Yang Wanju, Wang Haoyu, Li Jinghua, Chen Yuan, Zhang Yu, Niu Xiaoxia, Song Xiujun, Tang Yuhong, Chen Dan, Han Honglin, Huang Hai, Bao Ying, Li Xiaofeng, Ye Jianzhang, Zheng Yu, Chen Xiangxi, Liu Chang, Wang Congxiang, Chen Tiehong, Yu Bin, Yan Jingyan, Yang Kuiliang, Zhang Han, Zeng Qingyan, Li Shaowei
Aier Eye Hospital of Wuhan University, Wuhan, Hubei Province, 430063, China.
Department of Cornea and Ocular Surface Diseases, Wuhan Aier Hankou Eye Hospital, Wuhan, Hubei Province, 430021, China.
Ocul Surf. 2024 Oct;34:146-155. doi: 10.1016/j.jtos.2024.07.007. Epub 2024 Jul 27.
Associations were assessed between demographic/lifestyle factors and tear film breakup time (TBUT) defined dry eye disease (DED) in China.
The cross-sectional study involved 50,280 subjects (54 ± 17 y) in 217 clinics (25 provinces). Data included sleep disorders; digital screen exposure; and use of cosmetics, contact lenses, and eye drops (for asthenopia). Clinical examinations included TBUT; Schirmer I test; meibomian gland plug status. TBUT-defined DED was TBUT <10 s, with TBUT ≤5 s also considered (i.e., short TBUT-type DED), either unilateral or bilateral.
TBUT-defined DED was present in 81.6 % overall. The highest rates were in those 71 years or older, living in the north, with chronic daily sleep disorder, or daily cosmetic application; or daily digital screen exposure for 5 years, contact lenses 4 h, or 3 months eye drops. Compared with those without TBUT-defined DED, those with TBUT-defined DED showed lower Schirmer I results and more severe meibomian gland plug status (each, P < 0.001). Independent risk factors of DED were: aging; living in the southwest; daily digital screen exposure ≥3 h; and occasional cosmetic use. Risk factors of DED TBUT ≤5 s were: living in the southwest; wearing contact lenses (>3 y); and using eye drops. Rates of unilateral and bilateral DED were comparable.
DED in China is more likely in the aged and those in the north/southwest. DED rates increase with digital screen exposure, and use of cosmetics, contact lenses, or eye drops for asthenopia. Unilateral DED should be treated as promptly as bilateral.
评估中国人群中人口统计学/生活方式因素与泪膜破裂时间（TBUT）定义的干眼病（DED）之间的关联。
这项横断面研究纳入了来自217家诊所（分布于25个省份）的50280名受试者（年龄54±17岁）。数据包括睡眠障碍、数字屏幕暴露情况，以及化妆品、隐形眼镜和眼药水（用于治疗视疲劳）的使用情况。临床检查包括TBUT、Schirmer I试验、睑板腺堵塞状况。TBUT定义的DED为TBUT<10秒，TBUT≤5秒也纳入考虑（即短TBUT型DED），可为单侧或双侧。
总体上，TBUT定义的DED发生率为81.6%。发生率最高的人群为71岁及以上、居住在北方且有慢性日常睡眠障碍者，或每日使用化妆品者；或每日数字屏幕暴露5年、佩戴隐形眼镜4小时或使用眼药水3个月者。与无TBUT定义的DED者相比，有TBUT定义的DED者Schirmer I试验结果更低，睑板腺堵塞状况更严重（均为P<0.001）。DED的独立危险因素为：年龄增长、居住在西南部、每日数字屏幕暴露≥3小时、偶尔使用化妆品。TBUT≤5秒的DED危险因素为：居住在西南部、佩戴隐形眼镜（>3年）、使用眼药水。单侧和双侧DED的发生率相当。
中国老年人以及居住在北方/西南部的人群更易患DED。DED发生率随数字屏幕暴露、化妆品、隐形眼镜或用于视疲劳的眼药水的使用而增加。单侧DED应与双侧DED同样及时治疗。
