Yeh Thao N, Graham Andrew D, Lin Meng C
*OD, MPH, FAAO †MA ‡OD, PhD, FAAO Clinical Research Center, School of Optometry, University of California, Berkeley, Berkeley, California (all authors).
Optom Vis Sci. 2015 Sep;92(9):e264-72. doi: 10.1097/OPX.0000000000000649.
To examine the relationships among tear osmolarity, tear film stability, and several measures of dry eye (DE) symptoms in a multivariable analysis.
A cross-sectional study was conducted with 137 subjects (68 non-contact lens [CL] wearers and 69 soft CL wearers) recruited from a university campus. Tear breakup time (TBUT) was measured noninvasively (NITBUT) and with fluorescein (FTBUT). Tear osmolarity was measured by an osmometer. Dry eye symptoms were assessed using the Dry Eye Flow Chart and several different questionnaires.
Subjects ranged in age from 18 to 67 years, with a mean of 28 years. Subjects had a mean (SD) osmolarity of 293 (10) mOsm/L, NITBUT of 14.1 (10.9) seconds, and FTBUT of 14.8 (12.6) seconds. Shorter NITBUT and FTBUT were significantly associated with female sex (p = 0.001 and p = 0.027, respectively) and Asian ethnicity (p = 0.030 and p = 0.004, respectively). There were no clinically significant relationships between tear osmolarity and FTBUT, NITBUT, or DE symptoms. Higher Dry Eye Flow Chart score (i.e., worse symptoms) was associated with older age (p < 0.001), female sex (p = 0.014), CL wear (p < 0.001), shorter NITBUT (p < 0.001), and shorter FTBUT (p = 0.028). The sensitivities and specificities for using clinical measurements to diagnose moderate to severe DE were as follows: osmolarity, 0.67 and 0.46, respectively; NITBUT, 0.72 and 0.52, respectively; and FTBUT, 0.68 and 0.57, respectively.
In a population of asymptomatic, mild and moderate DE patients, increased tear osmolarity was not significantly associated with reported symptom severity and frequency. Tear osmolarity, NITBUT, and FTBUT exhibited similar sensitivities and specificities when used to diagnose moderate to severe DE.
在多变量分析中研究泪液渗透压、泪膜稳定性与干眼（DE）症状的几种测量指标之间的关系。
对从大学校园招募的137名受试者（68名非隐形眼镜佩戴者和69名软性隐形眼镜佩戴者）进行了一项横断面研究。采用无创测量（NITBUT）和荧光素测量（FTBUT）泪膜破裂时间（TBUT）。用渗透压计测量泪液渗透压。使用干眼流程图和几种不同的问卷评估干眼症状。
受试者年龄在18至67岁之间，平均年龄为28岁。受试者的平均（标准差）渗透压为293（10）mOsm/L，NITBUT为14.1（10.9）秒，FTBUT为14.8（12.6）秒。较短的NITBUT和FTBUT与女性（分别为p = 0.001和p = 0.027）以及亚洲种族（分别为p = 0.030和p = 0.004）显著相关。泪液渗透压与FTBUT、NITBUT或DE症状之间无临床显著关系。较高的干眼流程图评分（即症状更严重）与年龄较大（p < 0.001）、女性（p = 0.014）、佩戴隐形眼镜（p < 0.001）、较短的NITBUT（p < 0.001）和较短的FTBUT（p = 0.028）相关。使用临床测量诊断中度至重度DE的敏感性和特异性如下：渗透压分别为0.67和0.46；NITBUT分别为0.72和0.52；FTBUT分别为0.68和0.57。
在无症状、轻度和中度DE患者群体中，泪液渗透压升高与报告的症状严重程度和频率无显著关联。在用于诊断中度至重度DE时，泪液渗透压、NITBUT和FTBUT表现出相似的敏感性和特异性。
