Abstract：
OBJECTIVE: Exploring the prevalence of dry eye (DE) and the changes of tear film stability in patients with primary acquired obstruction of the nasolacrimal duct (PANDO).
METHODS: In this cross-sectional, observational study, 370 eyes in 223 patients with PANDO were assessed. The ocular surface disease index (OSDI) was used to evaluate ocular surface symptoms, and the Keratograph 5M non-invasive ocular surface analyser was used to assess ocular surface parameters. According to the TFOS DEWS II criteria, patients with OSDI ≥ 13 and NIKBUT < 10 s were diagnosed with DE.
RESULTS: Of the 223 PANDO patients, 65 (29.1%) met the diagnostic criteria for DE. Compared with patients without DE, PANDO patients with DE were significantly older (p < 0.001), had a longer duration of epiphora (p = 0.023), and more likely to have a positive regurgitation on pressure over the lacrimal sac (ROPLAS) sign (p = 0.003). Multifactorial analysis showed that older age, positive ROPLAS and hypertension were significant independent predictors of DE (p < 0.05). Among the 147 unilateral PANDO patients without DE, the TMH, NIKBUT-first, NIKBUT-average and bulbar erythema scores were significantly higher in the PANDO sides.
CONCLUSIONS: This study illustrated the prevalence of DE in PANDO patients was 29.1% and DE is more likely to occur in those who are older, have hypertension and are positive for ROPLAS. In addition, in patients with unilateral nasolacrimal duct obstruction, a decrease in tear film stability was observed in the healthy eye.
METHODS: In this cross-sectional, observational study, 370 eyes in 223 patients with PANDO were assessed. The ocular surface disease index (OSDI) was used to evaluate ocular surface symptoms, and the Keratograph 5M non-invasive ocular surface analyser was used to assess ocular surface parameters. According to the TFOS DEWS II criteria, patients with OSDI ≥ 13 and NIKBUT < 10 s were diagnosed with DE.
RESULTS: Of the 223 PANDO patients, 65 (29.1%) met the diagnostic criteria for DE. Compared with patients without DE, PANDO patients with DE were significantly older (p < 0.001), had a longer duration of epiphora (p = 0.023), and more likely to have a positive regurgitation on pressure over the lacrimal sac (ROPLAS) sign (p = 0.003). Multifactorial analysis showed that older age, positive ROPLAS and hypertension were significant independent predictors of DE (p < 0.05). Among the 147 unilateral PANDO patients without DE, the TMH, NIKBUT-first, NIKBUT-average and bulbar erythema scores were significantly higher in the PANDO sides.
CONCLUSIONS: This study illustrated the prevalence of DE in PANDO patients was 29.1% and DE is more likely to occur in those who are older, have hypertension and are positive for ROPLAS. In addition, in patients with unilateral nasolacrimal duct obstruction, a decrease in tear film stability was observed in the healthy eye.
摘要：
目的：探讨原发性获得性鼻泪管阻塞（PANDO）患者干眼（DE）的患病率和泪膜稳定性的变化。
方法：在此横截面中，观察性研究，对223例PANDO患者的370只眼进行了评估。眼表疾病指数（OSDI）用于评估眼表症状，并使用角膜摄影5M无创眼表分析仪评估眼表参数。根据TFOSDEWSII标准，OSDI≥13且NIKBUT<10s的患者被诊断为DE。
结果：在223名PANDO患者中，65（29.1%）符合DE的诊断标准。与没有DE的患者相比，患有DE的PANDO患者明显年龄较大（p<0.001），有一个较长的持续时间的溢泪（p=0.023），并且更可能对泪囊压力（ROPLAS）信号（p=0.003）有正反流。多因素分析表明，年龄较大，ROPLAS阳性和高血压是DE的显著独立预测因子(p<0.05)。在147例无DE的单侧PANDO患者中，TMH,NIKBUT-First,PANDO两侧的NIKBUT平均和球红斑评分明显较高。
结论：这项研究表明，在PANDO患者中，DE的患病率为29.1％，并且在年龄较大的患者中更容易发生，有高血压，ROPLAS阳性。此外,单侧鼻泪管阻塞的患者，在健康眼睛中观察到泪膜稳定性降低。
方法：在此横截面中，观察性研究，对223例PANDO患者的370只眼进行了评估。眼表疾病指数（OSDI）用于评估眼表症状，并使用角膜摄影5M无创眼表分析仪评估眼表参数。根据TFOSDEWSII标准，OSDI≥13且NIKBUT<10s的患者被诊断为DE。
结果：在223名PANDO患者中，65（29.1%）符合DE的诊断标准。与没有DE的患者相比，患有DE的PANDO患者明显年龄较大（p<0.001），有一个较长的持续时间的溢泪（p=0.023），并且更可能对泪囊压力（ROPLAS）信号（p=0.003）有正反流。多因素分析表明，年龄较大，ROPLAS阳性和高血压是DE的显著独立预测因子(p<0.05)。在147例无DE的单侧PANDO患者中，TMH,NIKBUT-First,PANDO两侧的NIKBUT平均和球红斑评分明显较高。
结论：这项研究表明，在PANDO患者中，DE的患病率为29.1％，并且在年龄较大的患者中更容易发生，有高血压，ROPLAS阳性。此外,单侧鼻泪管阻塞的患者，在健康眼睛中观察到泪膜稳定性降低。
