Huseva Yu A, Shymanets O V
Belarusian State Medical University, Minsk, Belarus.
Minsk Scientific and Practical Center of Surgery, Transplantology and Hematology, Minsk, Belarus.
Vestn Oftalmol. 2022;138(3):46-54. doi: 10.17116/oftalma202213803146.
To study tears for occult (latent) haemolacria in women and compare the representativeness of the main methods of tear examination.
Tear samples from 72 women aged between 18 and 46 years were evaluated using two methods: microscopic and chemical with reagent test strips.
In the follicular phase of the menstrual cycle, erythrocytes in tears were detected in 59.1% (13) subjects, which was significantly higher (χ=4.2, =0.041) compared to the luteal phase - erythrocytes were detected in 40.9% (9) women. The proportion of women in the luteal phase of the cycle who had single epithelial cells in the tear (76.9%) was significantly lower (χ=5.2, =0.022) than in women in the follicular phase (83.9%). The predictive value of the chemical method was 0.53 of that of the microscopic one. Microscopically, blood was detected in 30.6% of tear samples, while chemically - in 16.7%. An associative relationship was found between occult haemolacria in women and a diagnosis of endometriosis (K=0.75, ≤0.05). The proportion of women with erythrocytes in tears determined with the chemical method was 41.7% in patients with endometriosis, which was significantly higher (χ=6.5, =0.011) than 11.7% in women without endometriosis.
Fluctuations of hormones during the menstrual cycle are reflected in tear composition, manifested as an increase in the number of epithelial cells in the luteal phase, and erythrocytes in the follicular phase. Erythrocytes found in a tear amid accumulations of epithelial cells, their glandular atypia and neutrophilic infiltration in patients with endometriosis may indicate the manifestation of extragenital endometriosis. The microscopic method turned out to be more sensitive in detecting occult haemolacria, and additionally it provided information about other cells. At the same time, the chemical method, which was relatively diagnostically informative, faster and technically simpler, can be used for screening.
研究女性眼泪中的隐匿性（潜在性）血性泪液，并比较主要泪液检查方法的代表性。
使用两种方法对72名年龄在18至46岁之间的女性的泪液样本进行评估：显微镜检查法和使用试剂试纸的化学检查法。
在月经周期的卵泡期，59.1%（13名）受试者的泪液中检测到红细胞，与黄体期相比显著更高（χ=4.2，P=0.041），黄体期有40.9%（9名）女性检测到红细胞。月经周期黄体期泪液中有单个上皮细胞的女性比例（76.9%）显著低于卵泡期女性（83.9%）（χ=5.2，P=0.022）。化学检查法的预测价值是显微镜检查法的0.53倍。显微镜检查发现，30.6%的泪液样本中有血液，而化学检查法检测出的比例为16.7%。发现女性隐匿性血性泪液与子宫内膜异位症的诊断之间存在关联关系（K=0.75，P≤0.05）。子宫内膜异位症患者中通过化学检查法确定泪液中有红细胞的女性比例为41.7%，显著高于无子宫内膜异位症女性的11.7%（χ=6.5，P=0.011）。
月经周期中激素的波动反映在泪液成分中，表现为黄体期上皮细胞数量增加，卵泡期红细胞数量增加。在子宫内膜异位症患者中，上皮细胞聚集、腺细胞异型性和中性粒细胞浸润的泪液中发现的红细胞可能表明存在生殖器外子宫内膜异位症。显微镜检查法在检测隐匿性血性泪液方面更敏感，此外还能提供有关其他细胞的信息。同时，化学检查法相对具有诊断信息，速度更快且技术更简单，可用于筛查。
