Department of Oculoplastic, Orbital and Lacrimal Surgery, Aichi Medical University Hospital, 1-1 Yazako-Karimata, Nagakute, Aichi, 480-1195, Japan.
Rapti Eye Hospital, Dang, Nepal.
Sci Rep. 2021 Mar 5;11(1):5288. doi: 10.1038/s41598-021-84661-4.
Evaluation of tear film break-up pattern (TFBUP) is the main diagnostic method for tear film-oriented therapy (TFOT) of dry eye. This prospective, observational study examined TFBUPs in 154 eyes/sides from 78 patients with thyroid eye disease (TED) who met the diagnostic criteria for dry eye in Japan. TFBUPs were classified as area, line, spot, dimple, and random breaks. Results for the status of TED and dry eye were compared between the TFBUPs. Consequently, line, spot, dimple, and random breaks were observed in 80 (51.9%), 29 (18.8%), 10 (6.5%), and 35 eyes (22.7%) while no eyes showed area breaks. The random break group had the highest incidence of lid lag/Graefe sign and superior limbic keratoconjunctivitis (SLK) (P < 0.050). Although the incidence of each TFBUP is almost equal in patients with simple dry eye without TED, line breaks were more frequently observed in TED. In addition, while random breaks in simple dry eye are usually only associated with minor ocular surface damages, those in TED were associated with a higher incidence of concomitant SLK. These results will be helpful for understanding the etiology of dry eye in TED and for TFOT in TED.
泪膜破裂模式（TFBUP）的评估是干眼症的泪膜导向治疗（TFOT）的主要诊断方法。这项前瞻性观察研究检查了符合日本干眼症诊断标准的 78 例甲状腺眼病（TED）患者的 154 只眼/侧的 TFBUP。TFBUP 分为区域、线、点、凹痕和随机破裂。比较了 TFBUP 中 TED 和干眼症的状况。结果显示，80 只眼（51.9%）、29 只眼（18.8%）、10 只眼（6.5%）和 35 只眼（22.7%）出现线、点、凹痕和随机破裂，而没有眼出现区域破裂。随机破裂组的眼睑迟滞/Graefe 征和上睑缘角膜结膜炎（SLK）发生率最高（P<0.050）。虽然单纯性 TED 无干眼症患者的每种 TFBUP 发生率几乎相等，但 TED 中线破裂更为常见。此外，单纯性干眼症中的随机破裂通常仅与轻微的眼表面损伤有关，而 TED 中的随机破裂与更高的并发 SLK 发生率相关。这些结果将有助于了解 TED 中干眼症的病因和 TED 中的 TFOT。
