The Influence of Benign Essential Blepharospasm on Dry Eye Disease and Ocular Inflammation
The Influence of Benign Essential Blepharospasm on Dry Eye Disease and Ocular Inflammation
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良性原发性眼睑痉挛对干眼病和眼部炎症的影响
DOI：
10.1016/j.ajo.2013.11.014
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发表时间：
2014-03-01
影响因子：
4.2
通讯作者：
Li, Qian
中科院分区：
文献类型：
--
作者：
Lu, Rong;Huang, Ruisheng;Li, Qian
目的：通过分析伴有良性原发性眼睑痉挛的干眼病患者的临床特征、泪液细胞因子和治疗反应，研究眼睑痉挛对干眼病的影响。设计：前瞻性病例系列研究。方法：连续招募 40 名诊断为良性原发性眼睑痉挛（BEB）和干眼病（DED）的成年人。招募 40 名仅患有干眼病的受试者和 40 名健康成年人作为合格的对照。从所有参与者身上采集泪液样本进行细胞因子分析。良性原发性眼睑痉挛患者采用A型肉毒神经毒素治疗，主要观察指标如下：（1）眼表疾病指数（OSDI）问卷； (2)临床特征，包括泪膜破裂时间(BUT)、Schirmer I试验和荧光素染色； (3)结膜印迹细胞学检查； (4)多重细胞因子免疫珠试验。结果：DED+BEB患者的症状与DED对照和健康对照有显着差异。泪液细胞因子分析还显示，DED+BEB患者肿瘤坏死因子-a、白介素（IL）1(3、IL-6、IL-2、IL-17、血管内皮生长因子水平显着升高。治疗中，注射A型肉毒神经毒素可有效缓解所有DED+BEB患者的眼睑痉挛。而且，本组患者注射肉毒后OSDI显着下降。结论：BEB可能参与了DED+BEB患者炎症的进展，A型肉毒杆菌神经毒素注射可有效缓解DED+BEB患者的症状，改善眼表状况。
PURPOSE: To study the influence of blepharospasm on dry eye disease by analyzing the clinical features, tear cytokine, and treatment response of patients with dry eye disease accompanied by benign essential blepharospasm.DESIGN: Prospective case series study.METHODS: Forty adults with a diagnosis of benign essential blepharospasm (BEB) and dry eye disease (DED) were consecutively recruited. Forty subjects with dry eye disease only and 40 healthy adults were recruited as eligible controls. A tear specimen was collected from all participants for cytokine analysis. The patients with benign essential blepharospasm were treated with botulinum neurotoxin type A. The main outcome measures were the following: (1) Ocular Surface Disease Index (OSDI) questionnaire; (2) clinical features, including tear break-up time (BUT), Schirmer I test, and fluorescein staining; (3) conjunctival impression cytology; and (4) multiplex cytokine immunobead assay.RESULTS: The symptoms of DED + BEB patients were significantly different from those of DED controls and healthy controls. Cytokine analysis in tear fluid also showed that tumor necrosis factor-a, interleukin (IL)1(3, IL-6, IL-2, IL-17, and vascular endothelial growth factor levels were significantly increased in DED + BEB patients. In treatment, botulinum neurotoxin type A injection effectively relieved blepharospasm in all of the DED + BEB patients. Moreover, in this group of patients, OSDI decreased significantly after the botulinum neurotoxin type A injection, and BUT was increased as well.CONCLUSION: BEB may participate in the progress of inflammation in DED + BEB patients. Botulinum neurotoxin type A injections could effectively relieve the symptoms of DED + BEB patients and improve their ocular surface condition.