BACKGROUND Little is known about the ocular surface changes over the menstrual cycle in young women and the interactions with lifestyle factors. Therefore, the purpose of this study was to explore the associations between modifiable lifestyle factors and menstrual cycle phases on the ocular signs and symptoms of dry eye in young healthy women. METHODS This was a prospective 1-month observational study. Thirty young healthy women with regular, 24 to 32-day menstrual cycles were recruited. Participants attended three visits at day 7, 14, and 21 (± 1) of their menstrual cycle. At baseline, general health questionnaire was conducted. At each visit, symptomology was quantified using Ocular Surface Disease Index (OSDI) and overall ocular comfort (OOC, visual analogue scale). Ocular signs were assessed using Efron scales, tear break-up time (TBUT) and phenol red thread (PRT). Pearson's correlation was used to determine associations between variables at each visit. RESULTS A total of 26 participants (mean age = 22.3 ± 3.7 years) with an average menstrual cycle of 28.3 ± 1.3 days completed the 3 visits. The interaction between signs/symptoms and lifestyle factors changed over the cycle. At the follicular phase (day 7), lifestyle factors such diet and levels of stress were correlated with PRT and OSDI, (r = - 0.4, p = 0.022; r = 0.4, p = 0.045 respectively). At the ovulation phase (day 14), the general health score was correlated with OOC scores (r = 0.4, p = 0.047). At day 14, exercise frequency correlated with PRT (r = - 0.4, p = 0.028) and caffeine intake was positively correlate with both; TBUT (r = 0.5, p = 0.020) and PRT (r = 0.5, p = 0.014). At the luteal phase (day 21), we found no correlations between lifestyle factors and dry eye signs or symptoms. CONCLUSIONS The associations between lifestyle factors and objective and subjective ocular surface assessment appeared to be more pronounced during the ovulation phase of the menstrual cycle compared to the follicular and luteal phases. Misalignment of these factors with the ocular health during the luteal phase could be attributed to central sensitization and changes in levels of luteinising hormone. Natural hormonal changes during menstrual cycle should be considered for diagnosis and treatment of dry eye in young healthy women.

中文翻译：

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月经周期、生活方式因素和眼表临床评估之间的关联：一项前瞻性观察研究。


背景人们对年轻女性月经周期中眼表的变化以及与生活方式因素的相互作用知之甚少。因此，本研究的目的是探讨可改变的生活方式因素和月经周期阶段与年轻健康女性干眼症眼部体征和症状之间的关联。方法 这是一项为期 1 个月的前瞻性观察研究。招募了 30 名月经周期规律、24 至 32 天的年轻健康女性。参与者在月经周期的第 7 天、第 14 天和第 21 天 (± 1) 进行了 3 次访视。在基线时，进行了一般健康调查问卷。每次就诊时，使用眼表面疾病指数 (OSDI) 和整体眼部舒适度（OOC，视觉模拟量表）对症状进行量化。使用埃夫隆量表、泪膜破裂时间（TBUT）和酚红线（PRT）评估眼部体征。皮尔逊相关性用于确定每次访问时变量之间的关联。结果 共有 26 名平均月经周期为 28.3 ± 1.3 天的参与者（平均年龄 = 22.3 ± 3.7 岁）完成了 3 次就诊。体征/症状与生活方式因素之间的相互作用在整个周期中发生变化。在卵泡期（第 7 天），饮食和压力水平等生活方式因素与 PRT 和 OSDI 相关（分别为 r = - 0.4，p = 0.022；r = 0.4，p = 0.045）。在排卵期（第 14 天），一般健康评分与 OOC 评分相关（r = 0.4，p = 0.047）。第 14 天时，运动频率与 PRT 相关（r = - 0.4，p = 0.028），咖啡因摄入量与两者呈正相关； TBUT（r = 0.5，p = 0.020）和 PRT（r = 0.5，p = 0.014）。在黄体期（第 21 天），我们发现生活方式因素与干眼体征或症状之间没有相关性。 结论 与卵泡期和黄体期相比，生活方式因素与客观和主观眼表评估之间的关联在月经周期的排卵期似乎更为明显。这些因素在黄体期与眼部健康的不一致可能是由于中枢敏化和黄体生成激素水平的变化所致。对于年轻健康女性的干眼症的诊断和治疗应考虑月经周期期间的自然荷尔蒙变化。