中高近视患者眼表参数的综合评价。

IF 1.8 4区 医学 Q2 OPHTHALMOLOGY
International journal of ophthalmology Pub Date : 2025-10-18 eCollection Date: 2025-01-01 DOI:10.18240/ijo.2025.10.16
Bing-Qing Sun, Xiao-Jun Hu, Bing Qin, Xing-Tao Zhou, Mei-Yan Li
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引用次数: 0

摘要

目的:探讨中高度近视患者的眼表参数。方法:本前瞻性研究于2023年5月进行,纳入中至高度近视(球面等效屈光度≤-3.0 D)患者。完成眼表疾病指数(OSDI)问卷后,测量屈光参数和无创泪膜参数,然后进行Schirmer I试验和荧光素钠染色。根据2020年《中国干眼症专家共识》,干眼症的诊断基于OSDI评分、无创撕裂时间(NIBUT)、Schirmer I试验和荧光素钠染色结果。采用Mann-Whitney U检验比较中度和高度近视、干眼症和非干眼症患者的眼表参数。采用Pearson相关分析评估脂质/粘膜-水层与泪膜参数之间的关系。采用一般线性混合模型(GLMM)分析在调整年龄和性别后屈光参数对眼表参数的影响。结果:共纳入35只中至高度近视眼(男性12只,平均年龄30.30±5.45y)。其中正常眼26只,干眼9只。9例干眼患者中,高度近视组7例(18例),中度近视组2例(17例)。在入组患者中,高度近视组的OSDI评分显著高于中度近视组(P=0.0417)。干眼症患者的眨眼间隔明显短于非干眼症患者(P=0.0081), OSDI评分明显高于非干眼症患者(P=0.0001)。Pearson相关分析显示,脂质层厚度(LLT)与撕裂半月板高度呈正相关(r=0.395, P=0.023),粘膜-水层厚度变化率(MALTR)与OSDI评分呈显著负相关(r=-0.466, P=0.016)。经GLMM校正年龄和性别后,球面屈光度(SPH, β=-1.802, P=0.048)和眼轴长度(AL, β=2.784, P=0.048)显著影响OSDI评分。角膜前散光显著影响Schirmer I检验结果(β=8.377, P=0.024)。中央角膜厚度与最薄角膜厚度的差异显著影响LLT (β=-2.294, P=0.026)。白色到白色的直径显著影响MALTR (β=-81.758, P=0.037)。结论:在中高近视中,高SPH和AL与干眼症状增加相关,干眼症状与黏液和脂质层改变有关。角膜的规律性和直径也影响泪膜的动态。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comprehensive evaluation of ocular surface parameters in patients with moderate-to-high myopia.

Aim: To investigate the ocular surface parameters in patients with moderate to high myopia.

Methods: This prospective study was conducted in May 2023, enrolling patients with moderate to high myopia (spherical equivalent refraction ≤-3.0 D). After completing the Ocular Surface Disease Index (OSDI) questionnaire, refractive parameters and non-invasive tear film parameters were measured, followed by the Schirmer I test and fluorescein sodium staining. The diagnosis of dry eye disease was based on OSDI score, non-invasive tear breakup time (NIBUT), Schirmer I test, and fluorescein sodium staining results, according to the 2020 Chinese Expert Consensus on Dry Eye. The Mann-Whitney U test was used to compare ocular surface parameters between moderate and high myopia, as well as between patients with and without dry eye. Pearson correlation analysis was employed to assess the relationship between the lipid/muco-aqueous layers and tear film parameters. A general linear mixed model (GLMM) was used to analyze the impact of refractive parameters on ocular surface parameters after adjusting for age and sex.

