Kaido Minako, Kawashima Motoko, Ishida Reiko, Tsubota Kazuo
Department of Ophthalmology, Keio University School of Medicine, Tokyo.
Wada Eye Clinic, Chiba.
Clin Ophthalmol. 2017 May 5;11:861-869. doi: 10.2147/OPTH.S128939. eCollection 2017.
Validating the hypothesis that accommodative microfluctuations (AMFs) may be associated with severe symptoms in short tear break-up time (BUT) dry eye (DE).
This study included 12 subjects with short BUT DE (age: 49.6±18.3 years). Diagnoses were performed based on the presence of DE symptoms, BUT ≤5 s, Schirmer score >5 mm, and negative keratoconjunctival epithelial damage. Tear evaluation, AMF, and functional visual acuity (VA) examinations were conducted before and after DE treatment. The AMF parameters evaluated were: total high-frequency component (HFC), HFC with low accommodation for the task of staring into the distance (HFC1), HFC with high accommodation for deskwork (HFC2). A subjective questionnaire of DE symptoms was also performed.
Mean BUT increased from 1.9±2.0 to 6.4±2.5 s after treatment (<0.05). The mean logarithm of the minimum angle of resolution functional VA significantly improved (from 0.19±0.19 to 0.12±0.17; <0.05). Mean power spectrum values for total HFC and HFC1 decreased (from 61.3±5.7 to 53.8±6.6 dB and from 62.9±10.5 to 52.4±6.2 dB, respectively; <0.05), while the mean HFC2 power spectrum values did not differ before and after treatment (>0.05). Subjective DE symptoms were reduced in nine patients.
Along with the improvement of BUT after treatment, DE symptoms diminished and HFC1 and functional VA improved, suggesting that tear film instability is associated with deterioration of functional VA, AMF, and DE symptoms.
验证调节性微波动（AMF）可能与短泪膜破裂时间（BUT）干眼（DE）的严重症状相关这一假设。
本研究纳入了12名BUT短的DE患者（年龄：49.6±18.3岁）。根据DE症状、BUT≤5秒、泪液分泌试验评分>5毫米以及角膜结膜上皮损伤阴性进行诊断。在DE治疗前后进行泪液评估、AMF和功能性视力（VA）检查。评估的AMF参数包括：总高频成分（HFC）、远距离凝视任务低调节时的HFC（HFC1）、伏案工作高调节时的HFC（HFC2）。还进行了DE症状的主观问卷调查。
治疗后平均BUT从1.9±2.0秒增加到6.4±2.5秒（<0.05）。最小分辨角功能性VA的平均对数显著改善（从0.19±0.19提高到0.12±0.17；<0.05）。总HFC和HFC1的平均功率谱值降低（分别从61.3±5.7分贝降至53.8±6.6分贝和从62.9±10.5分贝降至52.4±6.2分贝；<0.05），而治疗前后HFC2的平均功率谱值无差异（>0.05）。9名患者的主观DE症状减轻。
随着治疗后BUT的改善，DE症状减轻，HFC1和功能性VA改善，表明泪膜不稳定与功能性VA、AMF和DE症状的恶化有关。
