Schulze Konrad, Großjohann Rico, Paul Sebastian, Bossaller Lukas, Tost Frank
Augenheilkunde, Universitätsmedizin Greifswald, F.-Sauerbruch-Str., 17475, Greifswald, Deutschland.
Rheumatologie, Universitätsmedizin Greifswald, Greifswald, Deutschland.
Ophthalmologe. 2021 Jun;118(6):561-568. doi: 10.1007/s00347-020-01208-0.
As one alternative to the Schirmer test, strip meniscometry has been presented as a methodology which also seems to be suitable for quantifying a lack of tear volume.
In a randomized prospective clinical study 391 eyes from 201 subjects were assigned to 3 groups according to the severity of eye surface deficiency (group 0: 225 healthy eyes, f/m = 1.25, mean age = 50.1 ± 17.6 years; group 1: 112 eyes with mild keratoconjunctivitis sicca (KCS), f/m = 1.38, mean age = 58.7 ± 13.9 years; group 2: 54 eyes with manifest KCS, f/m = 2.375, mean age = 52.6 ± 14.1 years). Objective test parameters used were strip meniscometry, Schirmer's 1 test and the Jones-test. In order to determine the condition of the ocular surface and tear film more precisely, slit-lamp examination, the detection of lid-parallel conjunctival folds (LIPCOF) and optical coherence tomography (OCT) meniscometry were also performed. Subjective discomfort was objectified by using the Ocular Surface Disease Index questionnaire (OSDI).
The results of strip meniscometry, Schirmer's 1 test, the Jones test and OCT meniscometry were significantly lower in KCS subjects than in healthy subjects (p < 0.001), whereas the OSDI score was significantly higher (p < 0.001). The parameters strip meniscometry, Schirmer's 1 test, the Jones test and OCT meniscometry scores correlated with each other. Sensitivity and specificity of strip meniscometry ranged from 0.79 to 0.89 and from 0.42 to 0.5.
Strip meniscometry is suitable to detect a lack of tear volume. Advantageous is the rapid performance of the procedure (5 s per eye) and a good agreement with established tests (e.g. Schirmer's test). To improve the specificity, strip meniscometry must be combined with other examination methods.
作为泪液分泌试验的一种替代方法，试纸泪液测量法已作为一种似乎也适用于量化泪液量不足的方法被提出。
在一项随机前瞻性临床研究中，根据眼表缺陷的严重程度，将201名受试者的391只眼睛分为3组（0组：225只健康眼睛，男女比例=1.25，平均年龄=50.1±17.6岁；1组：112只轻度干燥性角结膜炎（KCS）眼睛，男女比例=1.38，平均年龄=58.7±13.9岁；2组：54只显性KCS眼睛，男女比例=2.375，平均年龄=52.6±14.1岁）。使用的客观测试参数为试纸泪液测量法、泪液分泌试验1和琼斯试验。为了更精确地确定眼表和泪膜的状况，还进行了裂隙灯检查、睑结膜平行皱襞（LIPCOF）检测和光学相干断层扫描（OCT）泪液测量法。通过使用眼表疾病指数问卷（OSDI）将主观不适客观化。
KCS受试者的试纸泪液测量法、泪液分泌试验1、琼斯试验和OCT泪液测量法的结果显著低于健康受试者（p<0.001），而OSDI评分显著更高（p<0.001）。试纸泪液测量法、泪液分泌试验1、琼斯试验和OCT泪液测量法的参数相互关联。试纸泪液测量法的敏感性和特异性范围分别为0.79至0.89和0.42至0.5。
试纸泪液测量法适用于检测泪液量不足。该方法的优点是操作迅速（每只眼睛5秒），且与既定测试（如泪液分泌试验）一致性良好。为提高特异性，试纸泪液测量法必须与其他检查方法相结合。
