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目的探讨DR1泪膜干涉成像仪动态成像方法对干眼症的诊断价值,分析该方法结合其它检查方法对干眼症分类的指导意义。设计病例对照临床研究。研究对象干眼症患者58例(116眼),正常人30例(60眼)。方法应用DR1泪膜干涉成像仪拍摄泪膜的动态变化图像,采用UleadVideostudio6.0软件对图像进行分析,观察泪膜脂质层达到稳定图像的时间及脂质层扩散的形态。测定患者和正常人SchirmerI值和眼睑缘油脂印迹。主要指标泪膜扩散形态、泪膜稳定时间、眼睑缘印迹及SchirmerI值。结果泪膜动态图像显示正常人泪膜脂质层达到稳定图像所需时间为(0.91±0.04)秒,干眼症患者为(2.12±1.04)秒,差异有显著统计学意义(P=0.00),正常人与干眼症患者的泪膜扩散形态差异亦有显著统计学意义(P=0.00);正常人与干眼症患者的SchirmerI值分别为(19.30±7.50)mm、(11.78±10.02)mm,差异有统计学意义(P=0.03);两者的眼睑缘油脂印迹的类型亦有差异(P=0.02),依此进行干眼症分类。结论应用DR1泪膜干涉成像仪、眼睑缘油脂印迹和泪液量测量(SchirmerⅠ试验)三种方法可对干眼症进行诊断和分类。
Objective To investigate the diagnostic value of dynamic imaging of DR1 tear film interferometer for the diagnosis of dry eye, and to analyze the guiding significance of this method combined with other examination methods in the classification of dry eye syndrome. Design case-control clinical studies. Fifty-eight patients (116 eyes) and 30 normal subjects (60 eyes) were included in this study. Methods DR1 tear film interference imager was used to record the dynamic changes of tear film. UleadVideostudio 6.0 software was used to analyze the images, and the duration of the stable tear film lipid film and the distribution of lipid layer were observed. Schirmer I values and eyelid margins were measured in both patients and normal subjects. The main indicators of tear film diffusion patterns, tear film stability time, eyelid margin imprinting and SchirmerI value. Results The tear film dynamic images showed that the time required for stable images of the tear film lipid layer in normal people was (0.91 ± 0.04) second and that in the dry eye patients was (2.12 ± 1.04) seconds, the difference was statistically significant (P = 0.00) (P = 0.00). The SchirmerI values of normal and dry eye patients were (19.30 ± 7.50) mm and (11.78 ± 10.02) mm respectively, there was significant difference between the two groups mm, the difference was statistically significant (P = 0.03); both types of eyelid margins were also different (P = 0.02), according to the classification of dry eye syndrome. Conclusion Dry eye syndrome can be diagnosed and classified by using three methods: DR1 tear film interference imager, eyelid margin blotting and tear volume measurement (Schirmer Ⅰ test).