Abstract：
OBJECTIVE: To explore the changes in microcirculation and microvasculature of the bulbar conjunctiva during the short-term wearing of the scleral lenses (ScCL). And investigate the factors affecting the microcirculation and microvasculature of the bulbar conjunctiva.
METHODS: In this prospective cross-sectional study, functional slit lamp biomicroscopy (FSLB) was used to image the ocular surface microcirculation and microvascular images at two different sites (under the area of ScCL and outside of the area of ScCL) before (baseline) and during the wearing of ScCL at 0 h, 1 h, 2 h and 3 h. Anterior segment optical coherence tomography (AS-OCT) (RTVue, Optovue Inc, USA) was also used to image central post-lens tear film (PoLTF) and the morphology changes of the conjunctiva under the landing zone at the same time period. The semi-automatic quantification of microcirculation and microvasculature including vessel density (Dbox), vessel diameter (D), axial blood flow velocity (Va) and blood flow volume (Q). And the morphological changes of conjunctiva and PoLTF fogging grading were evaluated manually. The changes in the microcirculation and microvasculature of the ocular surface, PoLTF fogging grade and conjunctival morphology were compared before and during the ScCL wearing at different time periods, and the relationship between them was analyzed.
RESULTS: Nineteen eyes (11 right eyes, 8 left eyes) were analyzed in this study. Outside of the area of ScCL, the Dbox before wearing lenses was less than that at 0 h (P = 0.041). The Q at baseline was greater than that after 1 h ScCL wearing (P = 0.026). Under the area of the ScCL, the Q at 1 h was less than that at baseline and 3 h. During the ScCL wearing, statistically significant conjunctival morphology changes were found among different time stages (baseline (0 μm), 0 h (113.18 μm), 2 h (138.97 μm), 3 h (143.83 μm) (all P ＜0.05). Outside the area of the ScCL, the morphology changes of the conjunctiva were negatively correlated with the changes of Va (P＜0.001,r = -0.471) and Q (P = 0.003,r = -0.348),but positively correlated with the Dbox (P = 0.001,r = 0.386). Under the area of ScCL, the morphology changes of the conjunctiva were negatively correlated with the Q (P = 0.012, r = -0.291). The fogging grade was positively correlated with the Q under the area of the ScCL (P = 0.005, r = 0.331).
CONCLUSIONS: The microcirculation and microvasculature of the ocular surface and conjunctival morphology were changed after wearing ScCL in wearers, which indicated that the microvascular responses happened in the ScCL wearers and the severity of microvascular responses of the ocular surface related to the morphology changes of the conjunctiva. The quantification methods and findings in this study provide clues for the safety of ScCL wearing and may supervise the health of the wearer\'s ocular surface.
METHODS: In this prospective cross-sectional study, functional slit lamp biomicroscopy (FSLB) was used to image the ocular surface microcirculation and microvascular images at two different sites (under the area of ScCL and outside of the area of ScCL) before (baseline) and during the wearing of ScCL at 0 h, 1 h, 2 h and 3 h. Anterior segment optical coherence tomography (AS-OCT) (RTVue, Optovue Inc, USA) was also used to image central post-lens tear film (PoLTF) and the morphology changes of the conjunctiva under the landing zone at the same time period. The semi-automatic quantification of microcirculation and microvasculature including vessel density (Dbox), vessel diameter (D), axial blood flow velocity (Va) and blood flow volume (Q). And the morphological changes of conjunctiva and PoLTF fogging grading were evaluated manually. The changes in the microcirculation and microvasculature of the ocular surface, PoLTF fogging grade and conjunctival morphology were compared before and during the ScCL wearing at different time periods, and the relationship between them was analyzed.
RESULTS: Nineteen eyes (11 right eyes, 8 left eyes) were analyzed in this study. Outside of the area of ScCL, the Dbox before wearing lenses was less than that at 0 h (P = 0.041). The Q at baseline was greater than that after 1 h ScCL wearing (P = 0.026). Under the area of the ScCL, the Q at 1 h was less than that at baseline and 3 h. During the ScCL wearing, statistically significant conjunctival morphology changes were found among different time stages (baseline (0 μm), 0 h (113.18 μm), 2 h (138.97 μm), 3 h (143.83 μm) (all P ＜0.05). Outside the area of the ScCL, the morphology changes of the conjunctiva were negatively correlated with the changes of Va (P＜0.001,r = -0.471) and Q (P = 0.003,r = -0.348),but positively correlated with the Dbox (P = 0.001,r = 0.386). Under the area of ScCL, the morphology changes of the conjunctiva were negatively correlated with the Q (P = 0.012, r = -0.291). The fogging grade was positively correlated with the Q under the area of the ScCL (P = 0.005, r = 0.331).
