The relation between tear film tests in patients with dry eye disease

PURPOSE: The purpose of this report was to investigate the relation between dry eye diagnostic tests. METHODS: Dry eye patients were enrolled to complete a clinical examination, including the following dry eye tests: a meibomian gland evaluation, tear meniscus height, fluorescein tear breakup time, fluorescein staining of the cornea, the Schirmer 1 test, the phenol red thread test, and rose bengal staining of the conjunctiva. Statistical analyses, including correlation coefficients, the Wilcoxon sign rank test, chi-square test, and logistic regression were used to address the relation between these clinical tests of dry eye. RESULTS: There was a strong relation between the Schirmer test and fluorescein staining in all four statistical analyses. Similarly, there was also a strong relation between the phenol red thread test and both fluorescein and rose bengal staining. Finally, the results of the Schirmer test were associated with the tear breakup time test in three of four analyses. CONCLUSIONS: The results indicate that tests of aqueous deficiency (volume or production) are associated with ocular surface desiccation. This important relation should be recognized when choosing dry eye tests as outcomes in clinical trials and epidemiological studies.     

The relationship between habitual patient-reported symptoms and clinical signs among patients with dry eye of varying severity

PURPOSE: To investigate symptom profiles and clinical signs in subjects with dry eye and normal subjects in a cross-sectional multicenter study. METHODS: Subjects aged 35 to 65 were recruited according to dry eye diagnostic codes and telephone interview and completed the Dry Eye Questionnaire 2001, among others, and underwent dry eye clinical tests. RESULTS: Subjects (122) included 28 control subjects (C), 73 with non-Sj?gren's keratoconjunctivitis sicca (non-SS KCS) and 21 with Sj?gren's syndrome (SS). Subjects with SS or non-SS KCS reported discomfort and dryness most frequently and that many symptoms worsened over the day and were quite bothersome. Groups were significantly different in corneal fluorescein staining, conjunctival lissamine green staining, Schirmer 1 tear test, and tear break-up time (TBUT; chi2 and Kruskal-Wallis, P<0.0001). Statistically significant, but moderate, correlations were found between the frequency and evening intensity of dryness and discomfort and TBUT, Schirmer's tear test, overall corneal fluorescein staining, and temporal lissamine green conjunctival staining (Spearman r=0.31-0.45, P<0.01). Symptoms were moderately to highly correlated with the clinician's global grading of severity and highly correlated to patient's self-assessment of severity (r=0.46-0.86, P<0.0001), whereas signs showed lower correlations (r=0.22-0.46, P<0.0001). CONCLUSIONS: Subjects with SS or non-SS KCS reported frequent and intense ocular surface symptoms in the evening, some of which correlated moderately with clinical test results. The global clinician grade of dry eye correlated more highly with patient symptoms than did clinical signs, suggesting that patient symptoms influence dry eye diagnosis and grading of dry eye more than clinical test results.     

非加热型湿房镜治疗干眼的临床疗效

目的评价湿房镜治疗干眼的临床疗效。方法自身对照临床研究。连续收集2012年11月至2013年6月期间在门诊就诊的轻中度干眼患者56例（56眼）,填写干眼症状问卷、眼表疾病指数量表（OSDI）问卷,并进行眨眼频次、结膜充血程度、角膜荧光染色及泪液分泌试验（SIT）和泪膜破裂时间（BUT）测定。予配戴湿房镜1周后再次检查,内容同上。采用自身对照的配对t检验或秩和检验对治疗前后的数据进行统计学分析,并用秩和相关检验方法分析眼表保护指数（OPI）与角膜荧光染色的相关性。结果56例干眼患者配戴湿房镜1周后,干眼症状明显改善,其中干眼问卷评分（Z=-5.084,P＜0.01）及OSDI问卷评分（Z=-5.149,P＜0.01）较治疗前改善,差异有统计学意义;眨眼频次减少（t=6.430,P<0.01）;睑结膜充血（Z=-4.185,P＜0.01）、球结膜充血（Z=-2.598,P＜0.01）、角膜荧光染色（Z=-5.001,P＜0.01）及体征总分（Z=-5.288,P＜0.01）等临床体征评分明显降低,差异均有统计学意义;BUT明显增加（t=7.416,P<0.01）,OPI明显增加（Z=-5.622,P＜0.01）,差异具统计学意义。OPI指数与角膜荧光染色评分呈负相关（r=-0.445,P＜0.01）。结论湿房镜可有效缓解轻中度干眼患者主观症状,稳定泪膜,减轻临床体征,是干眼的有效治疗手段之一。     

