Tsubota K, Toda I, Yagi Y, Ogawa Y, Ono M, Yoshino K
Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan.
Cornea. 1994 May;13(3):202-9. doi: 10.1097/00003226-199405000-00002.
We analyzed patients with dry eye syndrome with regard to autoimmune conditions. A total of 116 patients with dry eye syndrome were divided into three groups: simple dry eye (SDE), i.e., dry eye with no circulating autoantibodies; autoimmune positive dry eye (ADE), dry eye with circulating autoantibodies; and Sjogren's syndrome (SS), dry eye associated with Sjogren's syndrome. Schirmer test showed values of 3.0 +/- 2.2 mm in SDE, 3.1 +/- 2.0 mm in ADE, and 2.4 +/- 2.3 mm in SS reflecting the inadequacy of this test in differentiating among the groups. However, Schirmer test with nasal stimulation showed values of 19.1 +/- 12.4 mm in SDE and 16.4 +/- 10.9 mm in ADE, which were significantly higher than the 7.0 +/- 6.6 mm found in SS (p < 0.01). Moreover, ocular surface alterations evaluated by vital staining and brush cytology were significantly milder in SDE and ADE than in SS. SDE and ADE have less ocular surface abnormalities with good reflex tearing, whereas SS has less reflex tearing and more squamous metaplasia.
我们针对自身免疫性疾病对干眼症患者进行了分析。总共116例干眼症患者被分为三组：单纯性干眼症（SDE），即无循环自身抗体的干眼症；自身免疫阳性干眼症（ADE），有循环自身抗体的干眼症；以及干燥综合征（SS），与干燥综合征相关的干眼症。泪液分泌试验显示，SDE组的值为3.0±2.2毫米，ADE组为3.1±2.0毫米，SS组为2.4±2.3毫米，这反映出该试验在区分各组方面的不足。然而，鼻刺激泪液分泌试验显示，SDE组的值为19.1±12.4毫米，ADE组为16.4±10.9毫米，显著高于SS组的7.0±6.6毫米（p<0.01）。此外，通过活体染色和刷片细胞学评估的眼表改变在SDE和ADE中明显比在SS中更轻微。SDE和ADE的眼表异常较少，反射性流泪良好，而SS的反射性流泪较少，鳞状化生较多。
