Purpose: 

Lid wiper epitheliopathy (LWE) is an epitheliopathy of the marginal conjunctival portion of the eyelids that wipes the ocular surface during blinking. Although LWE is often observed in patients with dry eye, the factors determining LWE severity in dry eye remain unknown. Therefore, we investigated the relationship between LWE, tear abnormalities, and blinks in dry eye.

Methods: 

This study involved 76 eyes of 76 female patients with dry eye (mean age: 57.2 yrs). In all eyes, tear meniscus radius, spread grade (SG) of the tear film lipid layer (ie, SG 1–5, with 1 being the best), fluorescein breakup time (FBUT), fluorescein breakup pattern, corneal and bulbar conjunctival epithelial damage (CED: 15 points maximum; CjED: 6 points maximum, respectively), upper eyelid LWE grade (3 points maximum), and Schirmer 1 test were evaluated. Blink rate, palpebral aperture height, upper eyelid opening/closing-phase amplitude, upper eyelid opening/closing-phase duration, and upper eyelid opening/closing-phase maximum velocity were measured by the use of a custom-made high-speed blink analyzer. Finally, the factors that determine the LWE grade were investigated by multiple regression analysis, in which the parameters were chosen using the stepwise procedure.

Results: 

Significant correlations were found between LWE grade and tear meniscus radius, SG, FBUT, CED, CjED, and Schirmer 1 test (P < 0.002). LWE grade was found to be described as −0.001 + (0.283 × SG) − (0.253 × FBUT) + (0.003 × upper eyelid closing-phase maximum velocity) (R² = 0.57, P < 0.0001). The prevalence and grade of LWE were significantly higher in aqueous deficient dry eye.

Conclusions: 

Tear volume, tear film stability, and blink should be considered as factors for determining LWE severity.

中文翻译：

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确定干眼中眼睑上皮病变严重程度的临床因素

目的： 

眼睑擦拭器上皮病 (LWE) 是一种在眨眼时擦拭眼表的眼睑边缘结膜部分的上皮病。尽管在干眼症患者中经常观察到 LWE，但决定干眼症 LWE 严重程度的因素仍然未知。因此，我们调查了干眼症、泪液异常和眨眼之间的关系。

方法： 

这项研究涉及 76 名女性干眼症患者的 76 只眼睛（平均年龄：57.2 岁）。在所有眼睛中，泪液半月板半径、泪膜脂质层的扩散等级 (SG)（即 SG 1-5，其中 1 为最佳）、荧光素分解时间 (FBUT)、荧光素分解模式、角膜和球结膜上皮评估了损伤（CED：最高 15 分；CjED：最高 6 分）、上眼睑 LWE 等级（最高 3 分）和 Schirmer 1 测试。通过使用定制的高速眨眼测量眨眼率、睑裂高度、上眼睑开闭相幅度、上眼睑开闭相持续时间和上眼睑开闭相最大速度分析仪。最后，通过多元回归分析研究了决定LWE等级的因素，其中使用逐步程序选择参数。

结果： 

LWE 分级与泪液半月板半径、SG、FBUT、CED、CjED 和 Schirmer 1 检验之间存在显着相关性（P < 0.002）。LWE 等级被描述为 -0.001 + (0.283 × SG) - (0.253 × FBUT) + (0.003 × 上眼睑闭合相最大速度) (R ² = 0.57, P < 0.0001)。LWE的患病率和等级在缺水性干眼中显着升高。

结论： 

泪液量、泪膜稳定性和眨眼应被视为确定 LWE 严重程度的因素。