Wada Eye Clinic, Chiba, Japan.
Tsubota Laboratory, Inc., Tokyo, Japan.
PLoS One. 2022 Nov 16;17(11):e0276945. doi: 10.1371/journal.pone.0276945. eCollection 2022.
The autonomic nervous system plays a crucial role in the maintenance of homeostasis. Neurogenic inflammation due to decreased stability of tear film may induce changes in autonomic nerve activity, which could be associated with symptom expression.This study aimed to measure biological parameters that represent autonomic nerve activity in dry eye (DE)s caused by tear film dysfunction and investigate their relationship with symptom intensity. This prospective, cross-sectional, comparative study evaluated 34 eyes of 34 participants (mean age: 52.5 ± 13.4 years; range: 20-81 years) without keratoconjunctival damage. Nineteen eyes in the DE group showed DE symptoms and tear break-up time (TBUT) of ≤5 seconds (short TBUT DE); the 15 eyes in the non-DE group showed no DE symptoms. Autonomic nerve activity was measured for 10 minutes-starting and ending 5 minutes before and after instilling ophthalmic solution-and evaluated using the low-frequency component (LF) to the high-frequency component (HF) ratio of heart rate variability (autonomic balance). The pre-ophthalmic solution administration LF/HF ratio was not significantly different (P = 0.59) between the two groups, however, the standard deviation of the LF/HF ratio (LF/HF-SD) tended to be higher in the DE group than that in the non-DE group (P = 0.086). The DE symptom intensity was significantly related to LF/HF-SD (P = 0.005), which significantly decreased after ophthalmic solution administration in the DE group (P = 0.04). The large fluctuations in autonomic balance may be key for the understanding of the mechanism underlying DE symptoms.
自主神经系统在维持体内平衡中起着至关重要的作用。由于泪膜稳定性降低而导致的神经源性炎症可能会引起自主神经活动的变化，这可能与症状表现有关。本研究旨在测量代表泪膜功能障碍性干眼症（DED）的自主神经活动的生物学参数，并研究其与症状严重程度的关系。这是一项前瞻性、横断面、对照研究，评估了 34 名参与者（平均年龄：52.5±13.4 岁；范围：20-81 岁）的 34 只眼，这些参与者均无角结膜损伤。DED 组 19 只眼出现 DED 症状和泪膜破裂时间（TBUT）≤5 秒（短 TBUT DED）；非 DED 组 15 只眼无 DED 症状。自主神经活动在滴眼前 5 分钟开始和滴眼后 5 分钟结束时测量 10 分钟，并通过心率变异性（自主平衡）的低频成分（LF）与高频成分（HF）的比值评估。滴眼前两组间心率变异性 LF/HF 比值无显著差异（P=0.59），但 DED 组 LF/HF 比值的标准差（LF/HF-SD）倾向于高于非 DED 组（P=0.086）。DED 症状严重程度与 LF/HF-SD 显著相关（P=0.005），DED 组滴眼后 LF/HF-SD 显著降低（P=0.04）。自主平衡的大幅波动可能是理解 DED 症状发生机制的关键。
