Shen Jiahui, Xu Zhiqiang, Wang Yuzhou, Ye Jingjian, Wei Linzhi, Xia Jiahui, Sun Yiran, Lu Fan, Hu Liang
National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China; and.
National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China.
Cornea. 2024 Jun 1;43(6):751-756. doi: 10.1097/ICO.0000000000003473. Epub 2024 Jan 25.
The aim of this study was to investigate the factors influencing dry eye disease (DED)-related ocular symptoms in participants with short fluorescein tear break-up time (FTBUT).
This cross-sectional study included 82 participants with short FTBUT (<10 seconds). Examinations included Ocular Surface Disease Index (OSDI), FTBUT, average noninvasive tear break-up time (NIBUTave), lid wiper epitheliopathy, lipid layer thickness, blink rate, partial blink, tear meniscus height, and meibomian gland (MG) evaluation which included ratio of residual MG area (RMGA) and MG grade in tarsal plates. One-way analysis of variance was used to detect differences between symptomatic tear film instability group (FTBUT <5 s, OSDI ≥13), asymptomatic tear film instability group (FTBUT <5 s, OSDI <13), and control group (FTBUT ≥5 s, OSDI <13). A bivariate correlation, partial correlation, and multiple linear regression analyses were used to identify major factors. Only the right eye was included.
Among the participants with FTBUT <5 seconds, symptomatic group showed less upper RMGA ( P < 0.001) and NIBUTave ( P = 0.010). OSDI was negatively associated with upper RMGA ( r = -0.450, P < 0.001) and NIBUTave ( r = -0.414, P = 0.001), and positively associated with upper MG grade ( r = 0.277, P = 0.027). Linear regression analysis showed that the upper RMGA significantly affected OSDI (B = -41.895, P = 0.001), while not significantly correlated with age, upper MG grade, and NIBUTave.
The upper RMGA might be the main factor affecting DED-related discomfort in participants with unstable tear film, indicating an early ocular change in DED.
本研究旨在调查影响荧光素泪膜破裂时间(FTBUT)短的参与者干眼疾病(DED)相关眼部症状的因素。
这项横断面研究纳入了82名FTBUT短(<10秒)的参与者。检查包括眼表疾病指数(OSDI)、FTBUT、平均无创泪膜破裂时间(NIBUTave)、睑缘上皮病变、脂质层厚度、眨眼率、不完全眨眼、泪液弯月面高度以及睑板腺(MG)评估,其中MG评估包括残余MG面积比(RMGA)和睑板内MG分级。采用单因素方差分析来检测有症状泪膜不稳定组(FTBUT<5秒,OSDI≥13)、无症状泪膜不稳定组(FTBUT<5秒,OSDI<13)和对照组(FTBUT≥5秒,OSDI<13)之间的差异。使用双变量相关性、偏相关性和多元线性回归分析来确定主要因素。仅纳入右眼。
在FTBUT<5秒的参与者中,有症状组的上睑RMGA(P<0.001)和NIBUTave(P = 0.010)较低。OSDI与上睑RMGA(r = -0.450,P<0.001)和NIBUTave(r = -0.414,P = 0.001)呈负相关,与上睑MG分级呈正相关(r = 0.277,P = 0.027)。线性回归分析表明,上睑RMGA显著影响OSDI(B = -41.895,P = 0.001),而与年龄、上睑MG分级和NIBUTave无显著相关性。
上睑RMGA可能是影响泪膜不稳定参与者DED相关不适的主要因素,提示DED早期眼部变化。