Miller School of Medicine, University of Miami, Miami, Florida, USA.
Miller School of Medicine, University of Miami, Miami, Florida, USA; Bascom Palmer Eye Institute, University of Miami, Miami, Florida, USA; Ophthalmology, Miami Veterans Affairs (VA) Medical Center, Miami, Florida, USA.
Am J Ophthalmol. 2021 Mar;223:193-204. doi: 10.1016/j.ajo.2020.10.003. Epub 2020 Oct 14.
To examine associations between indoor airborne microbial concentration and dry eye (DE) measures.
Prospective, observational, cross-sectional study.
A total of 157 individuals with normal external ocular anatomy were recruited from the Miami Veterans Affairs eye clinic. Subjects underwent a clinical evaluation that included assessment of DE symptoms and signs. Indoor air was sampled using bioaerosol impactors with nutrient and soy media, and samples were incubated for 48 hours at 37 C with 5% CO. Number of microbial colonies (CFU) was recorded. Outcome measures were DE symptoms and signs.
A total of 157 unique subjects participated in home and clinical visits and of these, 93 completed a 6-month follow-up of home and clinical visits. Older homes were found to have higher CFU compared to newer homes. A 1% increase in humidity was associated with a 3% increase in nutrient CFU (95% confidence interval [CI] = 0.01 to 0.04; P < .001). Instrumented CFU significantly associated with 2 DE measures: corneal epithelial disruption and lower eyelid meibomian gland (MG) dropout, adjusted for age and sex (odds ratio [OR] = 28.07, 95% CI =1.8, 443.8, P < .05; OR = 39.6, CI = 1.8, 875.2, P < .05 for soy, respectively). After adjusting for other confounders, CFU and age remained significantly associated with MG dropout. Other DE measures did not significantly associate with CFU.
Individuals with higher CFU counts in the home had more severe MG dropout, after adjusting for age and other confounders. This finding suggests that home CFU exposure may impact MG dropout, one of the DE measures, and may be a target for intervention.
研究室内空气微生物浓度与干眼症（DE）指标之间的关系。
前瞻性、观察性、横断面研究。
共招募了 157 名具有正常眼部解剖结构的个体，他们来自迈阿密退伍军人事务眼科诊所。受试者接受了临床评估，包括 DE 症状和体征的评估。使用带有营养和大豆培养基的生物气溶胶撞击器采集室内空气样本，并在 37°C 下孵育 48 小时，5% CO。记录微生物菌落数（CFU）。观察指标为 DE 症状和体征。
共有 157 名独特的受试者参加了家庭和临床访问，其中 93 名完成了家庭和临床访问的 6 个月随访。与较新的房屋相比，较旧的房屋发现 CFU 更高。湿度增加 1%，营养 CFU 增加 3%（95%置信区间[CI] = 0.01 至 0.04；P<.001）。仪器化 CFU 与 2 项 DE 指标显著相关：角膜上皮破裂和下眼睑睑板腺（MG）缺失，调整年龄和性别后（比值比[OR] = 28.07，95%CI = 1.8，443.8，P<.05；OR = 39.6，CI = 1.8，875.2，P<.05 分别为大豆）。在调整其他混杂因素后，CFU 和年龄与 MG 缺失仍显著相关。其他 DE 指标与 CFU 无显著相关性。
在调整年龄和其他混杂因素后，家中 CFU 计数较高的个体 MG 缺失更严重。这一发现表明，家庭 CFU 暴露可能会影响 MG 缺失，这是 DE 指标之一，可能是干预的目标。