CONCLUSIONS: The microcirculation and microvasculature of the ocular surface and conjunctival morphology were changed after wearing ScCL in wearers, which indicated that the microvascular responses happened in the ScCL wearers and the severity of microvascular responses of the ocular surface related to the morphology changes of the conjunctiva. The quantification methods and findings in this study provide clues for the safety of ScCL wearing and may supervise the health of the wearer\'s ocular surface.
摘要：
目的：探讨短期佩戴巩膜晶状体（ScCL）时球结膜微循环和微血管的变化。并探讨影响球结膜微循环和微血管的因素。
方法：在这项前瞻性横断面研究中，使用功能裂隙灯生物显微镜（FSLB）在佩戴ScCL之前（基线）和佩戴过程中，在两个不同部位（ScCL区域下方和ScCL区域外部）对眼表微循环和微血管图像进行成像。1h,2h和3h。前段光学相干断层扫描（AS-OCT）（RTVue，OptovueInc,USA）也用于成像中央晶状体后泪膜（PoLTF）以及在同一时间段着陆区下结膜的形态变化。微循环和微脉管系统的半自动定量，包括血管密度（Dbox），血管直径（D），轴向血流速度(Va)和血流量(Q)。人工评价结膜形态变化和PoLTF雾化分级。眼表微循环和微脉管系统的变化，比较ScCL佩戴前后不同时间段的PoLTF雾化等级和结膜形态,并分析了它们之间的关系。
结果：19只眼睛（11只右眼，在这项研究中分析了8只左眼）。在ScCL区域之外，戴眼镜前的Dbox小于0h时的Dbox（P=0.041）。基线时的Q值大于1hScCL佩戴后的Q值（P=0.026）。在ScCL的区域下，1h时的Q值小于基线和3h时的Q值。在ScCL佩戴期间，在不同时间阶段(基线(0μm)，0h(113.18μm),2h(138.97μm),3h(143.83μm)(均P＜0.05)。在ScCL的区域之外，结膜形态变化与Va(P＜0.001,r=-0.471)和Q(P=0.003,r=-0.348)的变化呈负相关,但与Dbox呈正相关(P=0.001,r=0.386)。在ScCL区域下,结膜形态变化与Q值呈负相关(P=0.012,r=-0.291)。雾化等级与ScCL面积下的Q值呈正相关(P=0.005,r=0.331)。
结论：佩戴者佩戴ScCL后，眼表和结膜形态的微循环和微血管改变，这表明ScCL佩戴者发生微血管反应，眼表微血管反应的严重程度与结膜的形态变化有关。本研究中的量化方法和结果为ScCL佩戴的安全性提供了线索，并可以监督佩戴者眼表的健康状况。
方法：在这项前瞻性横断面研究中，使用功能裂隙灯生物显微镜（FSLB）在佩戴ScCL之前（基线）和佩戴过程中，在两个不同部位（ScCL区域下方和ScCL区域外部）对眼表微循环和微血管图像进行成像。1h,2h和3h。前段光学相干断层扫描（AS-OCT）（RTVue，OptovueInc,USA）也用于成像中央晶状体后泪膜（PoLTF）以及在同一时间段着陆区下结膜的形态变化。微循环和微脉管系统的半自动定量，包括血管密度（Dbox），血管直径（D），轴向血流速度(Va)和血流量(Q)。人工评价结膜形态变化和PoLTF雾化分级。眼表微循环和微脉管系统的变化，比较ScCL佩戴前后不同时间段的PoLTF雾化等级和结膜形态,并分析了它们之间的关系。
结果：19只眼睛（11只右眼，在这项研究中分析了8只左眼）。在ScCL区域之外，戴眼镜前的Dbox小于0h时的Dbox（P=0.041）。基线时的Q值大于1hScCL佩戴后的Q值（P=0.026）。在ScCL的区域下，1h时的Q值小于基线和3h时的Q值。在ScCL佩戴期间，在不同时间阶段(基线(0μm)，0h(113.18μm),2h(138.97μm),3h(143.83μm)(均P＜0.05)。在ScCL的区域之外，结膜形态变化与Va(P＜0.001,r=-0.471)和Q(P=0.003,r=-0.348)的变化呈负相关,但与Dbox呈正相关(P=0.001,r=0.386)。在ScCL区域下,结膜形态变化与Q值呈负相关(P=0.012,r=-0.291)。雾化等级与ScCL面积下的Q值呈正相关(P=0.005,r=0.331)。
结论：佩戴者佩戴ScCL后，眼表和结膜形态的微循环和微血管改变，这表明ScCL佩戴者发生微血管反应，眼表微血管反应的严重程度与结膜的形态变化有关。本研究中的量化方法和结果为ScCL佩戴的安全性提供了线索，并可以监督佩戴者眼表的健康状况。
