一种用于干眼病诊断的临床替代荧光光度法的泪液生成测量方法。

A clinical alternative to fluorophotometry for measuring tear production in the diagnosis of dry eye.

机构信息

Department of Vision Sciences, Glasgow Caledonian University, Glasgow, United Kingdom.

出版信息

Cornea. 2010 Jul;29(7):745-50. doi: 10.1097/ICO.0b013e3181c58ee2.

DOI:10.1097/ICO.0b013e3181c58ee2

PMID:20489593

Abstract

PURPOSE

To determine the utility of the tear function index (Liverpool modification TFI) in assessing tear turnover rate (TTR), evaluate association of tear clearance rate (TCR) and TFI with measurements of TTR by fluorophotometry, and determine effectivity of these test measures in dry eye (DE) diagnosis.

METHODS

Forty-one subjects with DE and 15 control subjects participated. Tests included symptoms, fluorophotometry (by automated scanning fluorophotometry), and TCR and TFI from a prepared Liverpool modification TFI strip.

RESULTS

Significant differences between subjects with DE and control subjects were found for all tests. Although wetting length values gave highest sensitivity (SS) and specificity (SP) (71% and 73%, respectively), this resulted from a high degree of selection bias because the Schirmer test was one of the inclusion criteria for patients entering the study. Therefore, the best tear production test was found to be TTR (SS 71% and SP 60%). The TTR test is not readily available in clinical settings; therefore, associations between the TTR test and other tests were determined. Significant correlations were found between TTR and wetting length/TCR/TFI, indicating these latter clinical tests useful as surrogates. The strongest correlations, TTR/TCR at 0.69 (P = 0.000) and TTR/TFI at 0.65 (P = 0.000), indicate TCR/TFI with the Liverpool test can be used as an alternative to TTR by fluorophotometry. The diagnostic effectiveness between these tests was compared, with both TCR and TFI found to have equal effectivity of 78% SS and 40% SP (TCR) and 83% SS and 40% SP (TFI).

CONCLUSIONS

TCR measured by the commercially available Liverpool modification TFI strip is an acceptable alternative to TTR by fluorophotometry as a measure of tear production. It is effective as a single test for the discrimination of those with DE from those without the condition.

摘要

目的

确定泪液功能指数（利物浦改良 TFI）在评估泪液周转率（TTR）中的效用，评估泪液清除率（TCR）和 TFI 与荧光光度法测量 TTR 的相关性，并确定这些测试方法在干眼症（DE）诊断中的有效性。

方法

41 例 DE 患者和 15 例对照者参与。测试包括症状、荧光光度法（通过自动扫描荧光光度法）以及来自准备好的利物浦改良 TFI 条的 TCR 和 TFI。

结果

DE 患者和对照组之间的所有测试均存在显著差异。虽然湿润长度值的敏感性（SS）和特异性（SP）最高（分别为 71%和 73%），但这是由于选择偏倚程度较高，因为 Schirmer 测试是患者进入研究的纳入标准之一。因此，发现最佳的泪液产生测试是 TTR（SS 为 71%，SP 为 60%）。TTR 测试在临床环境中不易获得；因此，确定了 TTR 测试与其他测试之间的相关性。发现 TTR 与湿润长度/TCR/TFI 之间存在显著相关性，表明这些临床测试作为替代物是有用的。最强的相关性为 TTR/TCR 为 0.69（P = 0.000）和 TTR/TFI 为 0.65（P = 0.000），表明 TCR/TFI 与利物浦测试可替代荧光光度法的 TTR。比较了这些测试之间的诊断效果，发现 TCR 和 TFI 的 SS 分别为 78%和 40%（TCR）和 83%和 40%（TFI），SP 均为 40%。