Clinical Observation Of Double-Pass Optical Quality Analysis System And Mavefront Aberration Equipment Applied To Dry Eye

Objective:A optical quality analysis system based on double-pass technology and a wavefront aberration analyzer are used to detect the tear film stability and visual quality of dry eye disease(DED)patients and healthy people,and analyze the correlation between these two non-invasive objective examination methods and traditional dry eye examination methods,and explore the value of these two examinations for the diagnosis of dry eye,it provides a simpler and more efficient method for the examination and diagnosis of dry eye,and provides a reference for the preoperative evaluation of refractive cataract surgery.Methods:Using diagnostic test research methods.All subjects were scored using the ocular surface disease index(OSDI),slit lamp examination,fluorescein break-up time(FBUT),fluorescein corneal staining(fluorescent,FL)and basic tear secretion test(Schirmer Ⅰ test,SIT).According to the 2020 China Dry Eye Expert Consensus,dry eye diagnosis and grouping were performed.Use the tear film analysis program of the visual quality analysis system OQAS Ⅱ(Visiometrics,Spain)to record the objective scatter index(OSI),OSI standard deviation(SD),tolerance limitation(TL)within 20 seconds,calculate the change of OSI average value(△ OSI),the rate of change of OSI average value over time(△OSI/t).Use the tear film continuity analysis program of the wavefront aberration analyzer KR-1W(Topcon,Japan)to record the change in the total high-order aberration of the target within 10 seconds,and establish the following parameters to evaluate the dynamic change of the aberration:the change of RMS average value(△ RMS),the rate of RMS average change over time(△ RMS/t),RMS fluctuation index(FI)and RMS stability index(SI).The Kolmogorov-Smirnov test was used to test the normality of each group of values.Since FBUT,FL score,FI and SI are time series variables,the estimated mean and 95%confidence interval(CI)were used for repeated measurement analysis.Chi-square test analyzes gender differences between groups,and analysis of variance compares whether the differences in parameters between groups are statistically significant.Spearson correlation analysis was used to evaluate the correlation between OQAS Ⅱ parameters and KR-1W parameters and the results of traditional dry eye examination items.Draw ROC curve to evaluate and compare the qualitative diagnosis effect of OQAS Ⅱ parameters and KR-1W parameters.Results:The study finally included 100 eyes of 100 subjects(all right eyes),of which 33 eyes of 33 healthy adults belonged to the normal group,35 eyes of 67 dry eye patients belonged to the mild dry eye group,and 32 eyes belonged to the medium group.Degree of dry eye group.There was no significant difference in age(P>0.05)and gender(P>0.05)between the groups.1.In traditional dry eye examinations,compared with the normal group,both the mild dry eye group and the moderate dry eye group have lower values in the FBUT and Schirmer I tests,higher OSDI and FL scores,and differences between the groups were statistically significant(P<0.05).2.Compared with the normal group,the visual quality of the dry eye group has a significant change.The △ OSI,△ OSI/t,△ RMS,△ RMS/t,TL,FI and SI of dry eye patients were significantly higher than those of the normal group,and the differences between the groups were statistically significant(P<0.05);in addition,moderate The △ OSI,△ RMS,FI and SI of the dry eye group were significantly higher than those of the mild dry eye group,and the differences between the groups were statistically significant(P<0.05).3.In the correlation analysis,OSI SD was correlated with FL and TBUT respectively(r=0.454,r=-0.407;P<0.001).△ OSI was correlated with OSDI,TBUT,FL(r=0.567,r=-0.519,r=0.574;P<0.001).△ OSI/t was correlated with OSDI,TBUT,FL(r=0.631,r=-0.488,r=0.573;P<0.001).TL was correlated with OSDI,SIT,TBUT and FL respectively(r=-0.551,r=0.658,r=0.706,r=-0.620;P<0.001).△RMS was correlated with OSDI,SIT,TBUT,FL(r=0.522,r=-0.482,r=-0.518,r=0.631;P<0.001).△RMS/t was correlated with SIT,TBUT and FL respectively(r=-0.515,r=-0.534,r=0.522;P<0.001).FI was correlated with OSDI,SIT,TBUT and FL respectively(r=-0.680,r=-0.570,r=-0.643,r=0.823;P<0.001).SI was correlated with OSDI,TBUT,FL(r=0.504,r=-0.453,r=0.604;P<0.001).That is,there is a correlation between the parameters measured by OQAS Ⅱ and the parameters measured by KR-1W and the results of traditional clinical diagnostic tests for dry eye.4.The receiver operating characteristic curve(ROC)was used to analyze the diagnostic sensitivity and specificity of the parameters measured by OQAS Ⅱ and KR-1W.Among them,FI has the highest diagnostic accuracy,and the area under curve(AUC)of ROC is 0.978(P<0.001;95%CI:0.954,1.000),and when FI takes the diagnostic cutoff value of 0.017,the sensitivity is the highest(100%),and the specificity is 84.8%;The diagnostic accuracy of △RMS/t is the second,with AUC of 0.886(P<0.001;95%CI:0.815,0.957).When △RMS/t is taken as the diagnostic cutoff value of 0.01,the sensitivity is 89.6%and the specificity is 87.9%.TL has the lowest diagnostic ability,with an AUC of 0.050(P<0.001;95%CI:0.003,0.098),and OSI SD’s diagnostic ability is not ideal either,with AUC of 0.692(P=0.002;95%CI:0.586,0.797),when OSI SD takes the best diagnostic value of 0.190,the sensitivity and specificity are not high,which are 64.2%and 69.7%,respectively.Conclusions:The double-pass optical quality analysis system and wavefront aberration analyzer OQAS Ⅱ and KR-1W can provide non-invasive objective inspection of dry eye,and there is correlation between the results of traditional clinical diagnostic inspections of dry eye;through the detection of visual quality The changes in the tear film can objectively reflect the dynamic stability of the tear film and the severity of dry eye,which is helpful for the diagnosis and treatment of clinical dry eye.