Corneal Mechanical Thresholds Negatively Associate With Dry Eye and Ocular Pain Symptoms
Corneal Mechanical Thresholds Negatively Associate With Dry Eye and Ocular Pain Symptoms
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DOI：
10.1167/iovs.15-18133
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发表时间：
2016-02-01
影响因子：
4.4
通讯作者：
Galor, Anat
中科院分区：
文献类型：
--
作者：
Spierer, Oriel;Felix, Elizabeth R.;Galor, Anat
目的.检查角膜机械阈值和干眼指标之间的关联。这是一项对在迈阿密退伍军人事务部眼科诊所就诊的个人进行的横断面研究。评估包括关于干眼症状和眼痛的问卷调查、角膜机械检测和疼痛阈值以及全面的眼表检查。主要的结果测量是角膜阈值与干眼和眼痛的体征和症状之间的相关性。共有129例受试者参加了研究（平均年龄64 ± 10岁）。角膜上的机械检测和疼痛阈值与年龄相关（斯皮尔曼rho = 0.26，0.23;均P < 0.05），这意味着角膜敏感性随年龄而降低。干眼症症状严重程度评分和神经性疼痛症状量表（针对眼睛进行了修改）评分与角膜检测和疼痛阈值呈负相关（范围，r = -0.13至-0.27，P < 0.05，值在-0.18至-0.27之间），表明患有更严重眼部主诉的患者角膜敏感性增加。另一方面，眼部体征与角膜上的机械检测和疼痛阈值相关性较差且无显著性。多变量线性回归模型发现，创伤后应激障碍（PTSD）评分（β = 0.21，SE = 0.03）和角膜疼痛阈值（β =-0.03，SE = 0.01）与自我报告的诱发性眼痛（风痛、光痛、温度痛）显著相关，解释了约32%的测量变异性（R = 0.57）。在角膜上测量的机械检测和疼痛阈值与干眼症状和眼部疼痛相关。这表明，在干眼症和眼痛主诉更严重的患者中，角膜躯体感觉通路内存在超敏反应。
PURPOSE. To examine associations between corneal mechanical thresholds and metrics of dry eye.METHODS. This was a cross-sectional study of individuals seen in the Miami Veterans Affairs eye clinic. The evaluation consisted of questionnaires regarding dry eye symptoms and ocular pain, corneal mechanical detection and pain thresholds, and a comprehensive ocular surface examination. The main outcome measures were correlations between corneal thresholds and signs and symptoms of dry eye and ocular pain.RESULTS. A total of 129 subjects participated in the study (mean age 64 +/- 10 years). Mechanical detection and pain thresholds on the cornea correlated with age (Spearman's rho = 0.26, 0.23, respectively; both P < 0.05), implying decreased corneal sensitivity with age. Dry eye symptom severity scores and Neuropathic Pain Symptom Inventory (modified for the eye) scores negatively correlated with corneal detection and pain thresholds (range, r = -0.13 to -0.27, P < 0.05 for values between -0.18 and -0.27), suggesting increased corneal sensitivity in those with more severe ocular complaints. Ocular signs, on the other hand, correlated poorly and nonsignificantly with mechanical detection and pain thresholds on the cornea. A multivariable linear regression model found that both posttraumatic stress disorder (PTSD) score (beta = 0.21, SE = 0.03) and corneal pain threshold (beta = -0.03, SE = 0.01) were significantly associated with self-reported evoked eye pain (pain to wind, light, temperature) and explained approximately 32% of measurement variability (R = 0.57).CONCLUSIONS. Mechanical detection and pain thresholds measured on the cornea are correlated with dry eye symptoms and ocular pain. This suggests hypersensitivity within the corneal somatosensory pathways in patients with greater dry eye and ocular pain complaints.