Ho Dave S, Vaou Okeanis E, Hohler Anna D
Neurology, Boston University School of Medicine, Boston, MA, USA.
Steward Medical Group Neurology, St. Elizabeth's Medical Center, Brighton, MA, USA.
Clin Ophthalmol. 2020 Nov 20;14:4015-4021. doi: 10.2147/OPTH.S279520. eCollection 2020.
Patients with postural orthostatic tachycardia syndrome (POTS) present to outpatient dysautonomia clinics endorsing a wide range of symptoms. Dry eyes and mouth, or sicca complex are frequently reported. This retrospective study investigates the incidence and quantifies the severity of dry eye syndrome (DES) in patients with POTS.
This retrospective study compiles survey results, and dry eye clinical data from twenty-three POTS patients (22 females, average age 34.9 and st dev 14.0 years) surveyed during their initial or follow-up appointments. Patient's medication lists were documented to account for anticholinergics, antihistamines, and anticholinesterase use. Patients endorsing dry eye symptoms were tested with Schirmer's test strips to identify clinically dry eyes and stratified for severity.
Sixty-five percent of patients endorsed dry eye symptoms (15/23). Seventy-four percent of patients endorsed dry mouth symptoms (17/23). Among patients endorsing dry eyes, 81% of eyes had decreased tear production with Schirmer's strip wetting less than 10 mm/5 min (13/16).
DES is an additional and significant disease burden for the POTS patient population. Dry eye and exocrine gland function should be evaluated as part of the dysautonomia work up with referral to ophthalmology as appropriate. Patients with clinically dry eyes who report additional autonomic dysfunction should be further evaluated for widespread autonomic dysfunction.
体位性直立性心动过速综合征(POTS)患者前往门诊自主神经功能障碍诊所就诊时,会出现各种各样的症状。干眼和口干,即干燥综合征,经常被报告。这项回顾性研究调查了POTS患者干眼综合征(DES)的发病率并量化其严重程度。
这项回顾性研究汇总了23例POTS患者(22名女性,平均年龄34.9岁,标准差14.0岁)在初次就诊或随访时的调查结果及干眼临床数据。记录患者的用药清单,以了解抗胆碱能药、抗组胺药和抗胆碱酯酶的使用情况。对有干眼症状的患者使用泪液分泌试验试纸进行检测,以确定临床干眼情况并进行严重程度分层。
65%的患者有干眼症状(15/23)。74%的患者有口干症状(17/23)。在有干眼症状的患者中,81%的眼睛泪液分泌减少,泪液分泌试验试纸湿润度小于10毫米/5分钟(13/16)。
DES是POTS患者群体额外的重大疾病负担。干眼和外分泌腺功能应作为自主神经功能障碍检查的一部分进行评估,并酌情转诊至眼科。报告有其他自主神经功能障碍的临床干眼患者应进一步评估是否存在广泛的自主神经功能障碍。