目的:探讨睑板腺功能障碍(MGD)患者的长期病程,并分析影响睑板腺(MG)脱落恢复的潜在因素。
方法:本回顾性研究纳入79例MGD患者(79只眼),年龄36.03±15.78岁,随访一年以上。角膜荧光素染色(CFS),撕裂弯月面高度(TMH),非侵入性破裂时间(NIBUT),收集并分析了基线和最后一次访视时的非接触示波图.然后使用自动MG分析仪测量MG的形态和功能参数,包括它们的面积比(AR),弯曲指数(TI),和信号指数(SI)。AR增加超过5%的患者被定义为MG改善,MG恶化时AR下降5%以上。
结果:对79例患者(79只眼)进行了至少1年的随访。超过1/3的MGD患者(27眼,34.2%)进行了MG改善,30.4%的MGs恶化。年龄(P=0.002),性别(P<0.001),IPL治疗(P=0.013),CFS的变化(P=0.0015),SI的回收率(P=0.035)在不同恢复组之间存在显着差异。年龄(P<0.001),女性(P=0.003),ΔCFS(P<0.001),基线AR(P<0.001)与AR恢复呈负相关,SI(P=0.003)和IPL治疗(P=0.003)的变化与其呈正相关。其中,年龄(P=0.038),CFS的变化(P=0.004),和基线时的AR(P=0.007)被证实为预测MG长期变化的负相关因素。
结论:尽管MGD治疗持续超过1年,只有34.2%的MGD患者观察到MG改善.年轻的患者和CFS恢复更好的患者似乎有更多的机会来改善他们的MG。
OBJECTIVE: To explore the long-term course of patients with meibomian gland dysfunction (MGD), and to analyse potential factors affecting the recovery of meibomian gland (MG) dropout.
METHODS: Seventy-nine MGD patients (79 eyes) aged 36.03±15.78 years old who underwent more than one year of follow-up were enrolled in this retrospective study. Corneal fluorescein staining (CFS), tear meniscus height (TMH), noninvasive breakup time (NIBUT), and noncontact meibography at baseline and last visit were collected and analysed. Then an automatic MG analyzer was used to measure the morphological and functional parameters of MGs, including their area ratio (AR), tortuosity index (TI), and signal index (SI). The patients whose AR increased by more than 5% were defined as MG improvement, and AR decreased by more than 5% was MG worsening.
RESULTS: A total of 79 patients (79 eyes) were assessed with at least 1-year of follow-up. More than 1/3 of MGD patients (27 eyes, 34.2%) underwent MG improvement, and 30.4% of MGs became worsened. Age (P=0.002), gender (P<0.001), IPL treatment (P=0.013), the change of CFS (P=0.0015), and the recovery of SI (P=0.035) showed significant differences among different recovery groups. Age(P<0.001), female sex (P=0.003), ΔCFS (P<0.001), AR at baseline (P<0.001) were negative correlation with AR recovery, and the change of SI (P=0.003) and IPL treatment (P=0.003) had a positive correlation with it. Among them, age (P=0.038), the change of CFS (P=0.004), and AR at baseline (P=0.007) were confirmed as negatively correlated factors predicting the long-term change of the MG.
CONCLUSIONS: Although the MGD treatment has continued for more than 1 year, only 34.2% of MGD patients were observed to undergo MG improvement. Younger patients and patients with better CFS recovery seem to have more opportunities to improve their MGs.