非侵入性眼表综合分析仪及Lipiview眼表面干涉仪评估儿童干眼的特点

目的　利用非侵入性眼表综合分析仪及Lipiview眼表面干涉仪评估儿童干眼的特点。方法　选取2017年1月至8月于天津医科大学眼科医院第一次确诊为干眼的儿童98例（186眼），完成病史及眼表疾病指数（ocular surface disease index，OSDI）问卷后进行裂隙灯、泪膜破裂时间（tear film brek-up time，BUT）、泪液分泌试验（Schirmer Ⅰ test，S Ⅰ T）评估、非侵入性眼表综合分析仪及Lipiview眼表面干涉仪检查。结果　本组中159眼的BUT<5 s，30眼的SIt<5 mm。OSDI［13.63（9.09~15.91）分］与S Ⅰ T［（14.6±8.7）mm］无相关性（r=-0.119，P=0.259）；与BUT［3.00（2.00~5.00）s］无相关性（r=0.099，P=0.354）。第一次非侵入性泪膜破裂时间（first noninvasive tear film break-up time，NITBUT），平均非侵入性泪膜破裂时间（average noninvasive tear film break-up time，NITBUTav）与OSDI均呈正相关性，NIBUT与NIBUTav呈高度正相关性（均为P<0.05）。NIBUT、NIBUTav与BUT均无相关性（r=0.112，P=0.059；r=0.159，P=0.455）。泪膜脂质层厚度（lipid layer thickness，LLT）、LLT最大值与NIBUTav呈正相关性；不完全眨眼比例与NIBUTav呈负相关性（均为P<0.05）；其余指标与OSDI和NITBUTav无相关性。LLT、LLT最大值、LLT最小值与睑板腺缺失评分均无相关性（r=-0.083、-0.028、-0.024，P=0.494、0.842、0.869）。结论　儿童干眼大多数属于短BUT型干眼，其BUT缩短，睑板腺缺失明显，LLT变薄。NIBUT与NIBUTav较BUT更客观准确，LLT较睑板腺缺失评分更有价值。非侵入性眼表综合分析仪及Lipview眼表面干涉仪可以客观准确评估儿童干眼的特点。

Evaluation of dry eye in children by Keratograph 5 M and lipiview ocular surface interometry

Objective　To evaluate dry eye in children by Keratograph 5 M and lipiview ocular surface interometry.Methods　Totally 98 children （186 eyes） were firstly diagnosed as dry eye in Tianjin Medical University Eye Hospital in Jan to Aug of 2017.After completed questionnaires designed to detect subjective symptoms and ocular surface disease index（OSDI），children were underwent examinations including slit lamp，tear film break-up time （BUT），the Schirmertest （S Ⅰ T），Keratograph 5 M and lipiview ocular surface interometry.Results　Eyes with BUT<5 s were 159 and with S Ⅰ T<5 mm per 5 min were 30.OSDI ［13.63（9.09-15.91）］was not correlated with SIt ［（14.6±8.7）mm］ （r=-0.119，P=0.259） and BUT ［3.00（2.00-5.00）s］ （r=0.099，P=0.354）.First noninvasive tear film break-up time （NIBUT） and average noninvasive tear film break-up time （NIBUTav） were positively correlated with OSDI，NIBUT was strongly and positively correlated with NIBUTav （P<0.05）.NIBUT and NIBUTav were not correlated with BUT（r=0.112，0.059，P=0.159，0.455）.Lipid layer thickness （LLT） and the max of LLT were positively correlated with NIBUTav，partial blink rate was negatively correlated with NIBUTav （P<0.05）.Other indexes were not correlated with OSDI or NIBUTav.LLT，the max of LLT and min of LLT were not correlated with meibomian gland dropout degree（r=-0.083，-0.028，-0.024，P=0.494，0.842，0.869）.Conclusion　In dry eye of children，short-BUT is the common type.BUT become shorter，meibomian gland dropout become bigger and LLT become thinner.NIBUT and NIBUTav are more accurate than BUT.LLT is more useful than Meiboscore.Keratograph 5 M and lipview ocular surface interometry can evaluate dry eye in children objectively and succinctly.