From the New York University Grossman School of Medicine (V.S.), New York, New York; University of Miami Miller School of Medicine (B.S.B., A.C., N.K., A.G.), Miami, Florida; Ophthalmology, Miami Veterans Affairs Medical Center (K.C.), Miami, Florida; and Bascom Palmer Eye Institute, University of Miami (A.C., A.G.), Miami, Florida, USA.
From the New York University Grossman School of Medicine (V.S.), New York, New York; University of Miami Miller School of Medicine (B.S.B., A.C., N.K., A.G.), Miami, Florida; Ophthalmology, Miami Veterans Affairs Medical Center (K.C.), Miami, Florida; and Bascom Palmer Eye Institute, University of Miami (A.C., A.G.), Miami, Florida, USA..
Am J Ophthalmol. 2022 May;237:32-40. doi: 10.1016/j.ajo.2021.11.010. Epub 2021 Nov 13.
To examine dry eye (DE) symptoms and signs in individuals with vs without Gulf War illness (GWI).
Prospective cross-sectional study.
We performed a prospective, cross-sectional study of South Florida veterans who were active duty during the Gulf War era (GWE; 1990-1991) and seen at an eye clinic between October 1, 2020, and March 13, 2021. Veterans were split into 2 groups: those who met Kansas criteria for GWI (cases, n = 30) and those who did not (controls, n = 41). DE symptoms were assessed via standardized questionnaires whereas DE signs were assessed using a series of ocular surface parameters. Differences between groups were assessed via Mann-Whitney U test. Linear regression analyses were used to examine which GWI symptoms most closely aligned with DE symptoms.
Veterans with GWI had higher DE symptoms scores compared to controls (Ocular Surface Disease Index [OSDI] scores: mean 41.20±22.92 vs 27.99±24.03, P = .01). In addition, veterans with GWI had higher eye pain scores compared with controls (average eye pain over past week: 2.63±2.72 vs 1.22±1.50, P = .03), including on neuropathic ocular pain questionnaires (Neuropathic Pain Symptom Inventory modified for the Eye [NPSI-E]: 17.33±17.20 vs 9.63±12.64, P = .03). DE signs were mostly similar between the groups. GWI symptoms "nausea or upset stomach" (β=14.58, SE = 3.02, P < .001) and "headache" (β=7.90, SE = 2.91, P = .011) correlated with higher OSDI scores.
Individuals with GWI have more severe DE symptoms and ocular pain scores but similar tear and ocular surface parameters compared to controls without GWI. This finding suggests that mechanisms beyond tear dysfunction drive eye symptoms in GWI.
研究患有海湾战争病（Gulf War illness，GWI）与未患 GWI 的个体的干眼（dry eye，DE）症状和体征。
前瞻性横断面研究。
我们对南佛罗里达州的退伍军人进行了一项前瞻性的横断面研究，这些退伍军人在海湾战争时期（Gulf War era，GWE；1990-1991 年）处于现役，并于 2020 年 10 月 1 日至 2021 年 3 月 13 日在眼科诊所就诊。退伍军人分为两组：符合堪萨斯 GWI 标准的患者（病例组，n=30）和不符合 GWI 标准的患者（对照组，n=41）。DE 症状通过标准化问卷进行评估，而 DE 体征则通过一系列眼表面参数进行评估。通过 Mann-Whitney U 检验评估组间差异。使用线性回归分析来研究哪些 GWI 症状与 DE 症状最密切相关。
与对照组相比，患有 GWI 的退伍军人的 DE 症状评分更高（眼表疾病指数[Ocular Surface Disease Index，OSDI]评分：均值 41.20±22.92 与 27.99±24.03，P=0.01）。此外，患有 GWI 的退伍军人的眼部疼痛评分高于对照组（过去一周的平均眼部疼痛：2.63±2.72 与 1.22±1.50，P=0.03），包括神经病理性眼部疼痛问卷（改良的神经病理性疼痛症状量表[Neuropathic Pain Symptom Inventory modified for the Eye，NPSI-E]：17.33±17.20 与 9.63±12.64，P=0.03）。两组的 DE 体征大多相似。GWI 症状“恶心或胃部不适”（β=14.58，SE=3.02，P<.001）和“头痛”（β=7.90，SE=2.91，P=0.011）与较高的 OSDI 评分相关。
与无 GWI 的对照组相比，患有 GWI 的个体的 DE 症状和眼部疼痛评分更严重，但泪液和眼表面参数相似。这一发现表明，除了泪液功能障碍外，还有其他机制导致 GWI 中的眼部症状。
