Clinical Research Center, School of Optometry, University of California, Berkeley, California, United States.
Vision Science Graduate Program, University of California, Berkeley, California, United States.
Invest Ophthalmol Vis Sci. 2018 Apr 1;59(5):1878-1887. doi: 10.1167/iovs.17-23639.
There has been interest in determining whether lid wiper epitheliopathy (LWE) plays a key role in causing ocular discomfort. Conflicting reports have made it difficult to discern whether LWE is more prevalent in certain populations, what characteristics are associated with its severity, and what its role is in symptomology. This cross-sectional study on a large and diverse population attempts to answer these questions.
Subjects were asked to complete questionnaires related to dry eye and to ocular discomfort. A comprehensive set of ocular surface parameters were assessed, including LWE length and width, tear-film lipid layer thickness, fluorescein tear breakup time (FTBUT), lid-parallel conjunctival folds (LIPCOF), and corneal staining.
A total of 287 subjects participated in the study. LWE was observed in 45% of the study cohort and was twice as prevalent in Asians than non-Asians (P < 0.005). LWE was more likely to present in contact lens wearers than non-contact lens wearers (P = 0.03). Decreased FTBUT was associated with increased LWE length and width (P < 0.005 and P = 0.01, respectively), although only a small effect size was noted. Presence of LIPCOF was linked with a 0.25-grade increase in LWE width (P = 0.01). Only LWE width was associated with greater symptoms in contact lens wearers.
LWE was associated with decreased tear-film stability, contact lens wear, lid anatomy, and LIPCOF. LWE was not associated with symptoms in non-contact lens wearers. LWE width was associated with greater symptoms in contact lens wearers but was only clinically significant with moderate to severe LWE width.
人们一直有兴趣确定眼睑擦拭上皮病（LWE）是否在引起眼部不适方面起关键作用。由于报告相互矛盾，因此很难确定 LWE 是否在某些人群中更为普遍，与 LWE 严重程度相关的特征是什么，以及它在症状学中的作用是什么。本项针对大型和多样化人群的横断面研究试图回答这些问题。
要求受试者完成与干眼症和眼部不适有关的问卷。评估了一整套眼表参数，包括 LWE 的长度和宽度、泪膜脂质层厚度、荧光素泪膜破裂时间（FTBUT）、睑平行结膜皱褶（LIPCOF）和角膜染色。
共有 287 名受试者参加了这项研究。在研究队列中，有 45%的人观察到 LWE，亚洲人比非亚洲人多两倍（P < 0.005）。与非接触镜佩戴者相比，接触镜佩戴者更容易出现 LWE（P = 0.03）。FTBUT 降低与 LWE 长度和宽度增加相关（P < 0.005 和 P = 0.01，分别），尽管仅注意到较小的效应量。存在 LIPCOF 与 LWE 宽度增加 0.25 级相关（P = 0.01）。只有 LWE 宽度与接触镜佩戴者的症状增加相关。
LWE 与泪膜稳定性降低、接触镜佩戴、眼睑解剖结构和 LIPCOF 相关。LWE 与非接触镜佩戴者的症状无关。在接触镜佩戴者中，LWE 宽度与更大的症状相关，但仅在 LWE 宽度为中度至重度时具有临床意义。
