Department of Ophthalmology, Medical and Health Science Center, University of Debrecen, Debrecen, Hungary.
Cornea. 2012 Aug;31(8):867-71. doi: 10.1097/ICO.0b013e3182532047.
To evaluate tear osmolarity with the recently introduced TearLab system (TearLab Corporation, San Diego, CA) in patients with non-Sjögren syndrome dry eye (NSSDE) and Sjögren syndrome dry eye (SSDE), and in healthy subjects, and to compare the results with those from classical dry eye tests.
Thirty-nine eyes of 21 patients with NSSDE, 39 eyes of 20 patients with SSDE, and 44 eyes of 22 healthy individuals were included in the study. Tear osmolarity was measured with the TearLab system, lid-parallel conjunctival folds score was examined with the slit lamp, and then the classical diagnostic tests such as Schirmer I test, tear film break-up time, and corneal staining were carried out, followed by the examination of meibomian glands and corneal transparency.
Mean tear osmolarity was 296.77 ± 16.48 mOsm/L in NSSDE (15% abnormal), 303.36 ± 17.22 mOsm/L in SSDE (23% abnormal), and 303.52 ± 12.92 mOsm/L in the control group (16% abnormal; P = 0.018, Kruskal-Wallis). Schirmer test, corneal staining, tear film break-up time, and meibomian gland status were significantly different in the 2 patient groups when compared with those in the control group (P < 0.0001). In the control and SSDE groups, no significant correlation was disclosed between tear osmolarity and any of the dry eye tests performed.
Tear hyperosmolarity is considered a key factor that leads to dry eye symptoms and to the progression of clinical signs. Osmolarity measurements with the TearLab system disclosed no ability to distinguish between healthy individuals and patients with dry eye. This suggests that the TearLab device should not be used alone but in combination with classical dry eye tests.
使用最近推出的 TearLab 系统（TearLab 公司，圣地亚哥，CA）评估非干燥综合征性干眼症（NSSDE）和干燥综合征性干眼症（SSDE）患者的泪液渗透压，并与经典干眼症测试结果进行比较。
本研究纳入 21 例 NSSDE 患者的 39 只眼、20 例 SSDE 患者的 39 只眼和 22 例健康对照者的 44 只眼。使用 TearLab 系统测量泪液渗透压，用裂隙灯检查睑缘平行结膜皱褶评分，然后进行 Schirmer I 试验、泪膜破裂时间和角膜染色等经典诊断性检查，随后检查睑板腺和角膜透明度。
NSSDE 组平均泪液渗透压为 296.77 ± 16.48 mOsm/L（15%异常），SSDE 组为 303.36 ± 17.22 mOsm/L（23%异常），对照组为 303.52 ± 12.92 mOsm/L（16%异常；P = 0.018，Kruskal-Wallis）。与对照组相比，两组患者的 Schirmer 试验、角膜染色、泪膜破裂时间和睑板腺状态均有显著差异（P < 0.0001）。在对照组和 SSDE 组中，泪液渗透压与任何一项干眼症检查均无显著相关性。
泪液高渗透压被认为是导致干眼症症状和临床体征进展的关键因素。TearLab 系统的渗透压测量结果无法区分健康个体和干眼症患者。这表明 TearLab 仪器不应单独使用，而应与经典干眼症测试结合使用。