Keratoconjunctivitis sicca in juvenile rheumatoid arthritis

PURPOSE: To compare the symptoms, signs, and results of objective tests for keratoconjunctivitis sicca (KCS) in patients with juvenile rheumatoid arthritis (JRA) and controls. METHODS: Sixty-four patients with JRA and 64 age- and sex-matched controls were compared in terms of symptoms, signs, and results of objective tests for KCS. Relation between tear film breakup time (TBUT), Schirmer test results, and JRA-related variables such as age of onset, duration, and type of JRA; presence of antinuclear antibodies (ANAs); and history of uveitis were evaluated. Analysis of variance, multivariate regression analysis, Kruskall-Wallis, Student t tests, and chi tests were used for statistical analysis. RESULTS: Twelve and a half percent of patients with JRA complained of dry eye symptoms compared with 1.5% of the controls (P = 0.031). Dry eye signs were detected in 10.9% of patients with JRA compared with 1.5% of controls (P = 0.038). TBUT and Schirmer test results were lower in the JRA group than in controls (P = 0.032 and P = 0.029, respectively). Seven patients (10.9%) had definite and 1 (1.5%) had probable diagnosis of KCS in the JRA group compared with no children in the control group (P = 0.034). Within the JRA group, Schirmer test and TBUT results were significantly lower in male patients and ones with longer duration of disease. CONCLUSIONS: The prevalence of symptoms, signs, and definite diagnosis of KCS is higher and basal tear secretion and tear film stability are lower in children with JRA than in controls. Among children with JRA, male sex and longer duration of disease are independent risk factors for having decreased basal tear secretion and tear film stability.     

中西医结合治疗肝肾阴虚型干眼症的疗效观察

目的:通过对肝肾阴虚型干眼症患者采用“复明片”加减联合睑板腺疏通法临床治疗的疗效观察,说明中西医结合治疗肝肾阴虚型干眼症可以收到良好的效果。方法:对符合干眼症诊断标准的400例患者的性别、年龄、症状、临床表现进行详细记录并进行严格的中医辨证分型,并对辩证为“肝肾阴虚”型的干眼症患者90例随机分三组治疗:A组30例给予“复明片”加减联合睑板腺疏通法加人工泪液治疗;B组30例给予睑板腺疏通法加人工泪液治疗;C组30例给人工泪液治疗。三组患者的自觉症状、泪液分泌试验（SchirmerⅠtest,SⅠt）、泪膜破裂时间（tear break-up time,BUT）、角膜荧光素染色(fluorescein staining,FL)和角膜地形图的角膜表面规则指数（surface regularity index,SRI）和角膜表面不规则指数（surface asymmetry index,SAI）结果作为观察指标,对观察数据进行统计分析,每组治疗前后行配对资料的秩和检验;对三组的疗效行多个样本间两两比较的秩和检验。结果:A组观察指标改善情况及疗效明显优于B,C两组;B组的又优于C组;三组的有效率分别是90.0%,73.3%和53.3%;结论:对肝肾阴虚型干眼症,采用“复明片”加减联合睑板腺管疏通术和人工泪液的治疗方法可以取得良好的治疗效果。睑板腺功能障碍（MGD）直接相关或合并MGD是干眼症的病因之一;同时角膜地形图可以协助诊断和评价干眼症的严重程度和治疗效果。      

