角膜感觉、眨眼与泪膜质量之间的关系。

Relationship between Corneal Sensation, Blinking, and Tear Film Quality.

作者信息

Nosch Daniela Sonja, Pult Heiko, Albon Julie, Purslow Christine, Murphy Paul John

机构信息

*PhD, MSc, MCOptom†PhD, MSc, FAAO‡PhD§PhD, MCOptom∥MBA, PhD, FCOptom, FAAOSchool of Optometry and Vision Sciences, Cardiff University, Cardiff, United Kingdom (DSN, HP, JA, CP, PJM); Institute of Optometry, University of Applied Sciences (FHNW), Olten, Switzerland (DSN); Dr. Heiko Pult-Optometry and Vision Research, Weinheim, Germany (HP); Cardiff Institute of Tissue Engineering and Repair, Cardiff, United Kingdom (JA); Spectrum Thea Pharamaceuticals Ltd., Newcastle under Lyme, United Kingdom (CP); and School of Optometry and Vision Science, University of Waterloo, Waterloo, Canada (PJM).

出版信息

Optom Vis Sci. 2016 May;93(5):471-81. doi: 10.1097/OPX.0000000000000827.

DOI:10.1097/OPX.0000000000000827

PMID:27104591

Abstract

PURPOSE

To examine the possible role of corneal sensitivity and tear film quality in triggering a blink by investigating the relationship between blink rate, central corneal sensitivity threshold (CST), ocular surface temperature (OST), tear meniscus height (TMH), tear film quality (noninvasive tear break-up time [NIBUT]), and tear film lipid pattern under normal conditions.

METHODS

Forty-two volunteers (average age, 27.76 ± 5.36 years; 11 males) with good ocular health (Ocular Surface Disease Index, <15.0) were recruited for this cross-sectional cohort study. Blink rate, CST (noncontact corneal air gas aesthesiometry, NCCA), minimum and maximum OST in the central and inferior cornea between blinks (thermal infrared camera), TMH, NIBUT, and lipid pattern of the tear film (Keeler Tearscope Plus) were recorded on the right eye only.

RESULTS

Median blink rate was 11 blinks/min (interquartile range [IR], 6.95 to 17.05), CST was 0.35 mbars (IR, 0.30 to 0.40), minimum OST in the central cornea was 35.15°C (IR, 34.58 to 35.50), and NIBUT was 34.55 s (IR, 12.45 to 53.80). Moderate but statistically significant correlations were observed between CST and NIBUT (r = 0.535, p < 0.001), CST and blink rate (r = -0.398, p < 0.001), lipid pattern and OST (r = 0.556, p < 0.001), and between CST and OST (r = 0.371, p = 0.008). The correlations between blink rate and NIBUT (r = -0.696, p < 0.001) and between OST and NIBUT (r = 0.639, p < 0.001; Spearman test) achieved higher significance; this was highlighted by the linear regression model where NIBUT and minimum central and inferior OST were identified as significant predictor variables.

CONCLUSIONS

There is strong evidence for significant interactions between corneal sensitivity, NIBUT, OST, and blink frequency, emphasizing that ocular surface conditions represent a possible important trigger for the initiation of a blink. However, the mechanisms involved in the initiation of a blink are complex, with local ocular sensory input as only one trigger, along with other external influences and internal factors under cortical control.

摘要

目的

通过研究正常情况下眨眼频率、中央角膜敏感度阈值（CST）、眼表温度（OST）、泪液半月皱襞高度（TMH）、泪膜质量（非侵入性泪膜破裂时间[NIBUT]）和泪膜脂质形态之间的关系，探讨角膜敏感度和泪膜质量在引发眨眼过程中可能发挥的作用。

方法

招募42名眼部健康状况良好（眼表疾病指数<15.0）的志愿者（平均年龄27.76±5.36岁；男性11名）参与这项横断面队列研究。仅对右眼记录眨眼频率、CST（非接触式角膜空气气体测痛法，NCCA）、眨眼间中央和下方角膜的最低和最高OST（热红外摄像机）、TMH、NIBUT以及泪膜的脂质形态（Keeler Tearscope Plus）。

结果

眨眼频率中位数为11次/分钟（四分位间距[IR]，6.95至17.05），CST为0.35毫巴（IR，0.30至0.40），中央角膜最低OST为35.15°C（IR，34.58至35.50），NIBUT为34.55秒（IR，12.45至53.80）。观察到CST与NIBUT之间（r = 0.535，p < 0.001）、CST与眨眼频率之间（r = -0.398，p < 0.001）、脂质形态与OST之间（r = 0.556，p < 0.001）以及CST与OST之间（r = 0.371，p = 0.008）存在中度但具有统计学意义的相关性。眨眼频率与NIBUT之间（r = -0.696，p < 0.001）以及OST与NIBUT之间（r = 0.639，p < 0.001；Spearman检验）的相关性具有更高的显著性；线性回归模型突出了这一点，其中NIBUT以及中央和下方角膜最低OST被确定为显著的预测变量。