Kaido Minako, Kawashima Motoko, Ishida Reiko, Tsubota Kazuo
Department of Ophthalmology Keio University School of Medicine, Tokyo, Japan 2Shinanozaka Clinic, Tokyo, Japan 3Wada Eye Clinic, Chiba, Japan.
Department of Ophthalmology Keio University School of Medicine, Tokyo, Japan.
Invest Ophthalmol Vis Sci. 2016 Mar;57(3):914-9. doi: 10.1167/iovs.15-18447.
The purpose of this prospective comparative study was to investigate corneal sensitivity in subjects with unstable tear film, with and without dry eye (DE) symptoms.
Forty-one eyes of 41 volunteers (mean age: 45.1 ± 9.4 years; age range, 23-57 years), with normal tear function and ocular surface except for tear stability, were studied. The eyes were divided into two groups depending on the presence or absence of DE symptoms: 21 eyes with DE symptoms (symptomatic group); and 20 eyes without DE symptoms (asymptomatic group). Three types of corneal sensitivity values were measured using a Cochet-Bonnet esthesiometer: the sensitivity for perception of touch (S-touch), the sensitivity for blinking (S-blink), and the sensitivity for pain (S-pain).
Mean S-blink and S-pain were significantly higher in the symptomatic group than in the asymptomatic group (P < 0.05), whereas there was no significant difference in mean S-touch between these groups (P > 0.05).
Corneal sensitivity for blinking and pain evoked by increased stimuli was higher in the symptomatic group (subjects with short break-up time DE) compared with subjects who have no DE symptoms despite decreased tear stability. The presence of both tear instability and hyperesthesia, rather than tear instability alone, may contribute to DE pathogenesis.
这项前瞻性对照研究的目的是调查泪膜不稳定且有或无干眼(DE)症状的受试者的角膜敏感性。
对41名志愿者的41只眼(平均年龄:45.1±9.4岁;年龄范围23 - 57岁)进行研究,这些志愿者除泪膜稳定性外,泪液功能和眼表均正常。根据是否存在DE症状将眼睛分为两组:21只伴有DE症状的眼(有症状组);20只无DE症状的眼(无症状组)。使用Cochet - Bonnet触觉计测量三种类型的角膜敏感性值:触觉感知敏感性(S - touch)、眨眼敏感性(S - blink)和疼痛敏感性(S - pain)。
有症状组的平均S - blink和S - pain显著高于无症状组(P < 0.05),而两组之间的平均S - touch无显著差异(P > 0.05)。
与尽管泪膜稳定性降低但无DE症状的受试者相比,有症状组(泪膜破裂时间短的DE患者)对增加刺激引起的眨眼和疼痛的角膜敏感性更高。泪膜不稳定和感觉过敏同时存在,而非单独的泪膜不稳定,可能是DE发病机制的原因。