视觉感知训练配合0.05%环孢素A治疗对中度干眼症患者眼表及泪膜的影响

The effect of visual perception training combined with 0.05% Cyclosporine A treatment on ocular surface and tear film in patients with moderate dry eye disease

摘要:

目的 探讨视觉感知训练配合0.05%环孢素A治疗对中度干眼症患者眼表及泪膜的影响。方法 选取2021年2月—2023年2月首都医科大学附属北京朝阳医院收治的118例中度干眼症患者，采用随机数字表法分为对照组与观察组，各59例。对照组给予0.05%环孢素A治疗，观察组给予视觉感知训练配合0.05%环孢素A治疗。比较两组患者的干眼症状评分、眼表疾病指数量表（OSDI）、简式抑郁-焦虑-压力量表（DASS-21）、角膜荧光素染色（FL）评分、泪河高度、视觉质量分析系统（OQAS-Ⅱ）、泪膜破裂时间（BUT）、泪液分泌试验（SⅠt）。结果 观察组与对照组治疗前、治疗1周、治疗1个月、治疗3个月干眼症状评分比较，采用重复测量设计的方差分析，结果 ①不同时间点的干眼症状评分比较，差异有统计学意义（F =12.133，P =0.000）；②观察组与对照组干眼症状评分比较，差异有统计学意义（F =316.129，P =0.000），观察组与对照组相比干眼症状评分较低，效果较好；③观察组与对照组的干眼症状评分变化趋势比较，差异有统计学意义（F =10.158，P =0.000）。观察组治疗前后OSDI评分、DASS-21评分的差值高于对照组（P <0.05）；观察组治疗前后FL、泪河高度的差值高于对照组（P <0.05）；观察组治疗前后调制传递函数（MTF）截止频率、斯特列尔比、泪膜散射指数（TF-OSI）的差值均高于对照组（P <0.05）；观察组治疗前后BUT、SⅠt的差值均高于对照组（P <0.05）。结论 视觉感知训练配合0.05%环孢素A治疗对中度干眼症患者具有显著疗效，能够有效提高患者的干眼症状、眼表健康和视觉质量，是一种有效且安全的治疗方法。

Abstract:

Objective To investigate the effects of visual perception training combined with 0.05% Cyclosporine A on the ocular surface and tear film of patients with moderate dry eye syndrome.Methods A total of 118 patients with moderate dry eye syndrome treated at Beijing Chaoyang Hospital, Capital Medical University from February 2021 to February 2023 were selected and randomly divided into a control group and an observation group, with 59 cases in each group. The control group was treated with 0.05% Cyclosporine A, and the observation group was treated with visual perception training combined with 0.05% Cyclosporine A. The dry eye symptom score, Ocular Surface Disease Index (OSDI), Depression Anxiety Stress Scale-21 (DASS-21), corneal fluorescein staining (FL) score, tear meniscus height, Optical Quality Analysis System Ⅱ (OQAS-Ⅱ), tear film break-up time (BUT), and tear secretion test (SⅠt) were compared between the two groups.Results The repeated measures analysis of variance showed that there was a significant difference in the dry eye symptom score at different time points (F = 12.133, P = 0.000). The dry eye symptom score in the observation group was lower than that in the control group, and the difference was statistically significant (F = 316.129, P = 0.000). There was a significant difference in the change trend of dry eye symptom scores between the observation group and the control group (F = 10.158, P = 0.000). The difference in OSDI scores and DASS-21 scores before and after treatment was higher in the observation group than in the control group (P < 0.05). The difference in FL and tear meniscus height before and after treatment was higher in the observation group than in the control group (P < 0.05). The difference in MTF cutoff frequency, Strehl ratio, and TF-OSI before and after treatment was higher in the observation group than in the control group (P < 0.05). The difference in BUT and SⅠt before and after treatment was higher in the observation group than in the control group (P < 0.05).Conclusion Visual perception training combined with 0.05% Cyclosporine A has significant efficacy in the treatment of patients with moderate dry eye syndrome, can effectively improve dry eye symptoms, ocular surface health, and visual quality, and is an effective and safe treatment method.