Diagnosis of dry eye

Dry eve disease is characterized by symptoms, ocular surface damage, reduced tear film stability, and tear hyperosmolarity. There are also inflammatory components. These features can be identified by various kinds of diagnostic tests (symptom questionnaires, ocular surface staining, tear break-up time, and osmometry), although there may not be a direct correlation between the number or severity of symptoms and the degree of ocular surface damage or tear deficiency. Once the diagnosis of dry eye disease has been established, further tests can be used to classify the condition into tear-deficient or evaporative dry eve. The two forms of dry eye are not mutually exclusive and often co-exist. The optimal diagnosis of dry eye disease, therefore, depends on the results of several tests, and this article suggests an appropriate order for performing these tests at a single clinic visit.     

Correlations Among Symptoms, Signs, and Clinical Tests in Evaporative-Type Dry Eye Disease Caused by Meibomian Gland Dysfunction (MGD)

Purpose: To evaluate changes in symptoms, objective tests, and signs after medical treatment of subjects with evaporative-type dry eye disease (EDE) caused by Meibomian gland dysfunction (MGD), and to analyze correlations among symptoms, signs and test results in the worse eyes (W-eyes) of the subjects. Methods: Prospective clinical study of 21 symptomatic subjects with EDE caused by MGD. Subjects who were diagnosed with EDE in a first visit were treated for 6 weeks and re-evaluated in a second visit. The differences between initial and second visits were evaluated. Correlations among clinical symptoms, signs, and test results were performed using the data of the W-eyes. Variables evaluated included: dry eye symptoms, best corrected visual acuity (BCVA), contrast sensitivity, conjunctival hyperemia, phenol red thread test, tear break-up time (TBUT), tear meniscus height (TMH), corneal fluorescein and conjunctival rose Bengal staining, tear lysozyme concentration, Schirmer test, and lid margin assessment. Results: All items evaluated improved after treatment, but only conjunctival hyperemia and TMH improved significantly. TBUT and lid margin changes improved, but still remained abnormal. There were significant correlations among symptoms questionnaires and some clinical tests (TBUT, conjunctival hyperemia, TMH, and conjunctival rose Bengal staining). Conclusion: Despite the instability of the tear film and lid margin alterations that continued after treatment, subjects with MGD improved symptomatically. The low degree of correlations among W-eye signs, symptoms, and tests reflects the independency of symptoms and signs in this complex pathology.     

干眼症症状与体征的相关性研究

目的分析干眼症患者的主观症状与客观检查的相关性。方法选取2007年12月—2008年8月就诊于天津医科大学眼科中心门诊的干眼症患者126例252眼,检查前均取得患者书面同意。通过检查视力、泪膜干涉仪检查、泪液分泌试验（STⅠ）、干眼症问卷调查,并在15min后用裂隙灯检查眼前节,进行泪膜破裂时间（BUT）及荧光素（FL）染色检查。采用Spearman秩相关研究分析干眼症症状与体征间的关系。结果干眼症患者最常见的症状是视疲劳（85.7%）、干涩（75.4%）、视力波动（73.8%）、眼痒（65.9%）以及异物感（66.7%）。干眼症患者分泌物增多与STⅠ呈正相关（r=0.208,P=0.020）,流泪症状与STⅠ结果呈正相关（r=0.311,P=0.000）,眼痛与BUT呈负相关（r=-0.197,P=0.027）,眼红与FL染色呈正相关（r=0.227,P=0.011）,异物感与FL染色呈正相关（r=0.251,P=0.005）。其余干眼症症状与ST、BUT、FL染色无明显相关性（P〉0.05）,所有干眼症症状均与泪膜干涉图像分级无明显相关（P〉0.05）。结论干眼症患者症状复杂,干眼症症状与体征的相关性较差。     

