Ocular Surface Changes And Their Clinical Significance In Patients With Moderate To Severe Acne

Objective:To assess the ocular surface symptoms and dry eye clinical indicators in patients with moderate to severe acne without clinical intervention.To compare the changes of ocular surface between subjects with moderate to severe acne and those without acne.In order to explore the potential relationship between moderate to severe acne and dry eye.Methods:Patients with moderate to severe acne who visited the dermatology department of our hospital from June 2022 to January 2023 were included in the Acne group,and acne-free subjects who met the inclusion criteria were selected as the Nonacne group.The right eye was chosen for observation.All subjects were scored on the Ocular Surface Disease Index(OSDI),and ocular surface-related indexes such as tear meniscus height(TMH),the first and average non-invasive tear breakup time(NIBUTf and NIBUTav),Schirmer I test(SIT),lipid layer thickness score(LLT score),meibomian gland orifice obstruction score,the ratio of meibomian gland loss,meibum score,conjunctival hyperemia score,corneal fluorescein staining score(CFS score)and other ocular surface related indexes were detected.Compare the differences of the examination indicators and the percentage of dry eye patients in the acne group and nonacne group.The differences in examination indicators of dry eye patients in the acne group and nonacne group(Acne-DE group and Nonacne-DE group)were also compared.Results:(1)A total of 107 participants were included in this study,including 53 in the Acne group and 54 in the Nonacne group.There were no significant differences in basic characteristics between two groups(p>0.05).The dry eye patients in the Acne group and the Nonacne group were included in the Acne-DE group and the Nonacne-DE group,including 38 cases in the Acne-DE group and 26 cases in the Nonacne-DE group,there were no significant differences in the basic characteristics of the subjects between two dry eye groups(p>0.05).(2)Compared with participants in the Non-acne group,patients with moderate to severe acne experienced significant changes in the ocular surface.The TMH,NIBUTf and NIBUTav in the Acne group were lower than those of the Nonacne group,and the OSDI,meibum score,meibomian gland orifice obstruction score,the ratio of meibomian gland loss and conjunctival hyperemia score were higher than Nonacne group(p<0.05).There was no significant difference between CFS score,SIT and LLT score between two groups(p>0.05).(3)The dry eye population in the Acne group accounted for 71.70%(38 people)of the group’s total participants,and the dry eye population in the Nonacne group accounted for 48.15%(26 people)of the group.The proportion of dry eye patients in the Acne group was significantly higher than that in the Nonacne group,and the difference was statistically significant(p<0.05);(4)Compared witho Nonacne-DE group,the TMH,NIBUTf,NIBUTav,LLT score in the Acne-DE group were lower,and the meibomian gland orifice obstruction score,the ratio of meibomian gland loss,meibum score and conjunctival hyperemia score in the Acne-DM group were higher(p<0.05).There was no significant difference between OSDI,SIT and CFS score(p>0.05).Conclusion:Patients with moderate to severe acne are more likely to suffer from dry eyes than non-acne people,and the reduced stability of tear film and impaired meibomian gland structure and function are important reasons for their ocular surface changes.Ocular surface changes were also more pronounced in dry eye patients with moderate to severe acne than dry eye patients without acne.Early assessment of ocular surface status and the prevention and treatment of dry eye in patients with moderate to severe acne should be paid attention to.