Kumar Prachi, Bhargava Rahul, Arora Yogesh C, Kaushal Sidharth, Kumar Manjushri
Department of Pathology, School of Medical Sciences and Research, Sharda University, Greater Noida, India.
Department of Ophthalmology, School of Medical Sciences and Research, Sharda University, Greater Noida, India.
J Cytol. 2015 Oct-Dec;32(4):261-7. doi: 10.4103/0970-9371.171242.
Prolonged contact lens wear is often accompanied by dryness of the eyes. The aim of this study was to compare conjunctival impression cytology (CIC) and tear film tests such as tear film break up time (TBUT) and Schirmer test for dry eye evaluation in contact lens wearers and measure their correlation with dry eye symptoms.
A case control study was done at three referral eye centers.
The eyes of 230 contact lens users were compared to 250 eyes of age- and sex-matched controls. Participants were recruited based on their response to a questionnaire of dry eye symptoms, (Dry Eye Scoring System, DESS(©)) and measurements of TBUT, Schirmer test, and CIC was done. A correlation analysis between symptom severity and tear film tests was performed. Pearson's coefficient, R(2) > 0.5 was considered significant.
As compared to controls (r (2) = 0.010), Nelson grade correlated significantly with dry eye symptoms (r (2) = 0.765), among cases. However, there was moderate correlation between dry eye symptoms, Schirmer test, and TBUT (r (2) = 0.557 and 0.530, respectively) among cases and a weak correlation among controls (r (2) = 0.130 and 0.054, respectively). The sensitivity of TBUT was 86.4%, specificity was 82.4%, positive likelihood ratio (LR) was 4.50 [95% confidence interval (CI) 3.46-5.85)], and negative LR was 0.09. The sensitivity of the Schirmer test was 48.2%, specificity 88%, LR 2.12 (95% CI 1.48-2.96), and negative LR 0.83.
CIC correlates better than Schirmer and TBUT with dry eye symptoms. It may be the most appropriate test for dry-eye evaluation in contact lens wearers.
长期佩戴隐形眼镜常伴有眼睛干涩。本研究的目的是比较结膜印迹细胞学检查（CIC）和泪膜测试，如泪膜破裂时间（TBUT）和泪液分泌试验，以评估隐形眼镜佩戴者的干眼情况，并测量它们与干眼症状的相关性。
在三个眼科转诊中心进行了一项病例对照研究。
将230名隐形眼镜使用者的眼睛与250名年龄和性别匹配的对照者的眼睛进行比较。根据他们对干眼症状问卷（干眼评分系统，DESS(©)）的回答招募参与者，并进行TBUT、泪液分泌试验和CIC测量。对症状严重程度与泪膜测试之间进行相关性分析。Pearson系数，R(2)>0.5被认为具有显著性。
与对照组相比（r(2)=0.010），病例组中尼尔森分级与干眼症状显著相关（r(2)=0.765）。然而，病例组中干眼症状、泪液分泌试验和TBUT之间存在中度相关性（分别为r(2)=0.557和0.530），而对照组之间存在弱相关性（分别为r(2)=0.130和0.054）。TBUT的敏感性为86.4%，特异性为82.4%，阳性似然比（LR）为4.50[95%置信区间（CI）3.46-5.85]，阴性LR为0.09。泪液分泌试验的敏感性为48.2%，特异性为88%，LR为2.12（95%CI 1.48-2.96），阴性LR为0.83。
CIC与干眼症状的相关性优于泪液分泌试验和TBUT。它可能是评估隐形眼镜佩戴者干眼的最合适测试。