Alterations in expression of mucin, tenascin-c and syndecan-1 in the conjunctiva following retinal surgery and plaque radiotherapy

PURPOSE: Disturbances of the ocular tear film layer and dry eye symptoms are common complications following retinal surgery and ocular tumour therapy. Examined were the histopathological changes of the conjunctiva following posterior segment surgery and plaque radiotherapy. METHODS: Biopsy specimens of the superior bulbar conjunctiva were obtained during cataract surgery between 2 weeks and 7 years following vitrectomy (n=92) or plaque radiotherapy for uveal melanoma (n=20) and from control subjects without previous ocular surgery (n=29). These were examined using conventional histology (HE, PAS, Van Gieson) and immunochemistry [APAAP, using antibodies directed against MUC1, MUC5AC, syndecan-1 and tenascin-C (TN-C)]. The histopathological changes were graded and statistical analysis was performed using Wilcoxon and Kruskal-Wallis rank sum tests. RESULTS: Conjunctival specimens of patients following vitrectomy or plaque radiotherapy for uveal melanoma demonstrated increased epithelial stratification, a significant decrease in the number of PAS- and MUC5AC-positive goblet cells, and distributional changes in expression of MUC1, syndecan- and TN-C within conjunctival epithelium or stroma. These alterations - in particular the goblet cell reduction and stromal fibrosis - were most prominent in those patients who had undergone radiotherapy. CONCLUSIONS: Posterior segment surgery can lead to morphological alterations of the conjunctiva and distributional changes in ocular mucins, which may cause dry eye symptoms.     

Comparison of tear function tests and impression cytology with the ocular findings in acne rosacea

PURPOSE: The aim of this study was to determine the correlation between tear function tests and impression cytology results and the clinical findings in ocular rosacea. METHODS: Patients with a histopathologic and clinical diagnosis of acne rosacea were studied. Ocular examination consisted of best-corrected visual acuity measurement, slitlamp examination, tear break-up time (BUT), basal Schirmer test, and rose Bengal staining. Impression cytology was done two days later. Ocular findings and symptoms were checked and scored. Age-matched controls were assessed using the same parameters. RESULTS: The most frequent symptoms were itching (80%), redness (68%), burning (64%), and photophobia (60%). The most frequent clinical findings were meibomitis (92%), telangiectasis (88%), blepharitis (84%), superficial punctate keratopathy (72%), and hyperemia (60%). Mean tear BUT was 9.6+/-3.1 (SD) seconds (range 5-17 seconds). Mean Schirmer test measured 11.4+/-1.6 mm (SD) (range 8-15 mm). Mean rose Bengal staining scored 1.8+/-0.1. Mean tear BUT, Schirmer test and rose Bengal staining scores were lower in the rosacea group than the control group (p<0.003, p=0.04, p< or =0.038, respectively). Staining was pathologic in 18 patients (36%) and the highest staining score was 4. No significant difference was found between the stages of the nasal and temporal conjunctival impression cytologies in each eye, and there was no relationship between impression cytology stages and rose Bengal scores (p>0.05). A significant relation was observed between the stages of impression cytology and the severity of meibomitis (Fisher's test, chi2=9.625, p=0.001). The Schirmer test gave lower results in patients with severe blepharitis (Mann-Whitney U Test, U=180.5, p=0.034). CONCLUSIONS: Early diagnosis prevents serious ocular complications and chronic dry eye in rosacea. We suggest that in addition to tear function tests, rose Bengal staining and impression cytology can be successfully used in the early diagnosis of dry eye and in monitoring medical treatment in ocular rosacea. Meibomian glands play an important role in the pathogenesis of the ocular disease.     

