Yoshikawa Yamato, Yokoi Norihiko, Kusada Natsuki, Kato Hiroaki, Sakai Rieko, Komuro Aoi, Sonomura Yukiko, Sotozono Chie
Department of Ophthalmology, Osaka Medical and Pharmaceutical University, Takatsuki-City 569-8686, Japan.
Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto 602-0841, Japan.
Diagnostics (Basel). 2023 Dec 22;14(1):30. doi: 10.3390/diagnostics14010030.
In this study, the severity of eye pain (EP) and associated objective findings were evaluated in aqueous-deficient dry eye (ADDE) patients using PainVision, a quantitative pain-measuring device. This study involved 53 eyes of 53 ADDE patients (6 males and 47 females; mean age: 64.4 ± 13.4 [mean ± SD] years). Of those, 18 eyes of 18 patients underwent punctal occlusion, and EP and objective findings in those patients were evaluated before and after treatment. In all patients, the severity of EP as measured by PainVision was assessed using the Pain Degree (PD). The median PD for the 53 patients was 30.6 µA/µA (interquartile range, 16.9-93.2), and the nasal and central corneal staining score and the upper lid-wiper epitheliopathy score were significantly correlated with PD (R = 0.33, 0.33, and 0.28, respectively) (all: < 0.05). Using the least squares method, the central corneal staining score most significantly affected PD. In the 18 cases that underwent punctal occlusion, PD was significantly reduced (median PD: 24.8 to 7.1 µA/µA; < 0.0001). Using the least squares method, the central corneal staining score and tear meniscus radius were significantly more influential as factors contributing to PD before and after treatment, and central corneal epithelial damage was the factor most associated with ADDE-related EP.
在本研究中，使用一种定量疼痛测量设备PainVision对水液缺乏型干眼症（ADDE）患者的眼痛（EP）严重程度及相关客观检查结果进行了评估。本研究纳入了53例ADDE患者的53只眼（男性6例，女性47例；平均年龄：64.4±13.4[均值±标准差]岁）。其中，18例患者的18只眼接受了泪点封闭，并在治疗前后对这些患者的EP及客观检查结果进行了评估。在所有患者中，使用疼痛程度（PD）评估PainVision测量的EP严重程度。53例患者的PD中位数为30.6µA/µA（四分位间距，16.9 - 93.2），鼻侧和中央角膜染色评分以及上睑擦拭缘上皮病变评分与PD显著相关（R分别为0.33、0.33和0.28）（均P<0.05）。采用最小二乘法，中央角膜染色评分对PD的影响最为显著。在接受泪点封闭的18例患者中，PD显著降低（PD中位数：从24.8降至7.1µA/µA；P<0.0001）。采用最小二乘法，治疗前后中央角膜染色评分和泪河半径作为影响PD的因素更具显著影响力，且中央角膜上皮损伤是与ADDE相关的EP最相关的因素。
