| Objective:To analyze the detection rule of eyelash demodex and its effect on the ocular surface indexes of patients,and to explore the relationship between meibomian gland dysfunction(meibomian glanddysfunction,MGD)caused by eyelash demodex infection and the occurrence of dry eyes.Methods:A total of 182 patients with ocular discomfort in our hospital from February to September 2020 were collected.They were divided into MGD group(94 eyes)and nmgd group(88 eyes).Four eyelashes were taken from the upper and lower right eyelids to sample the eyelashes.The eyelashes were examined by optical microscope.According to the detection of demodex,the patients were divided into groups:positive(n=70)and negative(n=24)in MGD group,and positive(n=32)and negative(n=56)in NMGD group.The subjects examined the function of meibomian gland,such as using slit lamp to check for abnormal edge of eyelid,lipid secretion and excretion degree,and using non-contact infrared photography system to investigate the loss rate of eyelid gland.In addition,a questionnaire survey((Ocular surface disease index,OSDI)was conducted to evaluate the subjective symptoms and risk factors of dry eye disease,as well as a series of auxiliary examinations of dry eye disease,including Tear break-up time(BUT),Fluorescein staintest(FL)and Schirmer I test(SLT).Result:(1)Among 94 MGD patients,70 were infected with Demodex,the detection rate was 38%,and that of 88 cases NMGD was 32,the detection rate was 17%.There was significant statistical difference between the two groups(χ2=26.788,P<0.05).The detection rate of Demodex in the high age group was higher than that of the low age group(34%vs21%),the positive rate of Demodex in male patients(35%)was significantly higher than that of women(20%)(P<0.05).(2)There were significant differences in OSDI,BUT,FL,Meibomian gland loss rate and Slit lamp score(P<0.05),but no significant difference in SLT(P>0.05).There were significant differences in OSDI,BUT,FL and Slit lamp scores between Demodex positive(n=32)and Demodex negative(n=56)in NMGD group(P<0.05),but no significant differences in SLT and meibomian gland deletion rate(P>0.05).(3)The positive rate of Demodex infection(n=102)in osdi and FL was higher than that in Demodex negative group(n=80),but in positive group was lower than that in negative group(P<0.05).There was no significant difference in SLT(P>0.05).(4)OSDI,FL,BUT and Slit lamp scores of Demodex positive patients(n=102)were significantly improved after 4 weeks of treatment(P<0.05).The SLT was 6.39 ± 2.11mm and 6.19 ± 1.49mm respectively(Z=-1.278,P=0.201).The loss rate of meibomian gland was 49.72 ±15.19%and 49.37 ± 15.20%respectively(Z=-0.209,P=0.835).Compared with before treatment,the improvement degree was not obvious,and the difference was not statistically significant(P>0.05).Finally,the patients who were positive for demodex(nasty 102)were treated with anti-mite for 4 weeks,and the above ocular surface indexes were detected again after treatment.Conclusion:(1)The risk of Demodex infection in MGD patients was significantly higher than that in healthy people.(2)Severe demodex infection is one of the causes of MGD,and severe demodex infection may directly lead to and aggravate the ocular surface damage of dry eye.(3)Patients with severe ocular discomfort and shorter tear break-up time need to investigate the presence of Demodex and intervene. |
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