[A study on the diagnostic value of tear film objective scatter index in dry eye].

Objective: To study the sensitivity and specificity of tear film objective scatter index to the diagnosis dry eye disease (DED). Methods: A prospective case-controlled study. Fifty-three patients with DED and 32 healthy age- and sex-matched control subjects were included from July to October 2016. All subjects underwent the examinations sequentially as follows: evaluation of ocular surface disease symptoms using the Ocular Surface Disease Index, optical quality detection, lipid layer thickness, tear film breakup time and SchirmerⅠtest. With Optical Quality Analysis SystemⅡ, the values of modulation transfer function cut off, basic objective scatter index (OSI) and total OSI were measured. To eliminate the influence of other refractive media, the tear film OSI (TF-OSI) was calculated, and the difference in TF-OSI between two groups was analyzed with the independent-samples t test. Spearman's correlation analysis was used to detect the correlation of each parameter in the DED group. With the receiver operating characteristic curve and the area under the curve (AUC), the specificity and sensitivity of TF-OSI and other parameters were described to differentiate DED from normal eyes. Results: In the dry eye group, the value of modulation transfer function cut off (32.07±11.95) was significantly lower than the normal group (39.38±9.44, t=-3.096, P=0.003) , and the mean value and dispersion of TF-OSI (0.50±0.43, 0.52±0.81) were higher than the normal group (0.21±0.16, 0.12±0.01) (t=4.300, P=0.000, t=3.546, P=0.001) . The mean value of TF-OSI had a positive correlation with lipid layer thickness (r=0.365, P=0.007) and dispersion of TF-OSI (r=0.581, P=0.000), and a negative correlation with MTF cut off (r=-0.368, P=0.007). To the diagnostic value of DED, the mean value of TF-OSI had a sensitivity of 0.736, a specificity of 0.762, and the AUC was 0.764. The dispersion of TF-OSI had a sensitivity of 0.811 and a specificity of 0.810, and the AUC was 0.900. Conclusion: In the DED group, the mean value and dispersion of TF-OSI were higher than the normal group. With its advantages, the TF-OSI may be a new method for the auxiliary diagnosis of dry eye. (Chin J Ophthalmol, 2017, 53: 668-674).

[Evaluation of the diagnostic value for meibomian gland dysfunction examinations].

OBJECTIVE: To evaluate the sensitivity and specificity of clinical examinations in meibomian gland dysfunction (MGD). METHODS: A prospective case-controlled study. Fifty-two patients with MGD and 32 healthy age- and sex-matched control subjects were included from January to August 2013. All subjects were underwent the examinations sequentially as follows: evaluation of ocular surface disease symptoms using the Ocular Surface Disease Index (OSDI); lid margin and ocular surface examination by slit lamp microscrope; infrared meibomian photography; cornea sensation testing using the Cochet-Bonnet esthesiometer; tear film break-up time (BUT); corneal and conjunctival staining (Oxford scale); and Schirmer I test. One eye of each subject was included in the study. The parameters between MGD group and the control group were compared using the independent-samples T test. Spearman's correlation analysis was used to analyze the correlation of each parameter of MGD group. Receiver operating characteristic curve (ROC curve) and area under the curve (AUC) were used to describe the accuracy of each parameter to differentiate MGD from normal eyes. RESULTS: OSDI score, lid margin abnormality score, miss rate of meibomian glands and corneal and conjunctival staining score were obviously higher in MGD group (36.13 ± 14.71, 2.37 ± 0.937, (52.64 ± 17.23) %, 1.06 ± 1.75) than those in control group(5.22 ± 11.97, 0.94 ± 0.564, (23.97 ± 6.36) %, 0.03 ± 0.18) (t = 10.019, 7.808, 8.796, 3.293, respectively; P < 0.01). BUT, schirmer I value and corneal sensitivity score were significantly lower in MGD group (4.57 ± 2.13, 6.04 ± 7.09, 5.77 ± 0.38) than those in control group (13.31 ± 2.54, 12.56 ± 6.99, 5.98 ± 0.07) (t = -16.97, -4.119, -3.018, respectively; P < 0.01). AUC value of BUT was the largest (0.995), and the followings were the miss rate of meibomian (0.944), OSDI (0.925) and lid margin abnormalities (0.811). The sensitivity and the specificity of BUT were 90.4% and 100.0%; the miss rate of meibomian were 76.9% and 100.0%; OSDI were 97.4% and 87.1%; and lid margin abnormalities were 79.5% and 79.4%. The diagnostic value of these four parameters were better than the rest ones. CONCLUSION: BUT and the miss rate of meibomian have great value in diagnosis of MGD. Patients considered MGD can be performed these examinations to confirm the diagnosis.