Smith Janine A, Vitale Susan, Reed George F, Grieshaber Shirley A, Goodman Linda A, Vanderhoof Vien H, Calis Karim A, Nelson Lawrence M
Division of Epidemiology and Clinical Research, National Eye Institute, Developmental Endocrinology Branch, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20892-1863, USA.
Arch Ophthalmol. 2004 Feb;122(2):151-6. doi: 10.1001/archopht.122.2.151.
To examine whether women with premature ovarian failure (POF) have abnormal findings in ocular surface or tear parameters and whether they report symptoms of ocular discomfort compared with age-matched controls.
Sixty-five patients with POF and 36 age-matched healthy controls were examined for signs and symptoms of dry eye. The Ocular Surface Disease Index questionnaire and the 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ 25) were administered to the participants. Assessments of ocular surface damage (Oxford and van Bijsterveld scores of vital dye staining) and tear status (Schirmer tests 1 [without anesthesia] and 2 [with anesthesia] and tear breakup time) were performed.
Women with POF scored significantly worse than controls on all ocular surface damage parameters: Oxford score (3.2 vs 1.7; P =.001), conjunctival lissamine green (2.1 vs 1.3; P =.02), corneal fluorescein staining (1.2 vs 0.4; P =.005), and van Bijsterveld score (2.1 vs 1.3; P =.02). Further, the proportion of patients with POF meeting the dry eye diagnostic criterion of a van Bijsterveld score greater than or equal to 4 was significantly greater among women with POF than among controls (20% vs 3%; P =.02). The POF group also tended to have worse scores than controls on self-reported symptoms, as measured by the overall Ocular Surface Disease Index (12.5 vs 2.1; P<.001) and the overall NEI-VFQ (94 vs 98; P =.001) after adjustment for age and race. Schirmer test scores and tear breakup time did not differ.
Women with POF were more likely to exhibit ocular surface damage and symptoms of dry eye than age-matched controls. They were not, however, more likely to have reduced tear production. To our knowledge, this association between ocular surface disease and POF has not been previously reported. These data provide further evidence of the multifaceted role of sex hormones in the health and disease of the ocular surface.
探讨卵巢早衰（POF）女性在眼表或泪液参数方面是否存在异常表现，以及与年龄匹配的对照组相比，她们是否有眼部不适症状。
对65例POF患者和36例年龄匹配的健康对照者进行干眼体征和症状检查。向参与者发放眼表疾病指数问卷和25项美国国立眼科研究所视觉功能问卷（NEI-VFQ 25）。进行眼表损伤评估（活体染料染色的牛津评分和范·比斯特维尔德评分）和泪液状态评估（Schirmer试验1[无麻醉]和试验2[有麻醉]以及泪膜破裂时间）。
在所有眼表损伤参数方面，POF女性的得分显著低于对照组：牛津评分（3.2对1.7；P = 0.001）、结膜丽丝胺绿染色（2.1对1.3；P = 0.02）、角膜荧光素染色（1.2对0.4；P = 0.005）以及范·比斯特维尔德评分（2.1对1.3；P = 0.02）。此外，POF女性中范·比斯特维尔德评分大于或等于4且符合干眼诊断标准的患者比例显著高于对照组（20%对3%；P = 0.02）。在根据年龄和种族进行调整后，POF组在自我报告症状方面的得分也往往低于对照组，通过总体眼表疾病指数衡量（12.5对2.1；P<0.001）以及总体NEI-VFQ衡量（94对98；P = 0.001）。Schirmer试验得分和泪膜破裂时间无差异。
与年龄匹配的对照组相比，POF女性更有可能出现眼表损伤和干眼症状。然而，她们泪液分泌减少的可能性并未增加。据我们所知，此前尚未报道眼表疾病与POF之间的这种关联。这些数据进一步证明了性激素在眼表健康和疾病中的多方面作用。
