Diquafosol for Soft Contact Lens Dryness: Clinical Evaluation and Tear Analysis
Diquafosol for Soft Contact Lens Dryness: Clinical Evaluation and Tear Analysis
复制标题
DOI：
10.1097/opx.0000000000000877
复制
发表时间：
2016-08-01
影响因子：
1.4
通讯作者：
Fukui, Masaki
中科院分区：
文献类型：
--
作者：
Shigeyasu, Chika;Yamada, Masakazu;Fukui, Masaki
目的。目的：评价3%地喹硫磷四钠溶液外用治疗软性隐形眼镜配戴者干涩的疗效。除了临床试验和主观症状外，我们还评估了作为膜相关粘蛋白标志物的小麦胚芽凝集素结合荧光素(F-WGA)的荧光强度和作为分泌性粘液标志物的泪液中唾液酸浓度。12例有干燥症状的SCL佩戴者用地喹磷醇治疗4周。临床检查包括泪膜破裂时间(BUT)、角膜和结膜荧光素染色评分以及Schirmer值。主观症状采用干眼相关生活质量评分(DEQS)评定。用5%F-WGA溶液滴眼后5分钟，用荧光分光光度法检测角膜中央的荧光强度。采集泪液进行高效液相分析，测定泪液中唾液酸、总蛋白、分泌型IgA、乳铁蛋白、Lipocalin-1和溶菌酶蛋白的浓度。治疗前后比较，BUT(p<；0.01)、角膜结膜染色评分(p<；0.05)、角膜染色评分(p<；0.05)、DEQS评分(p<；0.01)均有统计学意义的改善。F-WGA的荧光强度(p<；0.0001)在治疗后显著增加，而唾液酸和泪液蛋白浓度无明显变化。局部应用地喹磷溶液可改善膜相关粘蛋白的生物标记物、角膜和结膜的染色以及主观症状。
Purpose. To evaluate the efficacy of topical application of 3% diquafosol tetrasodium solution for the treatment of soft contact lens (SCL) wearers with dryness. In addition to clinical tests and subjective symptoms, we assessed the fluorescence intensity of wheat germ agglutinin conjugate of fluorescein (F-WGA) used as a marker of membrane-associated mucins and sialic acid concentration in tear fluids as a marker of secreted mucins.Methods. Twelve SCL wearers with dryness symptoms were treated with diquafosol for 4 weeks. Clinical tests included the tear film break-up time (BUT), corneal and conjunctival fluorescein staining scores, and Schirmer values. Subjective symptoms were evaluated by the Dry Eye-Related Quality-of-Life Score (DEQS). Fluorescence intensities in the central cornea were measured by fluorophotometry at 5 minutes after a 5% F-WGA solution was applied to the eye. The tears collected by the Schirmer test strips were analyzed by high-performance liquid chromatography (HPLC), and the concentrations of sialic acid; total protein; and the four major tear proteins secretory IgA, lactoferrin, lipocalin-1, and lysozyme proteins were measured.Results. Comparing the results before and after diquafosol treatment, BUT (p < 0.01), kerato-conjunctival staining score (p < 0.05), corneal staining score (p < 0.05), and DEQS score (p < 0.01) showed statistically significant improvements. The F-WGA fluorescence intensities (p < 0.0001) significantly increased after treatment, whereas the concentrations of sialic acid and tear proteins remained unchanged.Conclusions. Topical application of diquafosol solution to the SCL wearers with dryness improved biomarker of membrane-associated mucins, BUT, staining of cornea and conjunctiva, and subjective symptoms.