| ObjectiveTo evaluate the visual quality and the stability of the tear film of patients with mild-to-moderate dry eye and normal healthy people by using Optical Quality Analysis System(OQAS-II,Spain,Visiometrics)And to explore the correlations between traditional dry eye test and this kind of noninvasive objective method. Try to analyze the value of this method for the diagnosis of dry eye, and the use of artificial tears on the effects of various parameters of two types of people at the same time.MethodsSubjects were randomly selected only one eye for basic inspection: slit lamp examination, computer optometry, Schirmer I, tear break up time(BUT), corneal staining scoring. The diagnosis of dry eye basis on The clinical diagnosis and treatment recommendations for dry eye from consensus of expert advice(2013).Exclusion criteria: often wear contact lenses, oblique amblyopia, cornea dyeing score 1 or more points, patients with severe dry eye, eye has a history of eye surgery or trauma history, active inflammation, high myopia, astigmatism is greater than 0.5 D, vitreous opacity, other diseases with refractive media.The dry eye grope contains 42 eyes of 42 mildly or moderate dry eye people diagnosed according to “The clinical diagnosis and treatment recommendations for dry eye from consensus of expert advice”.The normal group contains 29 eyes of 29 age- and gender- matched normal people.Evaluate the Modulation Transfer Function cut off(MTF cut off),Strehl Ratio(SR),object scatter index(OSI)of patients with mild-to-moderate dry eye and normal healthy people by using Optical Quality Analysis System. And then evaluate the dynamic changes of MTF cut off、OSI、OVA(Objective visual acuity). Choose continuous measurement images to analyze,record 0 s, 5 s, 10 s, 15 s four time point of OSI, MTF cut off, OVA, and calculate total variation of the parameters(△OSI =15s OSI- 0s OSI,the same for△MTF cut off、△OVA). Repeat the above checks after drop one drop of artificial tears after 10 min.Repeated measurement analysis of variance was used to compare the differences with those at different timepoints.Independent sample t-test to compare differences between groups at each time point.Use matching t test to compare differences between with or without artificial tears. The Mann- Whitney U test to compare two groups of △OSI、△MTF cut off、△OVA.The ability of △OSI、△MTF cut off、△OVA to identify dry eye was analysed by receiver operating characteristic curve(ROC curve)The correlation analysis use Spearson method.ResultsIn dry eye group, significant differences were detected among different time points in OSI(F = 15.44, P < 0.001), the MTF cut off(F = 28.87, P < 0.001), OVA(F = 26.46, P < 0.001),while no significant difference was detected in normal group:OSI(F=1.83,P=0.17)、MTF cut off(F=0.44,P=0.73)、OVA(F=0.75,P=0.53).No significant difference was detected between two groups at 0s:OSI(t =0.76,P=0.45)、MTF cut off(t =﹣0.12,P=0.91)、OVA(t =﹣0.14,P=0.89).Significant differences were detected between groups at 5s、10s、15s(the values of P are less than 0.05).OSI in dry eye group are greater,while MTF cut off、OVA are less than normal group.△OSI、△MTF cut off、△OVA value are 1.03±1.53、-8.37±9.64、-0.30±0.32 in dry eye group respectively,0.06±0.16、-0.37±5.27、-0.03±0.18 in normal group.AUC of △OSI、△MTF cut off、△OVA was 0.90、0.79、0.78 respectively. The cut off value of △ OSI 0.30 had 78.6% sensitivity and 93.1% specificity.Significant differences of OSI、MTF cut off、SR,△OSI、△MTF cut off、△OVA were detected between before and after artificial tears in dry eye group((P < 0.05),while no statistically significant difference were observed in the normal group before and after(P were greater than 0.05).ConclusionThe visual quality of dry eyes decreased with time while it kept stable in normal eyes. Tear film of dry eyes changed more quikly than normal eyes.This dynamic method can detect the stability of tear film and separate mild-moderate dry eyes from normal eyes.Artificial tears can improve visual quality of mild and moderate dry eye. |
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