Satitpitakul Vannarut, Kheirkhah Ahmad, Crnej Alja, Hamrah Pedram, Dana Reza
Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts; Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts.
Am J Ophthalmol. 2017 Jul;179:198-204. doi: 10.1016/j.ajo.2017.05.009. Epub 2017 May 17.
To quantify the severity of ocular pain in patients with dry eye disease (DED) and evaluate factors associated with pain severity.
Cross-sectional study.
Eighty-four patients with DED were asked to score their severity level of ocular pain using a 10-point scale, with 10 indicating the most severe pain. All patients also had a comprehensive ophthalmic assessment including a detailed history, Ocular Surface Disease Index (OSDI) questionnaire, and ocular surface examination. Regression analysis was used to determine the factors associated with ocular pain severity.
The mean OSDI score was 45.6 ± 23.1. At least some degree of ocular pain (score >1) was reported by 88.1% of patients, including mild pain (scores 2-4) in 46.4%, moderate pain (scores 5-7) in 34.5%, and severe pain (scores 8-10) in 7.1% of patients. Ocular pain levels significantly correlated with the OSDI score (r = 0.49, P < .001). Regression analysis showed that the severity of ocular pain had a significant association with use of antidepressant medications (P = .045) but not with tear breakup time, corneal fluorescein staining, or ocular medications used by patients. In patients without pain, a significant correlation was seen between OSDI and corneal fluorescein staining scores (r = 0.67, P = .01). However, such a correlation was not observed in those with ocular pain.
A majority of patients with DED report some degree of ocular pain, which correlates only moderately with the OSDI score. Severity of ocular pain correlates with nonocular comorbidities such as use of antidepressant medications rather than with clinical signs of DED.
量化干眼症（DED）患者眼部疼痛的严重程度，并评估与疼痛严重程度相关的因素。
横断面研究。
84例DED患者被要求使用10分制对其眼部疼痛的严重程度进行评分，10分表示最严重的疼痛。所有患者还进行了全面的眼科评估，包括详细病史、眼表疾病指数（OSDI）问卷和眼表检查。采用回归分析确定与眼部疼痛严重程度相关的因素。
OSDI平均评分为45.6±23.1。88.1%的患者报告至少有一定程度的眼部疼痛（评分>1），其中46.4%为轻度疼痛（评分2 - 4），34.5%为中度疼痛（评分5 - 7），7.1%为重度疼痛（评分8 - 10）。眼部疼痛程度与OSDI评分显著相关（r = 0.49，P <.001）。回归分析表明，眼部疼痛的严重程度与使用抗抑郁药物显著相关（P =.045），但与泪膜破裂时间、角膜荧光素染色或患者使用的眼部药物无关。在无疼痛的患者中，OSDI与角膜荧光素染色评分之间存在显著相关性（r = 0.67，P =.01）。然而，在有眼部疼痛的患者中未观察到这种相关性。
大多数DED患者报告有一定程度的眼部疼痛，其与OSDI评分仅呈中度相关。眼部疼痛的严重程度与非眼部合并症（如使用抗抑郁药物）相关，而非与DED的临床体征相关。
