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AIM: To evaluate the applicability of Chinese dry eye questionnaire in college students using the ocular surface disease index(OSDI)questionnaire as a reference.METHODS: Cross-sectional study. A total of 711 college students from Nanyang Medical College were enrolled in the study and assessed for dry eye condition using OSDI questionnaire and Chinese dry eye questionnaire. The response rate of each question in the two questionnaires was counted. Cronbach α was calculated to evaluate the internal consistency of both questionnaires. Correlation between the total scores of the two questionnaires was analyzed to evaluate the criterion validity. Based on OSDI scores, the discriminant validity of Chinese dry eye questionnaire was evaluated; receiver operating characteristic(ROC)curves was plotted for Chinese dry eye questionnaire scores, area under the ROC curve(AUC)was calculated, and diagnostic thresholds and corresponding sensitivity and specificity were also analyzed.RESULT: The response rates of the 12 questions on the OSDI questionnaire were 33.2%-100.0%, while it was 100.0% for each question on the Chinese dry eye questionnaire. The Cronbach α values of OSDI questionnaire and Chinese dry eye questionnaire were 0.905 and 0.789, respectively. The Chinese dry eye questionnaire score was positively correlated with the OSDI score(rs=0.712, P<0.001). According to OSDI questionnaire scores, dry eye severity was divided into normal group, mild dry eye group, moderate dry eye group and severe dry eye group. The scores of Chinese dry eye questionnaire in these groups were 4.00(2.00, 6.00), 9.00(7.00, 11.00), 12.00(9.00, 14.00)and 16.00(13.50, 22.00), respectively, which increased with the severity of dry eye, and the overall difference was statistically significant(P<0.001), as well as pairwise comparison between groups(P<0.05). The AUCs of Chinese dry eye questionnaire in distinguishing normal population from dry eye population, mild dry eye from moderate dry eye, moderate dry eye from severe dry eye were 0.862, 0.661 and 0.769, respectively, and the diagnostic thresholds were 6.5, 11.5 and 14.5, respectively.CONCLUSION:Chinese dry eye questionnaire has an equivalent reliability, validity, discriminant ability and better response rate for dry eye screening and epidemiological survey among college students in China compared with OSDI questionnaire.
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AIM:To explore the effect of genetic factors on the pathogenesis of keratoconus and its genetic model.METHODS: Genetic epidemiological methods were used to investigate the prevalence of keratoconus in 280 first-degree relatives of 100 patients with keratoconus who attended Henan Eye Hospital between July 2020 and April 2023. The heritability was estimated by Falconer regression method. The general genetic model was calculated using Penrose method, and the genetic model was confirmed by Falconer formula, Edwards approximation formula and the projection formula of San-Duo Jiang's threshold model theory.RESULTS: The results showed that there were 16(5.714%)first-degree relatives of keratoconus probands suffering from keratoconus, and the heritability of keratoconus was(86.100±7.400)%. The S/q score calculated by the Penrose method was 35.348, which was near to 1/(q)1/2, suggesting that the genetic model of keratoconus might be polygenic inheritance. The expected prevalence in first-degree relatives of keratoconus patients by Falconer formula, Edwards approximation formula and the projection formula of San-Duo Jiang's threshold model theory were 5.900%, 7.714% and 5.700%, respectively, which showed no significant differences from the actual prevalence(5.714%), suggesting that keratoconus was a polygenetic disease.CONCLUSION:Genetic factors might play an important role in the pathogenesis of keratoconus, and keratoconus is a polygenetic disease.
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AIM:To explore the correlation and consistency of three tear assessment methods in the diagnosis of dry eye, which include the Schirmer Ⅰ test(SⅠt), tear meniscus height(TMH)measurement and a new generation of tear detection technology-Strip meniscometry tube(SMTube).METHODS: A diagnostic test study. A total of 183 dry eye outpatients(183 right eyes)in the Dry Eye Center of Henan Eye Hospital were enrolled from May to June 2021. The SⅠt, TMH and SMTube were performed on all patients, and the correlation and consistency of the measurement results were analyzed.RESULTS:The ocular surface disease index(OSDI)of all included patients was 43.75(31.25, 58.33), noninvasive breakup time(NIBUT)was 7.26(4.97, 9.37)s, and the results of SⅠt, TMH and SMTube were 6(2, 12)mm/5min, 0.18(0.14, 0.22)mm and 5(3,8)mm/5s, respectively; The results of correlation analysis: TMH was positively correlated with SMTube(rs=0.751, P<0.001), however, SⅠt had no correlation with TMH(rs=0.139, P=0.060)and SMTube(rs=0.019, P=0.799). The results of consistency analysis: TMH showed good consistency with SMTube(Kappa=0.794, P=0.044), however, SⅠt showed poor consistency with TMH(Kappa=0.271, P=0.074)and SMTube(Kappa=0.193, P=0.070)respectively.CONCLUSION:SMTube is a new, simple and convenient tool for evaluating tear volume. It has a good correlation and consistency with TMH measurement results. Therefore, it can replace TMH measurement, but cannot replace SⅠt in clinical application.
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@#AIM: To investigate the characteristics of corneal stiffness parameters at the first applanation(SP-A1)in keratoconus patients among different age groups and severity classification groups. <p>METHODS: A cross-sectional study. Three hundred and forty-five eyes of 247 consecutive keratoconus patients diagnosed in Henan Eye Hospital were enrolled during September 2018 to December 2020. The mean age was(24.51±6.38)years. According to age, the subjects were divided into ≤20 years group, 21-30 years group and ≥31 years group. The severity of keratoconus was divided into AK1, AK2, AK3 and AK4 by Amsler krumeich(AK)classification method. The visual acuity, corneal flat curvature(K1), corneal steep curvature(K2), average corneal curvature(Km)and the thinnest corneal thickness(TCT)were measured. The SP-A1, intraocular pressure(IOP), deformation amplitude max(DA Max), velocity at the first applanation(A1V), time at the first applanation(A1T), time at the second applanation(A2T), velocity at the second applanation(A2V), biomechanical corrected IOP(bIOP), and Radius were measured by Corneal Visualization Scheimpflug Technology(Corvis ST). The correlation between SP-A1 and other parameters were analyzed by Spearman rank correlation, and one-way ANOVA was used to analyze the difference of SP-A1 among different age groups or disease severity groups. <p>RESULTS: No statistically differences of gender, visual acuity, IOP, K1, K2, Km, TCT and disease severity classification were found among different age groups(<i>P</i>>0.05). The SP-A1 was positively related to age(<i>r</i><sub>s</sub>=0.137, <i>P</i>=0.011). The SP-A1 of keratoconus patients in the ≥31 years group was significantly higher than that in the ≤20 years group and 21-30 years group(<i>P</i><0.05). SP-A1 was negatively correlated with K1, K2 and Km in patients in the ≤20 years group and 21-30 years group, while SP-A1 was negatively correlated with K2 in patients in the ≥31 years group(<i>P</i><0.05). In addition, SP-A1 was negatively correlated with DA Max, A1V and A2T, and positively correlated with TCT, IOP, bIOP, A1T, A2V and Radius. With the increase of disease severity, the SP-A1 values gradually decreased in patients in the ≤20 years group and 21-30 years group(<i>P</i><0.05). The values of SP-A1 between AK1 and AK4, AK2 and AK3, AK2 and AK4 were statistically different(<i>P</i>=0.008, 0.035, 0.001). <p>CONCLUSION: The value of SP-A1 in keratoconus was positively correlated with age. In patients less than 30 years old, the SP-A1 decreased with the increase of disease severity.