Fieß Achim, Hufschmidt-Merizian Clara, Gißler Sandra, Hampel Ulrike, Mildenberger Eva, Urschitz Michael S, Zepp Fred, Stoffelns Bernhard, Pfeiffer Norbert, Schuster Alexander K
Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany.
Department of Ophthalmology, University Hospital Leipzig, 04103 Leipzig, Germany.
J Clin Med. 2022 May 11;11(10):2702. doi: 10.3390/jcm11102702.
Background/Aims: This study aimed to analyze the effects of perinatal history on tear film properties and lid geometry in adults born preterm. Methods: The Gutenberg Prematurity Eye Study (GPES) is a German prospective examination of adults born preterm and term aged 18 to 52 years with Keratograph® 5M and Schirmer test I. Main outcome measures were first non-invasive tear film break-up time (F-NITBUT), bulbar redness (BR), Schirmer test, and nasal palpebral angle measurement. The associations with gestational age (GA), birth weight (BW), and BW percentile, retinopathy of prematurity (ROP), ROP treatment, and other perinatal factors were evaluated using regression analyses. Results: 489 eyes of 255 preterm and 277 eyes of 139 full-term individuals (aged 28.6 +/− 8.8 years, 220 females) were included. Of these, 33 participants (56 eyes) had a history of spontaneously regressed ROP and 9 participants (16 eyes) had a history of ROP treatment. After adjustment for age and sex, lower F-NITBUT (<20 s) was associated with ROP treatment (OR = 4.42; p = 0.025). Lower GA correlated with increased bulbar redness (B = −0.02; p = 0.011) and increased length of wetting in the Schirmer test (B = −0.69; p = 0.003). Furthermore, low GA was associated with narrowing of the nasal palpebral angle (B = 0.22; p = 0.011) adjusted for age and sex, but not when considering ROP in the multivariable model. Conclusion: Our analyses indicate that perinatal history affects ocular surface properties, tear production and lid geometry in adults born term and preterm. This might indicate that affected persons have a predisposition to diseases of the corneal surface such as the dry eye disease.
背景/目的：本研究旨在分析围产期病史对早产出生的成年人泪膜特性和眼睑形态的影响。方法：古登堡早产眼研究（GPES）是一项针对18至52岁早产和足月出生的成年人进行的德国前瞻性检查，采用角膜地形图仪5M和泪液分泌试验I。主要观察指标为首次无创泪膜破裂时间（F-NITBUT）、球结膜充血（BR）、泪液分泌试验和鼻睑角测量。使用回归分析评估与胎龄（GA）、出生体重（BW）、BW百分位数、早产儿视网膜病变（ROP）、ROP治疗及其他围产期因素的相关性。结果：纳入255名早产儿的489只眼和139名足月儿的277只眼（年龄28.6±8.8岁，女性220名）。其中，33名参与者（56只眼）有自发消退的ROP病史，9名参与者（16只眼）有ROP治疗史。在调整年龄和性别后，较低的F-NITBUT（<20秒）与ROP治疗相关（OR = 4.42；p = 0.025）。较低的GA与球结膜充血增加（B = -0.02；p = 0.011）和泪液分泌试验中湿润长度增加相关（B = -0.69；p = 0.）。此外，在调整年龄和性别后，低GA与鼻睑角变窄相关（B = 0.22；p = 0.011），但在多变量模型中考虑ROP时则不然。结论：我们的分析表明，围产期病史会影响足月和早产出生的成年人的眼表特性、泪液分泌和眼睑形态。这可能表明受影响的人易患角膜表面疾病，如干眼症。
