Yokoi Norihiko, Komuro Aoi
Department of Ophthalmology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Hirokoji-agaru, Kawaramachi-dori, Kamigyo-ku, Kyoto 602-0841, Japan.
Exp Eye Res. 2004 Mar;78(3):399-407. doi: 10.1016/j.exer.2003.09.020.
The interaction between the tear film and the ocular surface epithelium is crucial for the maintenance of ocular surface health; interference with this relationship may cause dry eye. Several diagnostic techniques have been developed to assess the tear film and diagnose dry eye but many of these tests are invasive and modify the parameter which they are designed to measure. Non-invasive or minimally invasive tests may overcome this problem and provide more reproducible and objective data. One test of this kind is meniscometry, which is particularly useful in assessing tear volume indirectly by measuring tear meniscus radius. The newly developed video-meniscometer, which enables calculation of the meniscus radius digitally, is useful for the diagnosis of tear-deficient dry eye. Video-meniscometry also has other applications, to the study of tear and eye drop turnover, determining the indication for punctal plugs and in demonstrating dysfunction of the tear meniscus. Interferometry of the tear film lipid layer is useful in screening and evaluating dry eye severity and in selecting dry eye candidates for punctal occlusion. It is also useful for analysing tear lipid layer pathophysiology more clearly, especially in combination with meniscometry. Meibometry is a minimally invasive technique to quantify the amount of meibomian lipid on the lid margin. Lipid is blotted onto a plastic tape and the change in optical density is used to calculate lipid uptake. Laser meibometry has increased the scope of this technique for the assessment of meibomian gland dysfunction; also, the delivery of lipids from the lid reservoir to the preocular tear film can be analysed using interferometry and laser meibometry. The present report reviews the application of these techniques to the study of tear film physiology and dry eye.
泪膜与眼表上皮之间的相互作用对于维持眼表健康至关重要；这种关系受到干扰可能会导致干眼。已经开发了几种诊断技术来评估泪膜并诊断干眼，但其中许多测试具有侵入性，会改变其旨在测量的参数。非侵入性或微创测试可能会克服这个问题，并提供更可重复和客观的数据。泪液弯月面测量法就是这样一种测试，它通过测量泪液弯月面半径间接评估泪液量特别有用。新开发的视频泪液弯月面测量仪能够数字计算弯月面半径，对泪液缺乏型干眼的诊断很有用。视频泪液弯月面测量法还有其他应用，可用于研究泪液和眼药水的更新、确定泪小点栓塞的指征以及证明泪液弯月面功能障碍。泪膜脂质层干涉测量法有助于筛查和评估干眼严重程度以及选择适合泪小点阻塞的干眼患者。它对于更清晰地分析泪液脂质层病理生理学也很有用，特别是与泪液弯月面测量法结合使用时。睑板腺脂质测量法是一种微创技术，用于量化睑缘睑板腺脂质的量。脂质被吸印到塑料胶带上，利用光密度的变化来计算脂质摄取量。激光睑板腺脂质测量法扩大了该技术在评估睑板腺功能障碍方面的应用范围；此外，还可以使用干涉测量法和激光睑板腺脂质测量法分析脂质从睑缘储库向眼前泪膜的输送情况。本报告综述了这些技术在泪膜生理学和干眼研究中的应用。
