Karalezli Aylin, Borazan Mehmet, Yilmaz Sema, Kiyici Halil, Akova Yonca Aydin
Department of Ophthalmology, Rheumatology and Pathology, Baskent University School of Medicine, Ankara, Turkey.
Acta Ophthalmol. 2009 Feb;87(1):39-43. doi: 10.1111/j.1755-3768.2008.01437.x. Epub 2008 Dec 16.
To evaluate the ocular surface changes and tear-film functions in patients with familial Mediterranean fever (FMF).
This prospective case-control clinical study examined 35 patients with FMF (group 1) and 35 controls (group 2). All patients underwent a full ophthalmological examination. Ocular surface changes were evaluated by determining cell content of surface conjunctival epithelium using conjunctival impression cytology and tear-film functions using Schirmer-I, break-up time (BUT), corneal fluorescein and Rose Bengal tests. Subjective ocular complaints were scored with a four-point scale. Between-group results were compared.
In group 1, impression cytology revealed grade 0 changes in 15 eyes, grade 1 changes in 11 eyes and grade 2 changes in nine eyes in group 1; in group 2, it revealed grade 0 changes in 27 eyes, grade 1 changes in five eyes and grade 2 changes in three eyes (p = 0.013). Mean goblet cell density was 765 +/- 45 cells/mm(2) in group 1 and 1730 +/- 100 cells/mm(2) in group 2 (P < 0.001). Mean results on the Schirmer-I test results were 17.36 +/- 3.18 mm in group 1 and 19.60 +/- 4.17 mm in group 2 (p = 0.364). Mean BUT was 8.20 +/- 1.60 seconds in group 1 and 9.93 +/- 2.33 seconds in group 2 (p = 0.001). Mean corneal fluorescein and Rose Bengal staining scores were 3.26 +/- 1.67 and 0.96 +/- 0.71 in group 1 and 1.37 +/- 0.34 and 0.40 +/- 0.49 in group 2 (p = 0.037, p = 0.005). The presence of subjective ocular complaints was more frequent in group 1 than in group 2.
Despite normal tear production, the ocular surface and tear-film functions of FMF patients differ from those of healthy individuals. These changes may be related to the chronic inflammatory nature of FMF.
评估家族性地中海热（FMF）患者的眼表变化和泪膜功能。
这项前瞻性病例对照临床研究纳入了35例FMF患者（第1组）和35例对照者（第2组）。所有患者均接受了全面的眼科检查。通过结膜印迹细胞学检查确定表面结膜上皮细胞含量来评估眼表变化，通过Schirmer - I试验、泪膜破裂时间（BUT）、角膜荧光素和孟加拉玫瑰红试验评估泪膜功能。用四分制对主观眼部不适进行评分。比较两组结果。
在第1组中，印迹细胞学显示15只眼为0级变化，11只眼为1级变化，9只眼为2级变化；在第2组中，27只眼为0级变化，5只眼为1级变化，3只眼为2级变化（p = 0.013）。第1组杯状细胞平均密度为765±45个细胞/mm²，第2组为1730±100个细胞/mm²（P < 0.001）。Schirmer - I试验平均结果在第1组为17.36±3.18 mm，在第2组为19.60±4.17 mm（p = 0.364）。第1组平均BUT为8.20±1.60秒，第2组为9.93±2.33秒（p = 0.001）。第1组角膜荧光素和孟加拉玫瑰红染色平均评分分别为3.26±1.67和0.96±0.71，第2组分别为1.37±0.34和0.40±0.49（p = 0.037，p = 0.005）。第1组主观眼部不适的出现频率高于第2组。
尽管泪液分泌正常，但FMF患者的眼表和泪膜功能与健康个体不同。这些变化可能与FMF的慢性炎症性质有关。
