Golebiowski Blanka, Chim Katrina, So Jennifer, Jalbert Isabelle
School of Optometry and Vision Science, The University of New South Wales, Sydney, New South Wales, Australia.
Optom Vis Sci. 2012 Oct;89(10):1443-9. doi: 10.1097/OPX.0b013e3182693cef.
Ocular surface sensitivity plays a role in dry eye and ocular comfort through its probable influence on the neural feedback loop that regulates tear secretion, but little is known specifically about the role of lid or lid margin sensitivity in ocular surface health. The aim of this study was to characterize the eyelid margin and explore the relationships between lid margin sensitivity and staining, meibomian gland dysfunction, tear osmolarity, and ocular symptoms. A secondary aim was to look for differences and associations between lower- and upper-lid characteristics.
Pilot study involving 27 healthy subjects (7 men, 20 women; mean age: 31 ± 14 years). Measurements included ocular symptoms (Ocular Surface Disease Index, Dry Eye Questionnaire), tear osmolarity, lid margin staining (fluorescein and lissamine green), meibomian gland dysfunction, and mechanical sensitivity of lower and upper lids.
Lower-lid margins were more sensitive (45.0 ± 13.2 vs. 40.0 ± 14.7 mm; p = 0.02) and displayed more staining (1.5 ± 1.0 vs. 0.2 ± 0.6, p < 0.001), but less evidence of meibomian gland dysfunction (2.0 ± 2.8 vs. 7.3 ± 6.2, p < 0.001), than upper-lid margins. Lid margin staining was more frequent in lower than upper lids (78% vs. 15% of subjects). Tear osmolarity correlated with upper-lid staining (r = 0.41, p = 0.04) and lower-lid sensitivity (r = 0.46, p = 0.02). Lid sensitivity was also inversely correlated with meibomian gland dysfunction at the lower lid (r = -0.51, p = 0.01). Surprisingly, there were no associations between symptoms and lid staining.
Our study highlighted clear clinical differences between the lower and upper lids and demonstrated, for the first time, significant relationships between tear osmolarity and lid characteristics, including lid sensitivity.
眼表敏感性可能通过对调节泪液分泌的神经反馈回路产生影响，从而在干眼和眼部舒适度方面发挥作用，但关于睑缘或睑缘敏感性在眼表健康中的作用，具体情况尚不清楚。本研究的目的是对睑缘进行特征描述，并探讨睑缘敏感性与染色、睑板腺功能障碍、泪液渗透压及眼部症状之间的关系。次要目的是寻找上下睑特征之间的差异和关联。
对27名健康受试者（7名男性，20名女性；平均年龄：31±14岁）进行初步研究。测量指标包括眼部症状（眼表疾病指数、干眼问卷）、泪液渗透压、睑缘染色（荧光素和丽丝胺绿）、睑板腺功能障碍以及上下睑的机械敏感性。
下睑缘比上睑缘更敏感（45.0±13.2对40.0±14.7毫米；p = 0.02），染色更多（1.5±1.0对0.2±0.6，p < 0.001），但睑板腺功能障碍的迹象更少（2.0±2.8对7.3±6.2，p < 0.001）。下睑缘染色比上睑缘更常见（受试者中分别为78%和15%）。泪液渗透压与上睑染色（r = 0.41，p = 0.04）和下睑敏感性（r = 0.46，p = 0.02）相关。下睑的睑敏感性也与睑板腺功能障碍呈负相关（r = -0.51，p = 0.01）。令人惊讶的是，症状与睑缘染色之间没有关联。
我们的研究突出了上下睑之间明显的临床差异，并首次证明了泪液渗透压与睑缘特征（包括睑缘敏感性）之间存在显著关系。
