眼科 ›› 2013, Vol. 22 ›› Issue (6): 370-374.

• 论著 • 上一篇    下一篇

长波长前节OCT在睑板腺形态检测中的初步应用研究

苏炳男  梁庆丰  周敏  Antoine Labbe   

  1. 100005 首都医科大学附属北京同仁医院 北京同仁眼科中心 北京市眼科研究所 北京市眼科学与视觉科学重点实验室(苏炳男、梁庆丰、周敏);法国Quinze-Vingts国立眼科医院 法国Versailles Saint-Quentin-Yvelines大学(Antoine Labbe)
  • 收稿日期:2013-09-20 出版日期:2013-11-25 发布日期:2013-12-10
  • 通讯作者: 梁庆丰,Email:lqflucky@163.com E-mail:lqflucky@163.com
  • 基金资助:

    首都卫生发展科研专项基金(2011-1016-04)

Morphological evaluation of meibomian gland by anterior segment optical coherence tomography with the wavelength of 1310 nm

SU Bing-nan1, LIANG Qing-feng1, ZHOU Min1, LABBE Antoine2   

  1.  1. Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing 100005, China; 2. Quinze-Vingts National Ophthalmology Hospital and Ambroise Paré Hospital, AP-HP, Paris, France
  • Received:2013-09-20 Online:2013-11-25 Published:2013-12-10
  • Contact: LIANG Qing-feng, Email: lqflucky@163.com E-mail:lqflucky@163.com

摘要:  目的 探讨长波长(1310 nm)前段相干光断层扫描(AS-OCT)在睑板腺形态检测中的应用价值。设计 前瞻性病例系列。研究对象 19~50岁正常自愿受试者8例(8眼)。方法 对受试者进行非接触红外线睑板腺照相及长波长AS-OCT检查。在睑板腺照相基础上从四个不同位置(睑板腺开口区、近睑板腺开口的腺体分布区、近穹窿部睑板腺区及中央区)进行AS-OCT扫描;利用自行开发“OCT图像增强软件”处理获得的扫描图像,分析睑板腺开口及腺体分布情况。明确睑板腺开口有无阻塞及脂栓形成;使用ImageJ软件半自动模块对睑板腺腺体宽度及距睑结膜位置等相关参数进行定量检测及对比分析。主要指标 睑板腺开口有无阻塞及脂栓形成;睑板腺腺体宽度及距睑结膜位置。结果 长波长AS-OCT在睑板腺开口区扫描线可观察睑板腺开口情况,计算阻塞及脂栓形成的睑板腺开口数量;近睑板腺开口的腺体分布区扫描线可清晰显示横断面睑板腺形态,是了解睑板腺腺体形态的最佳位置。同时发现,睑板腺开口阻塞者其睑板腺缺失面积较大者残存腺体增粗并距睑结膜位置较深。结论 使用长波长AS-OCT可较好地定量检测睑板腺腺体宽度、清昕地观察睑板腺开口阻塞情况,对睑板腺功能障碍的诊断具有潜在应用价值。

关键词: 前段相干光断层扫描, 睑板腺照相, 睑板腺功能障碍

Abstract:  Objective To evaluate the feasibility of anterior segment optical coherence tomography (AS-OCT) with the wavelength of 1310 nm in the morphological detection of meibomian gland. Design Prospective case series. Participants 8 volunteers (8 eyes) aged 19~50 years old. Methods All subjects were underwent the examinations of infrared meibomian gland tomography and AS-OCT. The AS-OCT scanning was taken in four different locations (meibomian orifices, the meibomian gland regions close to orifices and close to the zone of the fornix, and the middle area of meibomian gland). The images from AS-OCT were collected and processed with image-intensification software to clarify its morphology appearance. The existence and number of plugged meibomain gland orifices were detected and quantified. The width of every meibomain gland and the depth from the anterior surface of the palpebral conjunctiva were measured with ImageJ software. Main Outcome Measures morphology appearance of meibomain gland orifices, the width of meibomain gland, and the depth from the anterior surface of the palpebral conjunctiva. Results The AS-OCT images of meibomain gland from the meibomian orifices location exhibited the meibomian orifices clearly, and the number of the obstructed and plugged orifices could be counted and evaluated. The images from the meibomian gland regions close to orifices and close to the zone of the fornix location manifested the cross-section morphology of the meibomian gland, which is the ideal location of observation. Some cases manifested that meibomian gland with plugged orifices were matched with the larger dropout area of meibomian glands. In addition, these patients were revealed that unhealthy meibomian glands turned wider and located deeper from palpebral conjunctiva. Conclusion The AS-OCT with the wavelength of 1310 nm is a novel, noninvasive method for assessing the morphology of meibomian gland, and may have potential applications for the diagnosis and evaluation of meibomian gland dysfunction.

Key words: anterior segment optical coherence tomography, meibography system, meibomian gland dysfunction