Wang Michael T M, Power Barry, Xue Ally L, Craig Jennifer P
Department of Ophthalmology, Aotearoa New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand.
Department of Ophthalmology, Aotearoa New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand; Department of Ophthalmology, Royal Victoria Eye and Ear Hospital, Dublin, Ireland.
Cont Lens Anterior Eye. 2025 Jun;48(3):102369. doi: 10.1016/j.clae.2025.102369. Epub 2025 Jan 10.
To investigate the prognostic ability of blink rate and the proportion of incomplete blinking to predict dry eye disease diagnosis, as defined by the TFOS DEWS II criteria.
A total of 453 community residents (282 females, 171 males; mean ± SD age, 37 ± 19 years) were recruited in an investigator-masked, prospective registry-based, cross-sectional, prognostic study. Dry eye symptomology, tear film quality, and ocular surface characteristics were assessed in a single clinical session, and blink parameters evaluated by an independent masked observer.
Overall, 214 (47 %) participants fulfilled the TFOS DEWS II criteria for dry eye disease. Multivariate regression analysis demonstrated that an increased proportion of incomplete blinking was associated with a higher odds of dry eye disease (odds ratio, 1.12 per 10 % increase; 95 % CI, 1.05-1.19; p < 0.001), with the Youden-optimal prognostic threshold proportion being ≥ 40 % incomplete blinking. Higher levels of incomplete blinking were also associated with poorer dry eye symptomology, tear film stability, corneal and lid margin staining, lipid layer thickness, meibography, and meibum quality (all p ≤ 0.03). No significant associations were detected between blink rate and ocular surface parameters (all p > 0.10).
The degree of incomplete blinking is a significant predictor of dry eye disease, and the utility of incorporating blink assessment into diagnostic workup algorithms warrants further investigation. The association with meibomian gland dropout, expressed meibum quality, and lipid layer thickness would suggest that incomplete blinking may predispose towards the development of meibomian gland dysfunction.
根据TFOS DEWS II标准，研究眨眼率和不完全眨眼比例预测干眼病诊断的预后能力。
在一项研究者设盲、基于前瞻性登记的横断面预后研究中，招募了453名社区居民（282名女性，171名男性；平均年龄±标准差，37±19岁）。在一次临床检查中评估干眼症状、泪膜质量和眼表特征，并由独立的设盲观察者评估眨眼参数。
总体而言，214名（47%）参与者符合TFOS DEWS II干眼病标准。多变量回归分析表明，不完全眨眼比例增加与干眼病几率较高相关（比值比，每增加10%为1.12；95%置信区间，1.05 - 1.19；p < 0.001），尤登最优预后阈值比例为不完全眨眼≥40%。较高水平的不完全眨眼还与较差的干眼症状、泪膜稳定性、角膜和睑缘染色、脂质层厚度、睑板腺造影和睑脂质量相关（所有p≤0.03）。未检测到眨眼率与眼表参数之间的显著关联（所有p > 0.10）。
不完全眨眼程度是干眼病的重要预测指标，将眨眼评估纳入诊断检查算法的效用值得进一步研究。与睑板腺缺失、睑脂质量和脂质层厚度的关联表明，不完全眨眼可能易导致睑板腺功能障碍的发生。
