Yokoi N, Kinoshita S, Bron A J, Tiffany J M, Sugita J, Inatomi T
Department of Ophthalmology, Kyoto Prefectural University of Medicine, Japan.
Invest Ophthalmol Vis Sci. 2000 Nov;41(12):3748-53.
To elucidate the effect of the cotton thread test (CT-T) and Schirmer test (S-T) on the tear reservoir by evaluating the radius of tear meniscus curvature.
The radii (R) of the central lower tear menisci were measured by a newly developed video meniscometer in 11 eyes of 11 normal volunteers (6 men, 5 women; mean age, 27.7 +/- 3.6 years [SD]) and 9 eyes of 9 patients with tear deficiency and severe dry eye in whom the puncta had been therapeutically occluded (9 women; mean age, 50.6 +/- 10.4 years). In this dry eye group, the absence of reflex tearing, coupled with the absence of lacrimal drainage due to punctal occlusion allowed more precise observation of the removal of tears from the meniscus. A 1-minute CT-T was performed, followed after an interval of 10 minutes by a 1-minute S-T. Tear meniscus curvature was documented before (R:(0)) and during the tests at 30 seconds (R(30)) and 60 seconds (R:(60)).
In the normal group, respective R values (CT-T; S-T; mean +/- SD mm) were R(0) (0.26 +/- 0.11; 0.26 +/- 0. 07), R(30) (0.27 +/- 0.16; 0.20 +/- 0.13), and R(60) (0.29 +/- 0.15; 0.23 +/- 0.21); and in the dry eye group, respective R: values (CT-T; S-T) were R(0) (0.59 +/- 0.23; 0.51 +/- 0.19), R(30) (0.52 +/- 0.25; 0.22 +/- 0.09), and R(60) (0.51 +/- 0.19; 0.21 +/- 0.08). It was demonstrated in the dry eye group that R was diminished more by the S-T than by the CT-T in the time course of the measurement (P = 0.01). In the dry eye group alteration of R occurred within the first 30 seconds, and in this group significant correlation was found between R(0) and the S-T result (r = 0.67; P = 0.05), and between R(60)- R(0) and the S-T result (r = -0.81; P = 0.01). Also, there was a significant correlation between R(60)- R(0) and the S-T result in the normal group (r = 0.71; P = 0.02). There were no significant correlations between R(0) or R(60)- R(0) and the CT-T results in either group.
These studies afford some insight into the dynamics of the Schirmer test, suggesting that wetting is influenced by the negative hydrostatic pressure within the tear meniscus. With the protocol used, no conclusion could be drawn about the relation between meniscus radius and wetting of the cotton thread.
通过评估泪液半月皱襞曲率半径，阐明棉线试验（CT-T）和泪液分泌试验（S-T）对泪液储存器的影响。
使用新开发的视频半月皱襞测量仪，测量11名正常志愿者（6名男性，5名女性；平均年龄27.7±3.6岁[标准差]）的11只眼睛以及9名泪液缺乏和严重干眼且泪点已进行治疗性封闭的患者（9名女性；平均年龄50.6±10.4岁）的9只眼睛的中央下泪液半月皱襞的半径（R）。在这个干眼组中，由于泪点封闭导致反射性流泪缺失以及泪液引流缺失，使得能够更精确地观察泪液从半月皱襞的清除情况。进行1分钟的CT-T，间隔10分钟后进行1分钟的S-T。记录试验前（R:(0)）以及试验过程中30秒（R(30)）和60秒（R:(60)）时的泪液半月皱襞曲率。
在正常组中，各自的R值（CT-T；S-T；平均值±标准差毫米）分别为R(0)（0.26±0.11；0.26±0.07）、R(30)（0.27±0.16；0.20±0.13）和R(60)（0.29±0.15；0.23±0.21）；在干眼组中，各自的R:值（CT-T；S-T）分别为R(0)（0.59±0.23；0.51±0.19）、R(30)（0.52±0.25；0.22±0.09）和R(60)（0.51±0.19；0.21±0.08）。在干眼组中表明，在测量过程中S-T比CT-T使R减小得更多（P = 0.01）。在干眼组中，R的改变发生在最初30秒内，并且在该组中发现R(0)与S-T结果之间存在显著相关性（r = 0.67；P = 0.05），以及R(60)-R(0)与S-T结果之间存在显著相关性（r = -0.81；P = 0.01）。此外，在正常组中R(60)-R(0)与S-T结果之间也存在显著相关性（r = 0.71；P = 0.02）。在两组中，R(0)或R(60)-R(0)与CT-T结果之间均无显著相关性。
这些研究为泪液分泌试验的动力学提供了一些见解，表明湿润受到泪液半月皱襞内负静水压力的影响。使用所采用的方案，无法得出关于半月皱襞半径与棉线湿润之间关系的结论。
