Department of Ophthalmology, Sancaktepe Sehit Prof. Dr. Ilhan Varank Training and Research Hospital, Emek Mah. Namık Kemal Cad. No:54, 34785, Sancaktepe, Istanbul, Turkey.
Department of Pathology, Sancaktepe Sehit Prof. Dr. Ilhan Varank Training and Research Hospital, Istanbul, Turkey.
Int Ophthalmol. 2024 Feb 12;44(1):59. doi: 10.1007/s10792-024-02990-5.
To investigate the relationship between prolonged face mask use and ocular surface health utilizing conjunctival impression cytology, the Schirmer test, the tear break-up time (TBUT) test, and the ocular surface disease index (OSDI) questionnaire.
In this cross-sectional prospective study, individuals who used face masks for at least eight hours per day for at least six months were compared to healthy volunteers who used face masks for no more than one hour per day. Each participant completed an OSDI questionnaire. The Schirmer test (under anesthesia), the TBUT test, and conjunctiva impression cytology analysis according to the Nelson classification method were performed on each participant.
This study included 102 (49 male, 53 female) face mask users with an average age of 33.29 ± 7.71 years and 110 (60 male, 50 female) healthy controls with an average age of 32.96 ± 7.10 years (p = 0.746). The total OSDI score was significantly higher in face mask users than the control group (25.18 ± 3.54 vs 9.46 ± 2.13, p < 0.001). The mean Schirmer test value and TBUT were significantly lower in the study group than the control group (p < 0.001, p < 0.001). There was a statistically significant difference between the two groups in total score and stage of the Nelson classification system (p < 0.001, and p = 0.024, respectively). All conjunctiva impression cytology assessments, including cellularity, cell-cell contact, nucleus/cytoplasma ratio, goblet cell amount, and metaplasia, revealed statistically significant deterioration in the study group compared to the control group (p < 0.001, p = 0.025, p < 0.001, p < 0.001, and p < 0.001, respectively).
The prolonged use of face masks leads to dry eyes. The findings of conjunctiva impression cytology indicate the role of inflammation in the pathogenesis of mask associated dry eye.
利用结膜印迹细胞学、泪液分泌试验（Schirmer 试验）、泪膜破裂时间（TBUT）试验和眼表疾病指数（OSDI）问卷，研究长时间佩戴口罩与眼表健康之间的关系。
在这项横断面前瞻性研究中，我们将每天至少佩戴口罩 8 小时且至少持续 6 个月的人群与每天佩戴口罩不超过 1 小时的健康志愿者进行比较。每位参与者都完成了 OSDI 问卷。对每位参与者进行了 Schirmer 试验（麻醉下）、TBUT 试验和根据 Nelson 分类法进行的结膜印迹细胞学分析。
本研究共纳入 102 名（49 名男性，53 名女性）口罩使用者，平均年龄为 33.29±7.71 岁，以及 110 名（60 名男性，50 名女性）健康对照者，平均年龄为 32.96±7.10 岁（p=0.746）。口罩使用者的总 OSDI 评分明显高于对照组（25.18±3.54 与 9.46±2.13，p<0.001）。研究组的 Schirmer 试验值和 TBUT 均明显低于对照组（p<0.001，p<0.001）。两组在总评分和 Nelson 分类系统的阶段方面存在统计学差异（p<0.001 和 p=0.024）。与对照组相比，所有结膜印迹细胞学评估，包括细胞密度、细胞间接触、核/细胞质比、杯状细胞数量和化生，在研究组中均显示出统计学上的显著恶化（p<0.001，p=0.025，p<0.001，p<0.001，和 p<0.001）。
长时间佩戴口罩会导致干眼症。结膜印迹细胞学的发现表明，炎症在口罩相关干眼的发病机制中起作用。