眼针疗法治疗“气阴两虚型”干眼的临床研究

目的：观察眼针疗法治疗“气阴两虚型”干眼的临床疗效及其作用机制。方法：前瞻性随机对照研 究。收集2021年1—4月于辽宁中医药大学附属第二医院确诊为“气阴两虚型”干眼患者74例,通 过随机数字表法将74例患者分为眼针疗法组和常规针法组,各37例。常规针法组给予常规针刺治 疗,主穴为攒竹、四白、阳白、丝竹空、太阳;配穴为太溪、合谷、足三里、三阴交。眼针疗法组予 以眼针治疗,取肝区、肺区、脾区、肾区四穴治疗。疗程均为14 d。记录2组治疗前后眼表疾病指 数（OSDI）评分;检测无表麻泪液分泌试验（SⅠT）和角膜荧光素染色（CFS）;使用K5M眼表分析仪 采集首次泪膜破裂时间（NIBUTf）和平均泪膜破裂时间（NIBUTav）。数据采用t检验、Wilcoxon秩和 检验、χ2 检验进行统计分析。结果：常规针法组与眼针疗法组的OSDI评分、SⅠT、CFS、NIBUTf、 NIBUTav在组内治疗前后比较,差异均有统计学意义（均P<0.05）。治疗后2组患者的OSDI评分、 SⅠT、NIBUTf、NIBUTav比较,差异均有统计学意义（均P<0.05）;治疗后组间CFS比较差异无统计 学意义。结论：常规针法与眼针疗法均能有效治疗“气阴两虚型”干眼,眼针疗法在改善干眼的眼 表症状、泪液分泌及泪膜破裂时间方面优于常规针法治疗,其优效性和依从性更高。     

Dry eye syndrome in diabetic children

PURPOSE: To compare the symptoms, signs, and results of objective tests for dry eye syndrome (DES) in type 1 diabetes mellitus (T1DM) patients and controls. METHODS: A total of 104 children with T1DM and 104 age- and sex-matched controls were compared in terms of the symptoms, signs, and results of objective tests for DES. Duration of T1DM, presence of diabetic retinopathy, mean hemoglobin A1c level, pubertal status, and a history of accompanying autoimmune disease were noted in T1DM group. Analysis of variance, multivariate regression analysis, Student t, Mann-Whitney U, and chi-square tests were used for statistical analysis. RESULTS: A total of 15.4% of diabetic children complained of dry eye symptoms, versus 1.9% of the controls (p=0.029). Dry eye signs were detected in 7.7% of diabetic children, versus 0.96% of controls (p=0.034). Tear break-up time (TBUT) and Schirmer test results were significantly lower in T1DM group than controls (p=0.018, p=0.024, respectively). A total of 7.7% of diabetic children had definite and 0.96% had probable diagnosis of DES, versus none of the controls (p=0.03). TBUT and Schirmer test results were significantly lower in patients with more than 10 years duration of T1DM (p<0.001 for both). CONCLUSIONS: The prevalence of symptoms, signs, and definite diagnosis of DES are higher and basal tear secretion and tear film stability are lower in diabetic children than controls. Duration of T1DM is the only disease-related variable which is associated with basal tear secretion and tear film stability.     

The repeatability of clinical measurements of dry eye

PURPOSE: The repeatability of individual dry eye diagnostic tests has been reported in the literature on normal samples of patients and to a lesser degree in dry eye patients. In this study, the repeatability of a battery of clinical diagnostic tests for dry eye was assessed on mild to moderate dry eye patients. METHODS: A dry eye examination was performed on 75 patients on two occasions by a single examiner. The battery of dry eye tests included symptom assessment, contact lens and medical history, slit-lamp biomicroscopic evaluation of the eyelids, evaluation of Meibomian glands, assessment of tear film quality, tear meniscus height, assessment of blink quality, fluorescein tear breakup time (TBUT), fluorescein and rose bengal staining of the cornea and conjunctiva, phenol red thread test, and Schirmer test. RESULTS: The repeatability of subjective report of dryness (kappaW = 0.62) and grittiness (kappaW = 0.73) was moderate to high. In contrast, the repeatability of Meibomian gland disease classification (kappaW = 0.20), presence or absence of inferior corneal fluorescein staining (kappa = 0.25), and inferior conjunctival rose bengal staining (kappa = 0.21) was poor. When a summed staining score of corneal and conjunctival regions was evaluated, weighted kappa reliability was fair. The repeatability of tear breakup time was substantial [95% limits of agreement -5.71 to 5.83 seconds; intraclass coefficient coefficient (ICC) 0.65], and improved when the two timed readings were averaged. Repeatability of the Schirmer test is more variable as wetting scores increase. When the average Schirmer scores 相似文献   

