Characteristics of tear abnormalities associated with benign essential blepharospasm and amelioration by means of botulinum toxin type A treatment
Characteristics of tear abnormalities associated with benign essential blepharospasm and amelioration by means of botulinum toxin type A treatment
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DOI：
10.1007/s10384-019-00705-3
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发表时间：
2020-01-01
影响因子：
2.4
通讯作者：
Gomi, Fumi
中科院分区：
文献类型：
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作者：
Hosotani, Yuka;Yokoi, Norihiko;Gomi, Fumi
目的探讨良性特发性眼睑痉挛(BEB)泪液异常的特点及A型肉毒毒素(BTX-A)的治疗效果。研究设计前瞻性临床研究。方法40例(40眼)BEB合并泪液异常患者，男12例，女28例，年龄63.5+/-12.9岁。结果患者主观症状视觉模拟评分(VAS)平均为46.3分，干眼相关生活质量评分(DEQS)平均为63.7分。荧光素分解时间(FBUT)为2.7±1.6秒。在荧光素分解模式(FBUPs)中，29只眼(73%)出现酒窝破裂，其相应的机制是润湿性降低。NEI评分为0.4+/-0.7，van Bijester veld评分为0.6+/-0.8，Schirmer 1测试值为13.1+/-9.4 mm。18例患者接受了BTX-A治疗，VAS、DEQS和FBUT的主观症状严重程度均有显著改善。主要的FBUP由韧窝断裂变为随机断裂。结论BEB的泪液异常对应于短型干眼(DE)，根据FBUP可将其细分为润湿性降低的DE。
Purpose To investigate the characteristics of tear abnormalities with benign essential blepharospasm (BEB) and the effect of botulinum toxin type A (BTX-A) treatment. Study Design Prospective and clinical study. Methods Forty eyes of 40 patients (12 men and 28 women, ages 63.5 +/- 12.9) with BEB and tear abnormalities were enrolled. Results The average scores for subjective symptoms as evaluated by the visual analog scale (VAS) were 46.3 and Dry Eye-Related Quality-of-Life Score (DEQS) were 63.7. The fluorescein breakup time (FBUT) was 2.7 +/- 1.6 sec. Among fluorescein breakup patterns (FBUPs), dimple break, with the corresponding mechanism of decreased wettability was the most frequent, observed in 29 eyes (73%). The NEI score was 0.4 +/- 0.7 and the van Bijesterveld score was 0.6 +/- 0.8; the Schirmer 1 test value was 13.1 +/- 9.4 mm. Eighteen patients received BTX-A treatment, and significant improvement was found in severity of subjective symptoms both on VAS and DEQS as well as for FBUT. The main FBUPs changed from dimple break to random break. Conclusion Tear abnormalities seen in BEB correspond to short BUT-type dry eye (DE), subclassified into decreased wettability DE in view of FBUPs.