Purpose

To investigate whether standard clinical measures of tear film stability, meniscus height and symptomology reflect changes in evaporation rate induced by ocular surface provocations.

Methods

Forty participants (23.8 ± 4.5 years, 53 % female) with healthy to mild dry eyes underwent two tear film provocations in random sequence on separate occasions: playing a tablet computer high concentration game (http://slither.io/) for 30 min; and receiving treatment with humidity goggles for 10 min followed by liposomal spray application. Measures at baseline and 30 min later were: Symptom Assessment iN Dry Eye (SANDE) questionnaire, tear film lipid layer thickness (LLT), non-invasive tear film break-up time (NIBUT), tear meniscus height (TMH), dynamic tear film lipid layer pattern (DLP) and tear film evaporation (TFE).

Results

There were no differences in the baseline measurements before each provocation (p > 0.05). Dry eye symptoms significantly worsened with concentration task (p < 0.001) and improved with treatment (p < 0.001). DLP and LLT significantly increased with treatment (p < 0.05), but was unaffected with the concentration task (p > 0.05). NIBUT declined with the concentration task (p = 0.015), but was not enhanced with treatment (p = 0.142). TMH increased after treatment (p = 0.001) and decreased with the concentration task (p = 0.006). While evaporation decreased with the concentration task (p < 0.001), treatment had no effect (p = 0.333). LLT was associated with evaporation (p = 0.036) and additionally with symptom severity (p = 0.002) and tear volume (p = 0.017).

Conclusions

Sub-classifying dry eye based on an ‘evaporative’ component to inform treatment seems over-simplistic. However objective TMH, NIBUT and LLT seem to be the key clinical metrics that drive ocular comfort.

中文翻译：

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眼表刺激以研究干眼病的蒸发病理生理学。

目的

研究泪膜稳定性、半月板高度和症状的标准临床测量是否反映了眼表刺激引起的蒸发率变化。

方法

四十名参与者（23.8 ± 4.5 岁，53 % 女性）患有健康至轻度干眼症，在不同的场合以随机顺序接受两次泪膜刺激：玩平板电脑高浓度游戏 (http://slither.io/) 30 分钟; 并接受湿度护目镜处理 10 分钟，然后进行脂质体喷雾。基线和 30 分钟后的测量值是：干眼症状评估 (SANDE) 问卷、泪膜脂质层厚度 (LLT)、无创泪膜破裂时间 (NIBUT)、泪液半月板高度 (TMH)、动态泪液膜脂质层模式 (DLP) 和泪膜蒸发 (TFE)。

结果

每次激发前的基线测量值没有差异（p > 0.05）。干眼症状随着注意力任务显着恶化（p < 0.001），并随着治疗而改善（p < 0.001）。DLP 和 LLT 随治疗显着增加 (p < 0.05)，但不受注意力集中任务的影响 (p > 0.05)。NIBUT 随浓度任务而下降 (p = 0.015)，但未随治疗而增强 (p = 0.142)。治疗后 TMH 增加 (p = 0.001) 并随着注意力任务的增加而减少 (p = 0.006)。虽然蒸发随着浓缩任务而减少 (p < 0.001)，但处理没有影响 (p = 0.333)。LLT 与蒸发 (p = 0.036) 以及症状严重程度 (p = 0.002) 和泪液量 (p = 0.017) 相关。

结论

根据“蒸发”成分对干眼症进行子分类以告知治疗似乎过于简单化了。然而客观的 TMH、NIBUT 和 LLT 似乎是推动眼睛舒适度的关键临床指标。