Bulbar conjunctival microvascular responses in dry eye.
Bulbar conjunctival microvascular responses in dry eye.
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DOI：
10.1016/j.jtos.2016.12.002
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发表时间：
2017-04
期刊：
影响因子：
--
通讯作者：
Wang J
中科院分区：
文献类型：
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作者：
Chen W;Batawi HI;Alava JR;Galor A;Yuan J;Sarantopoulos CD;McClellan AL;Feuer WJ;Levitt RC;Wang J
结膜微血管反应可以作为支配眼表的传出神经通路功能的替代指标，因为血流在刺激后几秒钟内发生变化。由于体感功能障碍可能部分导致干眼症（DE），在本研究中，我们评估了球结膜微血管改变是否与DE的各个方面相关。在11个月的时间里，我们从退伍军人事务眼科诊所前瞻性地招募了56名DE患者。DE症状和眼痛与DE体征一起被评估。采用一种新型的功能性裂隙灯生物显微镜（FSLB）对右眼角膜中央刺激前后的颞球结膜进行成像。测量血流速度并绘制无创微血管灌注图（nMPMs）。刺激后球茎血流速度为0.55±0.17 mm/s，刺激前为0.50±0.15 mm/s (P<0.001)；平均速度变化为0.05±0.09。而nMPMs值和小静脉直径在刺激后无显著升高（基线时为1.64±0.004，刺激后为1.65±0.04，P=0.22，基线时为22.13±1.84 m，刺激后为22.21±2.04 μm， P=0.73）。基线血流速度与Schirmer评分呈正相关（r=0.40， P=0.002）。自评痛风过敏程度较高的患者在空气刺激中央角膜后血流速度变化较小（r= - 0.268， P=0.046）。风刺激后结膜血流速度增加，而血管直径或复杂性没有增加。基线流量与Schirmer评分正相关，而流量变化与自述风痛觉过敏负相关。
Conjunctival microvascular responses may be a surrogate metric of efferent neural pathway function innervating the ocular surface as changes in blood flow occur within seconds after a stimulus. As somatosensory dysfunction may partially underlie dry eye (DE), in this study we evaluate whether bulbar conjunctival microvascular alterations correlate with various aspects of DE. Fifty-six DE patients were prospectively recruited from a Veterans Affairs ophthalmology clinic over an 11-month period. DE symptoms and ocular pain were assessed along with DE signs. A novel functional slit lamp biomicroscope (FSLB) was used to image the temporal bulbar conjunctiva from the right eye before and after central corneal stimulation with an air puff. Blood flow velocities were measured and noninvasive microvascular perfusion maps (nMPMs) were created. The bulbar blood flow velocity was 0.50±0.15 mm/s at baseline and increased to 0.55±0.17 mm/s after stimulation (P<0.001); the average change in velocity was 0.05±0.09. nMPMs values and venule diameter, on the other hand, did not significantly increase after stimulation (1.64±0.004 at baseline, 1.65±0.04 after stimulation, P=0.22 and 22.13±1.84 m at baseline, 22.21±2.04 μm after stimulation, P=0.73, respectively). Baseline blood flow velocity positively associated with Schirmer scores (r=0.40, P=0.002). Those with higher self-rated wind hyperalgesia demonstrated less change in blood flow velocity (r= −0.268, P=0.046) after air stimulation on the central cornea. Conjunctival blood flow velocity, but not vessel diameter or complexity, increases after wind stimuli. Baseline flow positively correlated with Schirmer scores while change in flow negatively correlated with self-reported wind hyperalgesia.