ABSTRACT
Objective To evaluate the feature of meibomian glands and tear film lipid layer thickness (LLT) in dry eye of children with long-term visual display terminals (VDTs) exposure.Methods Cross-sectional case control observation was performed.Eighty-four 6-14 years old children (149 eyes) with long or short time VDTs exposure from January to August 2017 in Tianjin Medical University Eye Hospital were enrolled,including 29 children 56 eyes for long time VDTs group and 55 children 93 eyes for short time VDTs group.Questionnaires were designed to detect disease history and ocular surface disease index (OSDI).Slit lamp microscopy,Keratograph 5 M,lipiview ocular surface interometry examination,corneal-conjunctival fluorescence staining,tear film break-up time (BUT) and Schirmer test (S I t) were performed on all the subjects.The subjective OSDI and clinical signs were compared between long time VDTs group and short time VDTs group and correlation between OSDI and clinical signs were analyzed in each group.This study followed the declaration of Helsinki.Informed consent was obtained from each subject or the guardian prior to any medical examination.Results Compared with the short time VDTs group,high OSDI value and long average noninvasive BUT (NIBUTav) were observed in the long time VDTs group,the differences were statistically significant (OSDI:t =-2.662,P =0.009;NIBUTav:Z =2.315,P =0.021).The meibomian gland dropout score was significantly different between the 2 group (x2 =11.779,P =0.008).In long time VDTs group,OSDI was negatively correlated with S I t (rs =-0.598,P =0.050) and positively correlated with meibomian gland dropout score and NIBUTav (rs =0.522,P =0.022;rs =0.597,P =0.011).In short time VDTs group,OSDI was positively correlated with first time noninvasive BUT (NIBUTf),NITBUTav and partial blink rate (rs =0.372,P =0.030;rs =0.408,P =0.008;rs =0.426,P =0.050).Conclusions Compared with short time VDTs exposure,the value of subjective OSDI was high and meibomian gland dropout was serious in long term VDTs exposure dry eye children.The OSDI value is associated with NIBUTf and partial blink ratio in short time VDTs dry eye children.
ABSTRACT
Background Obstructive meibomian gland dysfunction (OMGD) is due to the meibomian gland duct obstruction and/or meibum abnormal secretion.Meibomian gland morphological change is important to clinical observation.Objective This study aimed to image the meibomian gland structures and the morphological changes in eyes with OMGD using a non-contact infrared meibography system (Keratograph 5M).Methods A case-control study was performed in Tianjin Medical University Eye Hospital from January to June in 2015.Sixty OMGD patients and 60 age-matched healthy controls were recruited.Ocular Surface Disease Index (OSDI) questionnaire was employed for the assess of ocular surface symptoms,and slit-lamp examination was performed for the observation of lid margin and meibomian gland orifices.Meibomian gland secretion scores and Keratograph 5M examination the morphological changes of the meibomian glands.According to OSDI questionnaire,the patients of OMGD were classified into mild group (12.0 ＜ OSDI ≤ 22.0) (23 eyes),moderate group (22.0 ＜ OSDI ≤ 32.0) (21 eyes) and severe group (32.0 ＜ OSDI ≤ 100.0) (16 eyes).Partial or complete loss of the meibomian glands (meibomian dropout) was scored from grade 0 (no loss) through out grade 3 (lost area was ＞2/3 of the total meibomian gland area).Written informed consent was obtained from all subjects before the examination.Results The OSDI,meibomian gland orifices,meibomian gland secretion scores and meibomian gland dropout scores were significantly higher,and BUT was dramatically shorter in the OMGD group than those in the normal group,showing significant differences between the two groups (Z =-9.425,-8.954,-7.781,all at P＜0.05).The BUT was (6.10± 1.91) s and (10.67-±2.11)s,and meibomian gland dropout scores were 1.35±0.90 and 0.88±0.64 in the OMGD group and normal control group,showing significant differences between the two groups (t=3.276,-12.418,both at P＜0.05).OSDI,meibomian gland secretion scores and meibomian gland dropout scores were significantly in three intergroups (H=52.121,13.642,37.180,all at P＜0.05).BUT,meibomian gland orifices were significantly different among the mild,moderate and severe OMGD (F=58.191,8.474,both at P＜0.05).OSDI showed a significantly high positive correlation with meibomian gland orifices,meibomian gland secretion scores and meibomian gland dropout scores (r =0.708,P =0.000;r =0.759,P =0.000;r =0.270,P =0.003).BUT showed negative correlation with meibomian parameters (r=-0.692,P=0.000;r=-0.691,P=0.000;r=-0.192,P=0.036).Conclusions Keratograph 5M provides an effective noninvasive method in assessing the image of the meibomian gland structures and meibomian gland dropout.There are differences in the ocular surface and meibomian glands between the OMGD patients and normal persons.