Abstract：
OBJECTIVE: To evaluate the prognostic ability of non-contact esthesiometry corneal and lid margin sensitivity measurements in detecting symptoms and signs of dry eye disease, as defined by the global consensus TFOS DEWS II criteria.
METHODS: A total of 87 community residents (58 females; mean ± SD age, 53 ± 16 years) were recruited in an investigator-masked, prospective, prognostic accuracy study. Dry eye symptomology, tear film parameters, and ocular surface characteristics were evaluated in a single clinical session, and non-contact esthesiometry corneal and lid margin sensitivity measurements performed by an independent masked assessor.
RESULTS: Overall, 49 (56%) participants fulfilled the TFOS DEWS II criteria for dry eye disease, while 57 (66%) exhibited clinical symptoms, and 67 (77%) had positive signs. The prognostic abilities of corneal and lid margin sensitivity measurements were significantly greater than chance for the detection dry eye signs (both p ≤ 0.03), but not for symptoms or overall disease diagnosis (all p > 0.10). The Youden-optimal prognostic cut-offs for corneal and lid margin sensitivity thresholds were both ≥0.8 mbar for the detection of clinical dry eye signs. Lid margin sensitivity demonstrated marginally higher predictive performance than corneal sensitivity (C-statistic, 0.688 versus 0.658), and was significantly correlated with tear film stability, corneal, conjunctival and lid wiper staining (all p < 0.05).
CONCLUSIONS: Corneal and lid margin sensitivity demonstrated moderate prognostic utility for detecting clinical dry eye signs. Future research is warranted to investigate the utility of incorporating non-contact esthesiometry in the workup for dry eye disease and neurotrophic keratopathy.
METHODS: A total of 87 community residents (58 females; mean ± SD age, 53 ± 16 years) were recruited in an investigator-masked, prospective, prognostic accuracy study. Dry eye symptomology, tear film parameters, and ocular surface characteristics were evaluated in a single clinical session, and non-contact esthesiometry corneal and lid margin sensitivity measurements performed by an independent masked assessor.
RESULTS: Overall, 49 (56%) participants fulfilled the TFOS DEWS II criteria for dry eye disease, while 57 (66%) exhibited clinical symptoms, and 67 (77%) had positive signs. The prognostic abilities of corneal and lid margin sensitivity measurements were significantly greater than chance for the detection dry eye signs (both p ≤ 0.03), but not for symptoms or overall disease diagnosis (all p > 0.10). The Youden-optimal prognostic cut-offs for corneal and lid margin sensitivity thresholds were both ≥0.8 mbar for the detection of clinical dry eye signs. Lid margin sensitivity demonstrated marginally higher predictive performance than corneal sensitivity (C-statistic, 0.688 versus 0.658), and was significantly correlated with tear film stability, corneal, conjunctival and lid wiper staining (all p < 0.05).
CONCLUSIONS: Corneal and lid margin sensitivity demonstrated moderate prognostic utility for detecting clinical dry eye signs. Future research is warranted to investigate the utility of incorporating non-contact esthesiometry in the workup for dry eye disease and neurotrophic keratopathy.
摘要：
目的：评估非接触美学角膜和眼睑边缘敏感性测量在检测干眼症症状和体征中的预后能力，根据全球共识TFOSDEWSII标准的定义。
方法：共有87名社区居民（58名女性；平均±SD年龄，53±16年））被招募为蒙面的调查员，prospective,预后准确性研究。干眼症状学,泪膜参数,和眼表特征在单个临床会话中进行评估，以及由独立的盲评估者进行的非接触美学角膜和眼睑边缘敏感度测量。
结果：总体而言，49名（56%）参与者符合TFOSDEWSII干眼症标准，57（66%）出现临床症状，67（77％）有积极的迹象。角膜和眼睑边缘敏感性测量的预后能力明显大于干眼症的检测机会（p≤0.03），但不适用于症状或整体疾病诊断（所有p>0.10）。用于检测临床干眼症征的角膜和眼睑边缘敏感性测量的Youden最佳预后截止值均≥0.8mbar。盖裕度敏感度显示出比(C统计量，0.688对0.658)，与泪膜稳定性显著相关，角膜,结膜和眼睑刮片染色（所有p<0.05）。
结论：角膜和眼睑边缘敏感性显示了检测临床干眼症的中等预后效用。有必要进行未来的研究，以研究在干眼病和神经营养性角膜病变的检查中纳入非接触式美学测量法的实用性。
方法：共有87名社区居民（58名女性；平均±SD年龄，53±16年））被招募为蒙面的调查员，prospective,预后准确性研究。干眼症状学,泪膜参数,和眼表特征在单个临床会话中进行评估，以及由独立的盲评估者进行的非接触美学角膜和眼睑边缘敏感度测量。
结果：总体而言，49名（56%）参与者符合TFOSDEWSII干眼症标准，57（66%）出现临床症状，67（77％）有积极的迹象。角膜和眼睑边缘敏感性测量的预后能力明显大于干眼症的检测机会（p≤0.03），但不适用于症状或整体疾病诊断（所有p>0.10）。用于检测临床干眼症征的角膜和眼睑边缘敏感性测量的Youden最佳预后截止值均≥0.8mbar。盖裕度敏感度显示出比(C统计量，0.688对0.658)，与泪膜稳定性显著相关，角膜,结膜和眼睑刮片染色（所有p<0.05）。
结论：角膜和眼睑边缘敏感性显示了检测临床干眼症的中等预后效用。有必要进行未来的研究，以研究在干眼病和神经营养性角膜病变的检查中纳入非接触式美学测量法的实用性。
