Relationships among Tear Film Stability, Osmolarity, and Dryness Symptoms.
Relationships among Tear Film Stability, Osmolarity, and Dryness Symptoms.
复制标题
DOI：
10.1097/opx.0000000000000649
复制
发表时间：
2015-09
期刊：
影响因子：
--
通讯作者：
Lin MC
中科院分区：
文献类型：
--
作者：
Yeh TN;Graham AD;Lin MC
在多变量分析中检查泪液渗透压、泪膜稳定性和干眼(DE)症状的几个指标之间的关系。对137名大学生(68名非隐形眼镜配戴者和69名软性CL配戴者)进行了横断面研究。无创性(NITBUT)和荧光素(FTBUT)测量泪液破裂时间(TBUT)。用渗透压计测量泪液渗透压。使用干眼流程图和几种不同的问卷来评估干眼症状。研究对象的年龄从18岁到67岁不等，平均28岁。受试者的平均渗透压(SD)为293mOsm/L，NITBUT为14.1(10.9)秒，FTBUT为14.8(12.6)秒。较短的NITBUT和FTBUT与女性(p=0.001和p=0.027)和亚裔(p=0.030和p=0.004)显著相关。泪液渗透压与FTBUT、NITBUT或DE症状之间没有明显的临床相关性。干眼图评分越高(即症状越差)，年龄越大(p<；0.001)，女性(p=0.014)，CL磨损(p<；0.001)，NITBUT(p<；0.001)和FTBUT(p=0.028)越短。临床诊断中重度DE的敏感性和特异性分别为：渗透压分别为0.67和0.46；NITBUT分别为0.72和0.52；FTBUT分别为0.68和0.57。在一组无症状、轻度和中度DE患者中，泪液渗透压升高与报告的症状严重程度和频率没有显著相关性。泪液渗透压、NITBUT和FTBUT在诊断中重度DE时显示出类似的敏感性和特异性。
To examine the relationships among tear osmolarity, tear film stability, and several measures of dry eye (DE) symptoms in a multivariable analysis. A cross-sectional study was conducted with 137 subjects (68 non–contact lens [CL] wearers and 69 soft CL wearers) recruited from a university campus. Tear breakup time (TBUT) was measured noninvasively (NITBUT) and with fluorescein (FTBUT). Tear osmolarity was measured by an osmometer. Dry eye symptoms were assessed using the Dry Eye Flow Chart and several different questionnaires. Subjects ranged in age from 18 to 67 years, with a mean of 28 years. Subjects had a mean (SD) osmolarity of 293 (10) mOsm/L, NITBUT of 14.1 (10.9) seconds, and FTBUT of 14.8 (12.6) seconds. Shorter NITBUT and FTBUT were significantly associated with female sex (p = 0.001 and p = 0.027, respectively) and Asian ethnicity (p = 0.030 and p = 0.004, respectively). There were no clinically significant relationships between tear osmolarity and FTBUT, NITBUT, or DE symptoms. Higher Dry Eye Flow Chart score (i.e., worse symptoms) was associated with older age (p < 0.001), female sex (p = 0.014), CL wear (p < 0.001), shorter NITBUT (p < 0.001), and shorter FTBUT (p = 0.028). The sensitivities and specificities for using clinical measurements to diagnose moderate to severe DE were as follows: osmolarity, 0.67 and 0.46, respectively; NITBUT, 0.72 and 0.52, respectively; and FTBUT, 0.68 and 0.57, respectively. In a population of asymptomatic, mild and moderate DE patients, increased tear osmolarity was not significantly associated with reported symptom severity and frequency. Tear osmolarity, NITBUT, and FTBUT exhibited similar sensitivities and specificities when used to diagnose moderate to severe DE.