Kuru Göz Hastalarında Gözyaşı Osmolarite Ölçümünün Gün İçi Değişiklikleri

Abstract

Amaç: Kuru gözü olan ve olmayan kişilerde gözyaşı osmolaritesinin gün içi değişikliklerini, ikincil olarak da bu değişikliklerin Schirmer Testi ve Gözyaşı kırılma zamanı (GKZ) ile ilişkisini değerlendirmeyi hedefledik. Ge reç ve Yön tem: Yeni tanı konmuş 20 kuru göz hastası ile aynı yaş ve cinsiyete sahip 20 sağlıklı gönüllü prospektif olarak çalışmaya dahil edildi. Katılımcıların tümüne tam oftalmolojik muayene yanı sıra Schirmer II Testi ve GKZ testleri yapıldı. Gözyaşı osmolaritesi ölçümleri, ön muayenenin yapıldığı gün sonrasında farklı bir günde yapıldı. Ölçümler saat 08.00 ile 17.00 arasında üçer saatlik aralarla TearLab osmolarite cihazı (TearLab Corporation, San Diego, CA, USA) ile kaydedildi. Sonuçlar, istatistiksel olarak değerlendirildi. Sonuçlar: Kontrol ve kuru göz sendromu (KGS) gruplarının yaş ortalamaları, cinsiyetleri arasında istatistiksel olarak anlamlı farklılık bulunmadı (p>0,05). KGS Grubunun Schirmer Testi ve GKZ ölçüm ortalamaları kontrol grubundan istatistiksel olarak anlamlı ölçüde düşük bulunmuştur (p=0,0001). KGS Grubunun saat 08.00, 11.00, 14.00 ve 17.00 gözyaşı osmolaritesi ölçümü ortalamaları kontrol grubuna göre istatistiksel olarak anlamlı ölçüde yüksek bulunmuştur (p=0,001, p=0,0001). KGS ve Kontrol Gruplarının, grup içi ve gruplar arası saat 08.00, 11.00, 14.00 ve 17.00 gözyaşı osmolaritesi ortalamaları arasında istatistiksel olarak anlamlı fark gözlenmemiştir (p>0,05). Tar t›fl ma: Kuru gözlü ve sağlıklı normal bireylerde, gün içi gözyaşı osmolaritesi ölçümlerinin değişkenliğini değerlendirdiğimiz çalışmamızın sonucunda, her iki grupta da anlamlı değişiklik saptamadık. İkincil sonuç olarak, KGS tanısında gözyaşı osmolaritesi, Shirmer ve GKZ testleri arasında fark olmadığı sonucuna vardık. (Turk J Ophthalmol 2013; 43: 437-41) Anah tar Ke li me ler: Kuru göz sendromu, gözyaşı osmolaritesi, Schirmer testi, gözyaşı kırılma zamanı Sum maryPur po se: We have targeted primarily to show the variations of tear osmolarity during the daytime period in subjects with dry eyes and non-dry eyes and, secondarily, to evaluate the relationship of these variations with Schirmer's test and break-up time (BUT). Ma te ri al and Met hod: Twenty newly diagnosed dry eye patients and 20 healthy voluntary subjects with similar age and gender were included in this prospective study. In addition to the full ophthalmic examination, Schirmer's test and BUT test were applied to all participants. Tear osmolarity measurements were done after pre-examination but in different day. The measurements were registered with TearLab Osmolarity System (TearLab Corporation, San Diego, CA, USA) every 3 hours within 8:00 AM and 5:00 PM. The results were evaluated statistically. Re sults: No statistically significant difference was found between the mean age and gender of dry eye syndrome (DES) and control groups (p>0.05). The mean measurements of Schirmer's test and BUT in the DES group were statistically significantly lower than those in the control group (p=0.0001). , and within DES and control groups (p>0.05). Dis cus si...

The effect of online education during the pandemic on ocular surface symptoms

“…The TBUT was affected in the group that developed new ocular symptoms after the onset of online education. In a study of dry eye patients, Yiğit et al [18] showed that the TBUT value decreased as screen exposure increased. Gümüş et al [19] examined the effect of computer use on ocular parameters and determined a negative relationship between TBUT and increased periods of computer work.…”

Diurnal variations of tear film osmolarity on the ocular surface

“…32 Actually, there is some controversy in how the tear film osmolarity value changes throughout the day. [33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52] While diurnal variations in tear film parameters are important in the daily clinic, over the last four decades there have not been too many clinical studies focused on the study of osmolarity diurnal changes. It has been hypothesized that eye closure creates a hypo-osmotic environment generated by the reduction of tear evaporation, production, and drainage.…”

“…There is no consensus in the time-point for the measurement session (from 6:00 am 37 to 10:00 pm), 33 or also the interval between them (from 10-minute intervals 34 to four/sixhour intervals) 49 (Table 1). In addition, some studies performed all the measurements in the same day, 35,39,40,42,43,45,47,48,51,52,56 while others followed the progression over two days, 37,46,50 or they repeated the protocol two consecutive days, 38,41 three nonconsecutive days with 2-to 5-day intervals, 49 or over a six-day period 36 (Table 1).…”

“…6 In the assessment of tear film osmolarity diurnal variation, the most common osmometer used was the TearLab (TearLab Corporation, San Diego, CA, USA), [58][59][60][61] an impedance electric osmometer specific for tear film osmolarity measurement (Table 1). [39][40][41][42][43][44][45]47,48,51,52,56 Nowadays, there are only two tear osmolarity assessment specific osmometers available on the market, the TearLab osmometer and the i-Pen osmometer, both based on the electric impedance principle. Electrical impedance measurement has been shown as an accurate and repeatable technique for dry eye diagnosis; 25,30,62,63 moreover, electrical impedance osmometers are more clinically accessible because do not take up as much space and do not require a large volume of tears on each measurement.…”

“…The sample size studied shows a high variation between studies: from only two subjects in a study done in the year 1986, 36 to a higher sample on studies performed in the last fifteen years where groups of forty-fifty participants could be found (Table 1). 38,40,45,51 On those late studies, samples were divided into same-sized groups of healthy and ocular surface disease or under environmental alteration conditions participants (Table 1). 38,40,45,51 An exception to this "higher sample trend" was a study from 2020 where only 10 subjects (4 healthy, 4 DED and 2 CLW participants) were enrolled.…”