目的:本研究旨在比较干眼患者COVID-19感染前后的干眼参数。
方法:我们从现有的干眼队列中纳入了44例干眼患者(88只眼),其中22人因先前的COVID-19感染而属于COVID-19后组,另外22人因无COVID-19病史而属于非COVID-19组。我们检查并比较了COVID-19后组的干眼参数,包括眼表疾病指数(OSDI),Schirmer的测试结果(ST),非侵入性角膜造影泪液破裂时间(NIKBUT),脂质层厚度(LLT),睑板腺功能障碍(MGD),以及乳头和卵泡的分级,COVID-19感染前后。我们还比较了COVID-19后组和非COVID-19组的干眼参数差异。
结果:COVID-19后组由平均年龄38.36±14.99岁的个体组成,其中82%是女性。两次试验间隔时间为16.92±5.40个月,与非COVID-19组没有显着差异。与前COVID-19的眼睛相比,COVID-19后的眼睛显示平均LLT显着降低(52.86±18.00nm与63.00±22.40nm,p<0.001),以及最大LLT(67.89±20.81nm与78.48±20.55nm,p<0.001)。COVID-19感染后,上眼睑(1.75±0.84)和下眼睑(1.43±0.73)的MGD恶化。此外,感染COVID-19后,乳头的分级更差(0.61±0.69与0.16±0.37,p<0.001)。多元线性回归模型显示COVID-19感染与NIKBUT平均值呈负相关(β=-2.98,95CI:(-5.82,-0.15),p=0.039),LLT-平均值(β=-14.12,95CI:(-22.66,-5.59),p=0.001),和LLT最大值(β=-15.65,95CI:(-23.09,-8.20),p<0.001)。
结论:从初步结果来看,我们得出的结论是,感染了COVID-19的干眼症患者似乎患有更严重的干眼症,较低的LLT证明了这一点,更糟糕的乳头和MGD,更短的NIKBUT。重要的是要提高对COVID-19这种潜在的长期症状的认识,特别是在现有的干眼症患者中。
OBJECTIVE: This study aims to compare dry eye parameters before and after COVID-19 infection in dry eye patients.
METHODS: We included 44 dry eye patients (88 eyes) from our existing dry eye cohort, with 22 belonging to the post-COVID-19 group due to a prior COVID-19 infection and the other 22 forming the non-COVID-19 group as they had no history of COVID-19. We examined and compared the dry eye parameters of the post-COVID-19 group, including the ocular surface disease index (OSDI), Schirmer\'s test results (ST), non-invasive Keratography tear break-up time (NIKBUT), lipid layer thickness (LLT), Meibomian gland dysfunction (MGD), and the grading of papillae and follicles, both before and after the COVID-19 infection. We also compared the dry eye parameters difference of the post-COVID-19 group with the non-COVID-19 group.
RESULTS: The post-COVID-19 group was comprised of individuals with an average age of 38.36 ± 14.99 years, of which 82% were female. The time interval between the two tests was 16.92 ± 5.40 months, which did not differ significantly from the non-COVID-19 group. Compared to the pre-COVID-19 eyes, the post-COVID-19 eyes showed a significant decrease in the average LLT (52.86 ± 18.00 nm vs. 63.00 ± 22.40 nm, p < 0.001), as well as the maximum LLT (67.89 ± 20.81 nm vs. 78.48 ± 20.55 nm, p < 0.001). The MGD in both the upper (1.75 ± 0.84) and lower eyelids (1.43 ± 0.73) worsened after a COVID-19 infection. Additionally, the grading of papillae was worse following a COVID-19 infection (0.61 ± 0.69 vs. 0.16 ± 0.37, p < 0.001). The multivariate linear regression model revealed a negative association between COVID-19 infection and NIKBUT-average (β = -2.98, 95%CI: (-5.82, -0.15), p = 0.039), LLT-average (β = -14.12, 95%CI: (-22.66, -5.59), p = 0.001), and LLT max (β = -15.65, 95%CI: (-23.09, -8.20), p < 0.001).
CONCLUSIONS: From preliminary results, we concluded that dry eye patients who have been infected with COVID-19 appear to have a more severe dry eye condition, as evidenced by lower LLT, worse papillae and MGD, and shorter NIKBUT. It is important to raise awareness of this potential long-term symptom of COVID-19, especially among existing dry eye patients.