Mathers W D, Shields W J, Sachdev M S, Petroll W M, Jester J V
Center for Sight, Georgetown University Medical Center, Washington, D.C. 20007.
Cornea. 1991 Jul;10(4):286-90. doi: 10.1097/00003226-199107000-00002.
We evaluated the meibomian gland function of 11 patients before and during treatment with isotretinoin (Accutane) by assessing tear osmolarity, meibomian gland morphology, tear production, rose bengal staining, and meibomian gland excreta. We found, during Accutane use, that meibomian glands appeared significantly less dense and atrophic by meibography. Excreta thickness increased from 1.7 +/- 0.9 to 3.1 +/- 1.2 (p less than 0.005), and expressible excreta volume decreased from 1.52 +/- 0.68 to 1.10 +/- 0.3 (p less than 0.05) (scale 1-4). We also found a significant increase in tear osmolarity from 304.9 +/- 11 to 316.3 +/- 10 mosmol/L (p less than 0.005). There was no significant change in the Schirmer test during treatment. We suggest that the clinical symptoms of blepharitis during Accutane therapy are related to decreased meibomian gland function and consequent increased tear evaporation and tear osmolarity.
我们通过评估泪液渗透压、睑板腺形态、泪液分泌、孟加拉玫瑰红染色以及睑板腺分泌物，对11例患者在异维A酸（泰尔丝）治疗前及治疗期间的睑板腺功能进行了评估。我们发现在使用异维A酸期间，睑板腺造影显示睑板腺密度显著降低且出现萎缩。分泌物厚度从1.7±0.9增加至3.1±1.2（p<0.005），可挤出的分泌物量从1.52±0.68降至1.10±0.3（p<0.05）（1 - 4级）。我们还发现泪液渗透压从304.9±11显著升高至316.3±10毫摩尔/升（p<0.005）。治疗期间泪液分泌试验无显著变化。我们认为异维A酸治疗期间睑缘炎的临床症状与睑板腺功能下降以及随之而来的泪液蒸发增加和泪液渗透压升高有关。
