Herbaut A, Liang H, Denoyer A, Baudouin C, Labbé A
Service d'ophtalmologie III, CHNO des Quinze-Vingts, IHU Sight Restore, Paris, France.
Service d'ophtalmologie III, CHNO des Quinze-Vingts, IHU Sight Restore, Paris, France; CHNO des Quinze-Vingts, IHU ForeRestore, INSERM-DHOS CIC 1423, Paris, France; Inserm, U968; UPMC Université Paris 06, UMR_S968, institut de la Vision; CNRS, UMR 7210; CHNO des Quinze-Vingts, INSERMDHOS CIC 503, Paris, France.
J Fr Ophtalmol. 2019 Mar;42(3):226-243. doi: 10.1016/j.jfo.2018.10.004. Epub 2019 Mar 15.
Dry eye is a complex multifactorial disease of the ocular surface and tears. It is associated with ocular surface symptoms and is one of the most common causes for ophthalmologic consultation. Despite their frequent use in clinical practice, the usual tests to evaluate dry eye and ocular surface disease-history of symptoms, tear break-up time (TBUT), Meibomian gland evaluation, corneal fluorescein staining, Schirmer test-have shown low reproducibility and reliability. In addition, subjective symptoms are often weakly or poorly correlated with objective signs. Since the tear film is the first system through which light must pass, the optical quality of the eye is highly dependent on the homogeneity of the tear film. Various investigative methods have been developed to evaluate both the structural and functional quality of the tear film, such as corneal topography, interferometry, tear meniscus measurement, evaporation rate, tear osmolarity and even aberrometry. Some are easily accessible to clinicians, while others remain in the field of clinical research. All of these tests provide a better understanding of the pathophysiology of the tear film. This review hopes to provide an overview of the existing tests and their role in evaluating the significance of the tear film in visual function.
干眼是一种眼表和泪液的复杂多因素疾病。它与眼表症状相关,是眼科会诊最常见的原因之一。尽管在临床实践中经常使用,但用于评估干眼和眼表疾病的常规检查——症状病史、泪膜破裂时间(TBUT)、睑板腺评估、角膜荧光素染色、泪液分泌试验——已显示出低再现性和可靠性。此外,主观症状通常与客观体征的相关性较弱或较差。由于泪膜是光线必须通过的第一个系统,眼睛的光学质量高度依赖于泪膜的均匀性。已经开发了各种研究方法来评估泪膜的结构和功能质量,如角膜地形图、干涉测量法、泪液弯月面测量、蒸发率、泪液渗透压甚至像差测量。有些方法临床医生很容易获得,而其他方法仍处于临床研究领域。所有这些检查都能更好地理解泪膜的病理生理学。本综述希望概述现有检查及其在评估泪膜在视觉功能中的意义方面的作用。