Impact of dry eye disease on the dynamic retinal image quality
Hu Ailian,Cai Xiaogu,Wan Xiuhua,Qiao Liya,Liang Qingfeng,Lin Zhong,Guan Zheng,Tan Jiarui,Wang Ningli
Beijing Institute of Ophthalmology， Beijing Tongren Eye Center， Beijing Tongren Hospital， Capital Medical University， Beijing Ophthalmology & Visual Sciences Key Laboratory， Beijing 100730， China
Objective To compare the dynamic ocular modulation transfer function （MTF） between normal and dry eye disease （DED） patients， to determine the associations between dry eye related examinations and ocular optical performance. Methods In a prospective cohort study， 22 eyes of 22 dry eye patients （DED group） and 20 eye of 20 normal subjects （control group） were consecutively enrolled from outpatient clinic in Beijing Tongren Hospital. Series of consecutive MTFcutoff frequency at 6-mm pupil was derived from dynamic retinal images obtained by a double-pass system （OQASⅡ， Spain， Visiometrics） after a blink （0-10 s）. Vision-related quality of life was evaluated using the ocular surface disease index （OSDI） questionnaire. The clinical examination included tear film assessment [tear film break-up time （BUT） and Schirmer Ⅰ test] and corneal fluorescence staining. Mean value of MTFcutoff in different time stages after blink and MTFcutoff progress index were compared between groups and analyzed the related factors. Results The BUT of DED/control group were 3.36±1.26 s/10.80±1.61 s（t=-12.27， P<0.01）. Schirmer Ⅰ test were 7.95±2.52 mm/12.75±3.89 mm （t=-2.74， P<0.01）； OSDI score were 30.96±15.45/12.86±9.71（t=4.42， P<0.01）. The mean MTFcutoff values of 0.0-2.5 s， >2.5-5 s， >5.0-7.5 s， >7.5-10 s after blink were 26.20±16.09， 24.60±15.99， 24.24±15.83， 23.20±15.05 （F=14.49， P<0.01） in DED group， 21.23±9.38， 20.98±8.72， 21.12±9.38， 20.11±8.28 （F=1.54， P>0.05） in control group. The MTFcutoff progression index of DED/control group were -0.36±0.38/-0.10±0.37（t=-2.16， P<0.05）. MTFcutoff progression index was statistically significant positive correlative with gender （r=0.46， P<0.01）， BCVA （r=0.33， P<0.05）， and BUT （r=0.34， P<0.05）， negative correlative with OSDI vision-related activities of daily living （r=-0.36， P<0.05） and OSDI overall averaged score （r=-0.31， P<0.05）. Conclusion Progressive degradation of retinal image quality is significant worse in DED eyes compared with normal， which is related with both the BUT and vision-related quality of life.
The definition and classification of dry eye disease： report of the Definition and Classification Subcommittee of the International Dry Eye WorkShop （2007）[J]. Ocul Surf，2007，5（2）：75-92.
[2]
Ridder WH 3rd， Tomlinson A， Huang JF， et al. Impaired visual performance in patients with dry eye[J]. Ocul Surf，2011，9（1）：42-55.
Denoyer A， Rabut G， Baudouin C. Tear film aberration dynamics and vision-related quality of life in patients with dry eye disease[J]. Ophthalmology，2012，119（9）：1811-1818.
[6]
Diaz-Douton F， Benito A， Pujol J， et al. Comparison of the retinal image quality with a Hartmann-Shack wavefront sensor and a double-pass instrument[J]. Invest Ophthalmol Vis Sci，2006，47（4）：1710-1716.
[7]
Benito A， Perez GM， Mirabet S， et al. Objective optical assessment of tear-film quality dynamics in normal and mildly symptomatic dry eyes[J]. J Cataract Refract Surg，2011，37（8）： 1481-1487.
Goto E， Yagi Y， Matsumoto Y， et al. Impaired functional visual acuity of dry eye patients[J]. Am J Ophthalmol，2002， 133（2）：181-186.
[12]
Ishida R， Kojima T， Dogru M， et al. The application of a new continuous functional visual acuity measurement system in dry eye syndromes[J]. Am J Ophthalmol，2005，139（2）：253-258.
[13]
Wang Y， Xu J， Sun X， et al. Dynamic wavefront aberrations and visual acuity in normal and dry eyes[J]. Clin Exp Optom， 2009，92（3）：267-273.
[14]
Tutt R， Bradley A， Begley C， et al. Optical and visual impact of tear break-up in human eyes[J]. Invest ophthalmol Vis Sci，2000，41（1）：4117-4123.
Shizuka K， Yasushi I， Toshiki S， et al. Effect of rebamipide ophthalmic suspension on optical quality in the short break-up time type of dry eye[J]. Cornea，2013，32（9）：1219-1223.
[18]
Montés-Micó R， Alió JL， Charman WN. Dynamic changes in the tear film in dry eyes[J]. Invest Ophthalmol Vis Sci，2005，46（15）：1615-1619.
Nathalie D， Xavier R， Ghislaine R， et al. The impact of dry eye disease on visual performance while driving[J]. Am J Ophthalmol，2013，156（1）：184-189.e3.
浙公网安备 33030202001892号