Kim Yuri, Lew Helen
Department of Ophthalmology, CHA Bundang Medical Center, Seongnam, South Korea.
Front Ophthalmol (Lausanne). 2022 Aug 19;2:960593. doi: 10.3389/fopht.2022.960593. eCollection 2022.
We analyzed the dynamics of blink and defined the blink index in facial nerve palsy (FNP) patients using an ocular surface interferometer associated with clinical characteristics and clinical progress.
In total, 49 patients were enrolled this study. All patients were tested using an ocular surface interferometer which is used to measure blink patterns (total blink (TB), partial blink rate (PBR)) and blink dynamics (blink time (BT), lid closing time (LCT), closure time (CT), lid opening time (LOT), interblink time (IBT), closing speed (CS), and opening speed (OS)) using 600 frames recorded over 20 s. The distance of lagophthalmos and modified interpalpebral fissure (IPF), which was defined as the actual moving distance of the upper eyelid, subtracting the distance of lagophthalmos from IPF, was measured using the ImageJ program. The types of FNP were "idiopathic" (Bell's palsy) and "surgical" (following the neurosurgery). Patients were classified into "acute" and "chronic" based on the duration of 6 months from the onset time of FNP. The clinical characteristics were classified into mild or severe according to the severe degree of exposure keratopathy-as "severe" if treatment such as tarsorrhaphy and gold plate insertion was required.
Reduced MRD, brow height, and modified IPF and increased lagophthalmos were noted in the palsy side. LCT was longer and CS, modified CS, and modified OS were shorter in the palsy side. The LCT was longer and the modified CS was shorter in idiopathic patients with acute onset and with clinically severe. IBT was increased in idiopathic patients with clinically severe.
Analyzing the blink patterns and blink dynamics, this study suggests meaningful indicators among blink profiles and dynamics, LCT, and modified CS based on modified IPF. It was more associated in the idiopathic type than in the surgical type of FNP patients. The modified CS can be a useful tool for evaluating the activity and severity indicator of FNP.
我们分析了眨眼动态，并使用眼表干涉仪结合临床特征和临床进展情况，确定面神经麻痹（FNP）患者的眨眼指数。
本研究共纳入49例患者。所有患者均使用眼表干涉仪进行检测，该仪器通过记录20秒内的600帧图像来测量眨眼模式（总眨眼次数（TB）、部分眨眼率（PBR））和眨眼动态（眨眼时间（BT）、眼睑闭合时间（LCT）、闭合时间（CT）、眼睑张开时间（LOT）、眨眼间隔时间（IBT）、闭合速度（CS）和张开速度（OS））。使用ImageJ程序测量睑裂闭合不全的距离和改良睑裂（IPF），改良睑裂定义为上睑的实际移动距离，即从IPF中减去睑裂闭合不全的距离。FNP的类型为“特发性”（贝尔麻痹）和“手术性”（神经外科手术后）。根据FNP发病时间6个月的病程，将患者分为“急性”和“慢性”。根据暴露性角膜病变的严重程度，将临床特征分为轻度或重度，若需要进行睑裂缝合术和植入金片等治疗，则为“重度”。
在麻痹侧观察到MRD、眉高和改良IPF降低，睑裂闭合不全增加。麻痹侧的LCT较长，CS、改良CS和改良OS较短。急性起病且临床症状严重的特发性患者，其LCT较长，改良CS较短。临床症状严重的特发性患者的IBT增加。
通过分析眨眼模式和眨眼动态，本研究表明基于改良IPF的眨眼特征和动态、LCT和改良CS中有意义的指标。在FNP患者中，特发性类型比手术类型的相关性更强。改良CS可作为评估FNP活动度和严重程度的有用工具。