主诉为干眼症状的围绝经期妇女临床资料分析

目的 探讨围绝经期妇女的干眼症状与干眼病诊断的相关性. 方法分析56例具有干眼症状的围绝经期妇女眼部检查的临床资料,观察主诉为干眼症状患者的干眼病确诊率及其关系.结果 56例以干眼症状为主要表现的围绝经期妇女,确诊水液缺乏型干眼17例(30.4%),蒸发过强型干眼12例(21.4%),混合型干眼8例(14.3%);不能诊断干眼病的19例(33.9%),最终诊断为围绝经期综合征. 结论围绝经期妇女干眼病确诊率较高(66.1%),但部分干眼症状可以只是围绝经期综合征的精神神经症状的一种表现,临床诊断干眼应慎重.     

针灸联合人工泪液治疗干眼症的疗效观察

目的观察针灸结合人工泪液治疗干眼症的临床疗效。方法回顾性分析我院2009年4月至12月门诊患者中诊断为干眼症的92例患者资料。其中54例采用单纯人工泪液治疗,38例使用针灸结合人工泪液治疗。治疗后21d及停止治疗后21d复查。采用SAS6.12软件对双眼的Schirmer I试验结果(SIt)及泪膜破裂时间(BUT)进行方差分析;对双眼FL染色评分进行秩和检验;对患者自觉疗效评价结果进行χ2检验。结果单纯人工泪液组有38例(70.37%)自觉症状好转,针灸结合人工泪液组有29例(76.32%)自觉症状好转,两组差异无统计学意义(P>0.05)。治疗后21d两组SIt、BUT均延长,FL染色评分下降,两组之间差异无统计学意义(均为P>0.05)。停止治疗21d后针灸结合人工泪液组SIt、BUT检测结果[分别为(3.51±2.05)mm和(2.88±1.23)s]优于单纯人工泪液组[分别为(2.87±2.30)mm和(2.39±1.05)s],差异均有统计学意义(均为P<0.05)。结论针灸结合人工泪液治疗干眼症的持续效应优于单纯人工泪液治疗。     

中老年患者干眼症临床分析

目的探讨中老年患者干眼症的临床特点及诊治要点。方法通过问卷调查、泪膜破裂时间（BUT）、SchirmerⅠ试验、角膜荧光素染色以及DR-1泪膜干涉成像仪的检查，分析了60例（97只眼）中老年干眼症患者的临床资料。结果干眼症患者主要的眼部不适症状依次为眼疲劳（50．49％）、眼红（49．48％）、异物感（47．42％）、干涩感（39．18％）、分泌物（38．14％）、痒（29．90％）、水分过多感（21．65％）、烧灼感（9．28％）。SchirmerⅠ试验结果为（11．10±3．14）mm，BUT试验结果为（3．12±1．05）s，角膜荧光素染色评分结果为1．26±0．37。干眼仪的敏感度为63．75％，特异度为49．84％。泪液蒸发过强型、泪液分泌减少合并泪液蒸发过强型、单纯泪液分泌减少型所占比例依次为63．92％、30．93％、5．15％。60例患者中曾经误诊为其他眼病者43例（71．7％）。结论眼科医生应掌握中老年患者干眼症的临床特点，重视症状、病史的询问以及传统的三项检查（Schii-merⅠ试验、BUT试验、角膜荧光素染色），避免误诊误治。     

