Galor Anat, Zlotcavitch Leonid, Walter Scott D, Felix Elizabeth R, Feuer William, Martin Eden R, Margolis Todd P, Sarantopoulos Konstantinos D, Levitt Roy C
Miami Veterans Administration Medical Center, Miami, Florida, USA Bascom Palmer Eye Institute, University of Miami, Miami, Florida, USA.
Bascom Palmer Eye Institute, University of Miami, Miami, Florida, USA.
Br J Ophthalmol. 2015 May;99(5):665-8. doi: 10.1136/bjophthalmol-2014-306057. Epub 2014 Oct 21.
Studies of patients with non-ocular pain suggest that it is therapeutically useful to identify those with features of neuropathic pain. No data is available, however, on whether this approach has similar utility in dry eye. The purpose of this study was to determine whether severity and persistence of dry eye symptoms associate with self-reported symptoms of neuropathic ocular pain (NOP).
Cohort study.
PARTICIPANTS/SETTING: 102 men seen in the Miami Veterans Affairs eye clinic. A baseline evaluation was performed consisting of the dry eye questionnaire 5 (DEQ5) and ocular surface evaluation. Patients were contacted ≥2 years later to repeat the DEQ5 and complete questionnaires that further characterised their eye pain.
The relationship between dry eye symptom severity and persistence (DEQ5) and additional measures of ocular pain (NOP).
Of 102 patients with variable dry eye symptoms, 70 reported at least mild symptoms on both encounters (DEQ5≥6). Fifty-four of 70 (77%) reported ≥1 NOP feature, and the number of NOP features correlated moderately with dry eye symptoms at both encounters (r=0.31-0.46, p<0.01). Patients with any symptom of NOP had higher dry eye symptom scores at both encounters (p<0.05), but similar ocular surface parameters. Hypersensitivity to wind and photoallodynia were associated with having mild or greater symptoms on both encounters (OR 3.4, 95% CI 1.2 to 10.0, p=0.02; OR 15.6, 95% CI 2.0 to 123, p=0.009, respectively).
NOP features are common in patients with symptomatic dry eye and these features correlate with symptom severity and persistence.
对非眼部疼痛患者的研究表明，识别出具有神经性疼痛特征的患者具有治疗意义。然而，尚无关于这种方法在干眼症中是否具有类似效用的数据。本研究的目的是确定干眼症状的严重程度和持续时间是否与自我报告的神经性眼痛（NOP）症状相关。
队列研究。
参与者/研究地点：102名在迈阿密退伍军人事务眼科诊所就诊的男性。进行了包括干眼问卷5（DEQ5）和眼表评估在内的基线评估。在≥2年后联系患者，重复进行DEQ5并完成进一步描述其眼痛的问卷。
干眼症状严重程度和持续时间（DEQ5）与眼部疼痛的其他指标（NOP）之间的关系。
在102例有不同干眼症状的患者中，70例在两次就诊时均报告至少有轻度症状（DEQ5≥6）。70例中的54例（77%）报告有≥1项NOP特征，且两次就诊时NOP特征的数量与干眼症状呈中度相关（r=0.31-0.46，p<0.01）。有任何NOP症状的患者在两次就诊时干眼症状评分均较高（p<0.05），但眼表参数相似。对风的超敏反应和光过敏与两次就诊时出现轻度或更严重症状相关（OR分别为3.4，95%CI 1.2至10.0，p=0.02；OR为15.6，95%CI 2.0至123，p=0.009）。
NOP特征在有症状的干眼患者中很常见，且这些特征与症状的严重程度和持续时间相关。