Results: A total of 35 eyes with moderate to high myopia (12 males; mean age, 30.30±5.45y) were included in the study. Among them, 26 eyes were classified as normal and 9 as dry eye. Of the 9 dry eye cases, 7 were observed in the high myopia group (n=18) and 2 in the moderate myopia group (n=17). Among the enrolled patients, those with high myopia demonstrated significantly higher OSDI scores than those with moderate myopia (P=0.0417). Patients with dry eye exhibited significantly shorter interblink intervals (P=0.0081) and higher OSDI scores (P=0.0001) than those without dry eye. Pearson correlation analysis revealed a significant positive correlation between lipid layer thickness (LLT) and tear meniscus height (r=0.395, P=0.023), and a significant negative correlation between the muco-aqueous layer thickness change rate (MALTR) and OSDI score (r=-0.466, P=0.016). After adjusting for age and sex using the GLMM, spherical refraction (SPH, β=-1.802, P=0.048) and axial length (AL, β=2.784, P=0.048) significantly impacted OSDI score. Corneal front astigmatism significantly influenced Schirmer I test results (β=8.377, P=0.024). The difference between central corneal thickness and the thinnest corneal thickness significantly affected LLT (β=-2.294, P=0.026). White-to-white diameter significantly impacted MALTR (β=-81.758, P=0.037).

Conclusion: In moderate to high myopia, higher SPH and AL correlate with increased dry eye symptoms, which are associated with muco-aqueous and lipid layer alterations. Corneal regularity and diameter also affect tear film dynamics.

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来源期刊
CiteScore
2.50
自引率
7.10%
发文量
3141
审稿时长
4-8 weeks
期刊介绍: · International Journal of Ophthalmology-IJO (English edition) is a global ophthalmological scientific publication and a peer-reviewed open access periodical (ISSN 2222-3959 print, ISSN 2227-4898 online). This journal is sponsored by Chinese Medical Association Xi’an Branch and obtains guidance and support from WHO and ICO (International Council of Ophthalmology). It has been indexed in SCIE, PubMed, PubMed-Central, Chemical Abstracts, Scopus, EMBASE , and DOAJ. IJO JCR IF in 2017 is 1.166. IJO was established in 2008, with editorial office in Xi’an, China. It is a monthly publication. General Scientific Advisors include Prof. Hugh Taylor (President of ICO); Prof.Bruce Spivey (Immediate Past President of ICO); Prof.Mark Tso (Ex-Vice President of ICO) and Prof.Daiming Fan (Academician and Vice President, Chinese Academy of Engineering. International Scientific Advisors include Prof. Serge Resnikoff (WHO Senior Speciatist for Prevention of blindness), Prof. Chi-Chao Chan (National Eye Institute, USA) and Prof. Richard L Abbott (Ex-President of AAO/PAAO) et al. Honorary Editors-in-Chief: Prof. Li-Xin Xie(Academician of Chinese Academy of Engineering/Honorary President of Chinese Ophthalmological Society); Prof. Dennis Lam (President of APAO) and Prof. Xiao-Xin Li (Ex-President of Chinese Ophthalmological Society). Chief Editor: Prof. Xiu-Wen Hu (President of IJO Press). Editors-in-Chief: Prof. Yan-Nian Hui (Ex-Director, Eye Institute of Chinese PLA) and Prof. George Chiou (Founding chief editor of Journal of Ocular Pharmacology & Therapeutics). Associate Editors-in-Chief include: Prof. Ning-Li Wang (President Elect of APAO); Prof. Ke Yao (President of Chinese Ophthalmological Society) ; Prof.William Smiddy (Bascom Palmer Eye instituteUSA) ; Prof.Joel Schuman (President of Association of University Professors of Ophthalmology,USA); Prof.Yizhi Liu (Vice President of Chinese Ophtlalmology Society); Prof.Yu-Sheng Wang (Director of Eye Institute of Chinese PLA); Prof.Ling-Yun Cheng (Director of Ocular Pharmacology, Shiley Eye Center, USA). IJO accepts contributions in English from all over the world. It includes mainly original articles and review articles, both basic and clinical papers. Instruction is Welcome Contribution is Welcome Citation is Welcome Cooperation organization International Council of Ophthalmology(ICO), PubMed, PMC, American Academy of Ophthalmology, Asia-Pacific, Thomson Reuters, The Charlesworth Group, Crossref,Scopus,Publons, DOAJ etc.
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