Kato Hiroaki, Yokoi Norihiko, Watanabe Akihide, Komuro Aoi, Sonomura Yukiko, Sotozono Chie, Kinoshita Shigeru
Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Frontier Medical Science and Technology for Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Cornea. 2019 Mar;38(3):318-324. doi: 10.1097/ICO.0000000000001841.
Considering that tears play the role of a lubricant, it is speculated that in the pathophysiology of dry eye, increased friction during blinking results in corneal and conjunctival damage, which may subsequently affect the blink. The purpose of this study was to investigate the relationship between ocular surface epithelial damage, tear abnormalities, and blinks in patients with dry eye.
This study involved 45 eyes of 45 female patients with dry eye (mean age: 57.6 years). In all eyes, tear meniscus radius (mm), spread grade of the tear film lipid layer (SG: 1-5: 1 being the best), fluorescein breakup time (FBUT, seconds), corneal and bulbar conjunctival epithelial damage (CED: 15 points maximum and CONJUNCTIVAL EPITHELIAL DAMAGE (CjED): 6 points maximum, respectively), and Schirmer I test (ST1, mm) were evaluated. Blink rate (BR, blinks per minute), palpebral aperture height (mm), upper-eyelid opening-phase amplitude/upper-eyelid closing-phase amplitude (mm), upper-eyelid opening-phase duration/upper-eyelid closing-phase duration (ms), and upper-eyelid opening-phase maximum velocity/upper-eyelid closing-phase maximum velocity (mm/s) were measured using a custom-made high-speed blink analyzer. Finally, the factors that determine CED and CjED were investigated by multiple regression analysis, in which the parameters were chosen using the stepwise procedure.
CED and CjED were found to be described as 2.687 + (1.816 × SG) - (0.937 × FBUT) (R = 0.656, P < 0.0001) and 0.684 + (0.801 × SG) - (0.526 × FBUT) - (0.041 × ST1) + (0.010 × upper-eyelid closing-phase maximum velocity) (R = 0.714, P < 0.0001), respectively.
Although CED was significantly related to only tear abnormalities, CjED was significantly related to tear abnormalities and blinking.
鉴于眼泪起到润滑剂的作用，据推测在干眼症的病理生理学中，眨眼过程中摩擦力增加会导致角膜和结膜损伤，进而可能影响眨眼。本研究的目的是调查干眼症患者眼表上皮损伤、泪液异常与眨眼之间的关系。
本研究纳入了45例女性干眼症患者的45只眼（平均年龄：57.6岁）。对所有眼睛评估泪液半月皱襞半径（mm）、泪膜脂质层扩展等级（SG：1 - 5，1为最佳）、荧光素破裂时间（FBUT，秒）、角膜和球结膜上皮损伤（CED：最高15分）以及结膜上皮损伤（CjED：最高6分），并进行Schirmer I试验（ST1，mm）。使用定制的高速眨眼分析仪测量眨眼频率（BR，每分钟眨眼次数）、睑裂高度（mm）、上睑睁开相幅度/上睑闭合相幅度（mm）、上睑睁开相持续时间/上睑闭合相持续时间（ms）以及上睑睁开相最大速度/上睑闭合相最大速度（mm/s）。最后，通过多元回归分析研究决定CED和CjED的因素，其中参数采用逐步法选择。
发现CED可描述为2.687 +（1.816×SG） - （0.937×FBUT）（R = 0.656，P < 0.0001），CjED可描述为0.684 +（0.801×SG） - （0.526×FBUT） - （0.041×ST1） + （0.010×上睑闭合相最大速度）（R = 0.714，P < 0.0001）。
虽然CED仅与泪液异常显著相关，但CjED与泪液异常和眨眼均显著相关。
