-up time, and the Schirmer test[J]. Am J Ophthalmol, 2008, 145(5):795-800.
[[16]]   NICHOLS J J, BERNTSEN D A, MITCHELL G L, et al. An assessment of grading scales for meibography images[J]. Cornea, 2005, 24(4):382-388.
[[17]]   FULLER D G, PORTS K, WKIM J. Noninvasive tear breakup times and ocular surface disease[J]. Optom Vis Sci, 2013, 90(10):1086-1091.
[[18]]   HONG J, SUN X, WEI A, et al. Assessment of tear film stability in dry eye with a newly developed keratograph[J]. Cornea, 2013, 32(5):716-721.
[[19]]   ARRIOLA-VILLALOBOS P, FERNANDEZ-VIGO J I, DIAZ-VALLE D, et al. Assessment of lower tear meniscus measurements obtained with Keratograph and agreement with Fourier-domain optical-coherence tomography[J]. Br J Ophthalmol, 2015, 99(8):1120-1125.
[[20]]   ABDELFATTAH N S, DASTIRIDOU A, SADDA S R, et al. Noninvasive imaging of tear film dynamics in eyes with ocular surface disease[J]. Cornea, 2015, 34 Suppl 10:S48-S52.
[[21]]   LAN W, LIN L, YANG X, et al. Automatic noninvasive tear breakup time (TBUT) and conventional fluorescent TBUT[J]. Optom Vis Sci, 2014, 91(12): 1412-1418.
[[22]]   JIANG Y, YE H, XU J, et al. Noninvasive Keratograph assessment of tear film break-up time and location in patients with age-related cataracts and dry eye syndrome[J]. J Int Med Res, 2014, 42(2):494-502.
[1] HE Miao, TANG Xiaojun, LONG Qian, WEI Jie, SUN Zhenxing, YANG Xuewei, TANG Shenglan. Influencing factors of diabetic patients applying for specific disease health insurance and its treatment cost[J]. Journal of ZheJiang University(Medical Science), 2016, 45(3): 323-329.
[2] GU Jing-hua, QIU Yi-jun, LU Yi-hua, XU Xu-dong, XU Zhi-hao. Value of quality of life evaluation in prognosis of chronic obstructive pulmonary disease[J]. Journal of ZheJiang University(Medical Science), 2014, 43(2): 207-211.
[3] . Acceptability of pre-exposure prophylaxis among female sex workers in Xinjiang[J]. Journal of ZheJiang University(Medical Science), 2011, 40(3): 281-285.
[4] . Sleep quality and influencing factors of perimenopausal women in Ningbo region[J]. Journal of ZheJiang University(Medical Science), 2011, 40(1): 85-89.
[5] . Reliability and validity of a Chinese version of the Quality of Life in Epilepsy Inventory (QOLIE-31-P)[J]. Journal of ZheJiang University(Medical Science), 2009, 38(6): 605-610.