Ayaki Masahiko, Hanyuda Akiko, Negishi Kazuno
Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan.
Clin Optom (Auckl). 2024 Sep 2;16:223-231. doi: 10.2147/OPTO.S481279. eCollection 2024.
Risk factors for presbyopia have not been fully determined although previous studies suggested presbyopia was associate with age, dry eye, and retinal ganglion cell complex thickness (GCC). We accessed these signs and common ocular symptoms in the middle-aged population focusing on sex differences when women have drastic hormonal change.
This cohort study consecutively enrolled 2743 patients aged 36-45 years (n=1000), 46-55 years (n=1000), and 56-65 years (n=743). All underwent ocular surface tests and had near add power and GCC measured. Common ocular symptoms were asked using questionnaire.
Among female participants, visual symptoms (eye strain and photophobia) were more prevalent in the age group 46-55, whereas non-visual symptoms (dryness, irritation, and pain) were not. We identified symptomatic presbyopia (near add power ≥ 1.5D) in 14.4%, 73.8%, and 97.8%, positive corneal staining in 29.1%, 23.8%, and 23.9%, and a mean GCC of 98.2 μm, 105.3 μm, and 89.6 μm in the age groups 36-45, 46-55, and 56-65, respectively. Mean tear break-up time were 3.3, 3.5, and 3.3 seconds, respectively. Results indicated a large progression of presbyopia (<0.01) from the period of 36-45 years onward and significantly increased GCC (<0.01) in women of age group 46-55. No notable tendency was observed in symptoms and GCC for male participants.
Visual symptoms in women were worse between 46 and 55 years than before or after these ages. The increase of symptomatic presbyopia and GCC may be contributing to visual symptoms in addition to menopausal transition symptoms in this age group.
尽管先前的研究表明老花眼与年龄、干眼和视网膜神经节细胞复合体厚度（GCC）有关，但老花眼的危险因素尚未完全确定。我们研究了中年人群中的这些体征和常见眼部症状，重点关注女性激素发生剧烈变化时的性别差异。
这项队列研究连续纳入了2743名年龄在36 - 45岁（n = 1000）、46 - 55岁（n = 1000）和56 - 65岁（n = 743）的患者。所有患者均接受了眼表检查，并测量了近附加光度和GCC。通过问卷询问常见的眼部症状。
在女性参与者中，视觉症状（眼疲劳和畏光）在46 - 55岁年龄组中更为普遍，而非视觉症状（干涩、刺激和疼痛）则不然。我们在36 - 45岁、46 - 55岁和56 - 65岁年龄组中分别发现有症状性老花眼（近附加光度≥1.5D）的比例为14.4%、73.8%和97.8%，角膜染色阳性的比例为29.1%、23.8%和23.9%，平均GCC分别为98.2μm、105.3μm和89.6μm。平均泪膜破裂时间分别为3.3秒、3.5秒和3.3秒。结果表明，从36 - 45岁起老花眼有大幅进展（<0.01），46 - 55岁年龄组女性的GCC显著增加（<0.01）。男性参与者的症状和GCC未观察到明显趋势。
46至55岁女性的视觉症状比该年龄之前或之后更严重。有症状性老花眼和GCC的增加可能是导致该年龄组视觉症状的原因之一，此外还有更年期过渡症状。