Association between the levels of prostaglandin E2 in tears and severity of dry eye

AIM: To investigate the relationship between the levels of prostaglandin E2 (PGE2) in tears and dry eye disease severity based on both clinical symptoms and signs. METHODS: Tear samples were collected from 36 non-Sjögren syndrome dry eye patients (10 males and 26 females, mean age 50.11±11.17y). All participants completed the Ocular Surface Disease Index (OSDI) questionnaire and underwent a detailed ophthalmic examination including, tear film breakup time (TBUT), ocular surface fluorescein staining, Schirmer I test, and meibomian gland assessment. The level of PGE2 in tears was measured using enzyme-linked immunosorbent assay (ELISA). The independent associations between tear PGE2 levels and other variables including demographics, OSDI scores, TBUT, Schirmer scores, ocular surface staining scores, and stage of meibomian gland dysfunction (MGD) were evaluated using linear regression analysis. RESULTS: The mean PGE2 level in tears of dry eye patients was 537.85±234.02 pg/mL. The tear PGE2 levels significantly positively correlated with OSDI scores (R=0.608, P<0.001), however, they did not significantly associate with TBUT (R=0.153, P=0.373), Schirmer scores (R=-0.098, P=0.570), ocular surface staining scores (R=0.282, P=0.095), and stage of MGD (R=-0.107, P=0.535). Male sex was significantly negatively correlated with tear PGE2 levels. CONCLUSION: The levels of PGE2 in tears are positively correlated with dry eye symptoms. However, no significant association was found between tear PGE2 levels and the results of other common dry eye diagnostic tests.     

干眼症误诊临床分析

目的：分析干眼症的误诊原因,探讨防止误诊的措施。方法：对178例干眼症误诊进行回顾性临床分析,以干眼症的三项检查结果（泪液分泌试验、泪膜破裂时间、角膜荧光素染色）为诊断标准。结果：误诊疾病包括流行性角结膜炎、病毒性角膜炎、点状角膜炎、慢性结膜炎;误诊时间1个月－3年8个月;误诊原因为忽视干眼症的临床特点和对其病情缺乏全面系统分析。结论：症状是干眼症诊断的重要依据,结合传统的干眼症诊断试验检查可减少其误诊的发生。     

干眼症检查的进展

干眼症是导致眼部不适,甚至引起视力障碍的常见病,其病因及病理生理十分复杂。在干眼症的诊断中,传统的泪液分泌试验、泪膜破裂时间、眼表面荧光素染色、虎红染色等检查均存在其不足。近年来干眼症的检查手段得到很大发展,检查方法达数十种之多,不仅提高了此病诊断的准确性,而且可进行病因诊断和病情严重程度的分析。复习了近年来关于传统的和新发展的干眼症检查方面的文献,对各检查方法的原理,优缺点及适应证进行综述。     

Relationship of impression cytology and tear ferning to reports of dry eye.

PURPOSE: This study investigated whether there is a significant correlation between mild-to-moderate patient reports of dry eye and results on the tear ferning and impression cytology tests. METHODS: One hundred and four subjects were surveyed for presence or absence of dry eye symptoms. Membrane impression cytology and tear ferning were performed on each subject. Impression cytology specimens were evaluated for the presence of goblet cells, presence of epithelial cell sheets, and epithelial cell morphology. Tear specimens were evaluated for quality of ferning. RESULTS: A significant correlation was found between subjective dry eye symptoms and impression cytology results (cc = 0.28, p = 0.003). However, there was no statistically significant correlation between dry eye symptoms and tear fern results (cc = 0.072, p = 0.458). CONCLUSIONS: Impression cytology appeared to be a better predictor of mild-to-moderate dry eye symptoms than tear ferning.