Vision and Hearing Sciences Research Centre, Anglia Ruskin University, Cambridge United Kingdom.
Department of Vision Sciences, Glasgow Caledonian University, Glasgow, United Kingdom.
Optom Vis Sci. 2024 Sep 1;101(9):589-594. doi: 10.1097/OPX.0000000000002173. Epub 2024 Aug 26.
When using lissamine green for bulbar conjunctival evaluation, the most staining was observed with two applications of the same strip in the same eye, wetted with a drop of saline. The first application was 5 seconds after wetting the strip, and the second was 1 minute later, followed by immediate viewing. This suggests that bulbar staining should be viewed before the lid wiper region.
This study aimed to optimize the assessment of lissamine green staining of the bulbar conjunctiva by investigating the application technique and subsequent observation period.
Twenty-two participants with dry eye (as defined by the Tear Film and Ocular Surface Society Dry Eye Workshop II) were recruited to trial five application methods in randomized order: (1) application immediately after wetting a single strip, (2) application 5 seconds after wetting a single strip, (3) application 10 seconds after wetting a single strip, (4) consecutive single application of sodium fluorescein followed by lissamine green 5 seconds after wetting, and (5) two applications using the same lissamine green strip 5 seconds after wetting, 1 minute apart. Slit-lamp photography of the conjunctiva was performed immediately following application and at 30, 60, 90, and 300 seconds after application. Three experienced (masked) practitioners independently quantified the visible punctate spots and graded the staining intensity within the images in a random order.
Values for punctate spot count ( F = 6.29, p<0.0001) and lissamine green staining intensity ( F = 6.29, p<0.0001) varied significantly between the different application methods. Using two applications of the same lissamine green strip, 1 minute apart, in the same eye resulted in the greatest values for both punctate spot count and lissamine green staining intensity. Lissamine green staining decreased with time for both spot count ( F = 18.87, p<0.0001) and lissamine green staining intensity ( F = 11.33, p<0.0001), with the most staining found immediately after application followed by a gradual decline. There was no evidence of any interaction effect between time and application method for either measure (p>0.05 for both).
The optimal approach for assessing bulbar conjunctival lissamine green staining involves two applications of a whole infused drop resting on the same strip for 5 seconds, applied 1 minute apart. The ocular surface should be viewed immediately after application to maximize the conjunctival staining observed.
当使用丽丝胺绿进行球结膜评估时，在同一眼同一根条带湿润一滴生理盐水后进行两次应用，观察到最明显的染色。第一次应用是在条带湿润后 5 秒，第二次是 1 分钟后，随后立即观察。这表明球结膜染色应在眼睑擦拭区域之前进行观察。
本研究旨在通过研究应用技术和随后的观察期来优化丽丝胺绿染色的评估。
招募了 22 名干眼症患者（定义为泪膜和眼表面协会干眼工作坊 II）进行五项随机应用方法的试验：（1）在湿润单一条带后立即应用，（2）在湿润单一条带后 5 秒应用，（3）在湿润单一条带后 10 秒应用，（4）连续应用单次钠荧光素，然后在湿润后 5 秒应用丽丝胺绿，（5）在湿润后 5 秒使用同一丽丝胺绿条带两次应用，1 分钟后。在应用后立即以及 30、60、90 和 300 秒进行结膜裂隙灯摄影。三名经验丰富的（蒙面）从业者以随机顺序独立对图像中的可见点状斑点进行量化，并对染色强度进行分级。
在不同的应用方法之间，点状斑点计数（ F = 6.29，p<0.0001）和丽丝胺绿染色强度（ F = 6.29，p<0.0001）的值差异显著。使用同一丽丝胺绿条带在同一眼内进行两次应用，间隔 1 分钟，可获得最大的点状斑点计数和丽丝胺绿染色强度值。丽丝胺绿染色随着时间的推移而减少，无论是斑点计数（ F = 18.87，p<0.0001）还是丽丝胺绿染色强度（ F = 11.33，p<0.0001），应用后立即观察到的染色最明显，随后逐渐下降。在这两种措施中，均未发现时间和应用方法之间存在任何交互作用（p>0.05）。
评估球结膜丽丝胺绿染色的最佳方法涉及将整个浸润滴应用于同一根条带两次，每次应用 5 秒，间隔 1 分钟。应用后应立即观察眼表面，以最大限度地观察到结膜染色。
