Instability of tear film and loss of meibomian glands in patients with acne vulgaris / Instabilidade do filme lacrimal e perda de glândulas meibomianas em pacientes com acne vulgaris

ABSTRACT Purpose: In this prospective study, we compared ocular clinical variables in patients with acne vulgaris with those of healthy controls. These variables included tear film break-up time, meibomian gland dropout rate, and anterior chamber parameters. Methods: Our sample comprised 73 eyes from 73 patients with acne vulgaris and 67 eyes from 67 healthy controls. All participants underwent a non-invasive first tear film break-up time test and the average tear film break-up time was evaluated. Meibography was used to identify any meibomian gland dropout. The parameters of the cornea and anterior chamber were measured using Scheimpflug topography imaging. Finally, the ocular surface disease index questionnaire was administered to score each participant on their subjective experience of ocular complaints. Results: The noninvasive first tear film break-up time values of the acne vulgaris Group and the control Group were 4.7 ± 2.8 and 6.4 ± 3.5 sec, respectively. There was a significant difference between the groups (p=0.016). The number of eyes with tear break-up at any time during the measurement period was also significantly higher in the acne Group (p=0.018). In the acne vulgaris Group, the mean meibomian gland dropout rates were 33.21 ± 15.5% in the upper lids and 45.4 ± 14.5% in the lower lids. In the control group, these rates were 15.7 ± 6.9% and 21 ± 9.7% respectively. Dropout was significantly higher in the acne group for both the upper and lower lids (p=0.000). Conclusion: We found impaired tear stability in patients with acne vulgaris and a high rate of meibomian gland dropout. These glands play a key role in tear stability and their dropout is likely to result in evaporative dry eye. Measurement of the variables in this study allows objective diagnosis of this condition using a non-invasive, dye-free methodology, with minimum contact.

RESUMO Objetivo: Neste estudo prospectivo, pacientes com acne vulgaris e indivíduos saudáveis do grupo controle foram comparados em relação ao tempo de ruptura do filme lacrimal, taxa de abandono de glândulas meibomianas e parâmetros da câmara anterior, usando o tempo de ruptura do filme lacrimal topográfico não invasivo, meibografia não invasiva e fotografia de Scheimpflug, respectivamente. Métodos: Setenta e três olhos de 73 pacientes com acne vulgaris e 67 olhos de 67 indivíduos saudáveis foram incluídos. Todos os participantes submetidos ao primeiro tempo de ruptura do filme lacrimal não-invasivo e ao tempo médio de ruptura do filme lacrimal não-invasivo foram avaliados pelo uso do tempo de ruptura do filme lacrimal; perda de glândulas meibomianas foram avaliadas por meibografia; os parâmetros da córnea e da câmara anterior foram medidos por fotografia de Scheimpflug; e, finalmente, as queixas oculares subjetivas foram pontuadas com o uso do questionário do Indice de doenças de superfície ocular. Resultados: Os valores do tempo de ruptura do primeiro filme lacrimal não-invasivo do Grupo com acne vulgaris e do Grupo controle foram 4,7 ± 2,8 e 6,4 ± 3,5 segundos, respectivamente, refererindo-se a uma diferença significativa entre os valores dos grupos (p=0,016). Qualitativamente, o número de olhos com ruptura lacrimal a qualquer momento durante o período de medição foi significativamente maior no grupo de pacientes. (p=0,018). No Grupo com acne vulgaris, a perda de glândulas meibomianas nas pálpebras superiores foi de 33,21 ± 15,5% e nas pálpebras inferiores foi de 45,4 ± 14,5%; por outro lado, no Grupo controle foi de 15,7 ± 6,9% e 21 ± 9,7% respectivamente; ambos os casos referem-se a uma diferença significativa entre os grupos (p=0,000). Conclusão: Encontramos estabilidade comprometida do filme lacrimal em pacientes com acne vulgaris. No entanto, o comprometimento foi de grau muito menor, em comparação com a taxa de perda das glândulas meibomianas que desempenham um papel fundamental na estabilidade do filme lacrimal. Esta condição pode ser documentada de forma objetiva - uma metodologia parcialmente sem contato, totalmente não-invasiva e livre de corantes.

Construcción y Validación de una Escala de Conductas de Separación de Pareja / Construction and Validation of a Scale of Couple Separation Behaviors

Resumen Las investigaciones en torno a una ruptura de pareja plantean medir las estrategias y conductas que las personas llevan a cabo para terminar sus relaciones románticas. Se propone entender la separación de pareja a partir del Modelo de Inversión de Rusbult (1979). Resulta relevante probar el modelo incluyendo elementos psicométricos que permitan comprender su validez al evaluar las conductas de separación. De esta forma el propósito de este estudio fue someter a prueba, un análisis exploratorio y confirmatorio de una escala que mida las conductas que las personas realizan para terminar su relación de pareja. Para ello se creó una escala de Conductas ante la separación de pareja a partir de un estudio exploratorio. La escala en su versión inicial contó con 50 reactivos en escala tipo Likert, aplicados en línea a 230 adultos de la Ciudad de México y Área Metropolitana. Al inicio del Análisis Factorial Exploratorio se obtuvo una escala final de 18 reactivos distribuidos en 4 factores (alejamiento, confrontación, depresión por separación e infidelidad) que explican el 68,47% de la varianza explicada con una confiabilidad de α = .871. Esta estructura fue corroborada por un Análisis Factorial Confirmatorio. Se encuentra una escala robusta y confiable, y se concluye que las conductas de separación evaluadas a partir del alejamiento con la expareja, que puede ser por medio de la comunicación o de ejercer conductas que transgreden como una infidelidad, afectan principalmente el estado emocional de las personas que lo viven.

Abstract Research on a couple's breakup aims to measure the strategies and behaviors that people carry out to end their romantic relationships. We propose to understand couple separation based on Rusbult's Reversal Model (1979). It is revealing to test the model including psychometric elements that allow us to understand its validity. Thus, the purpose of this study was to test an exploratory and confirmatory analysis of a scale that measures the behaviors that people perform to end their relationship. The initial version of the scale had 50 items on a Likert scale, applied online to 230 adults in Mexico City and Metropolitan Area. At the beginning of the exploratory factor analysis, a final scale of 18 items distributed in 4 factors (distancing, confrontation, depression due to separation and infidelity) was obtained, explaining 68.47% of the variance explained with a reliability of α = .871. This structure was corroborated by a Confirmatory Factor Analysis. A robust and reliable scale is found, and it is concluded that the separation behaviors evaluated from the distance with the ex-partner, which can be through communication or exercising behaviors that transgress such as infidelity, mainly affect the emotional state of the people who live it.

Comparison of strip meniscometry and Schirmer tear test results and tear film breakup time between healthy dogs and dogs with dry eye disease / Comparação entre o teste de meniscometria em tira, o teste lacrimal de Schirmer e o tempo de ruptura do filme lacrimal em cães normais e com olho seco

ABSTRACT Purpose: To compare strip meniscometry and Schirmer tear test 1 results and tear film breakup time between dogs with normal eyes and dogs diagnosed with keratoconjunctivitis sicca. Methods: One-hundred fifty-six eyes of 78 dogs, 88 normal eyes, and 68 eyes diagnosed with keratoconjunctivitis sicca were included in the study. The tests were performed in the following sequence: Schirmer tear test 1 was used to allocate the dogs to the normal or keratoconjunctivitis sicca group, followed by the strip meniscometry test and tear film breakup time measurement. Results: The results (mean ± standard deviation) of the tests in the normal group were as follows: Schirmer tear test 1, 22.75 ± 3.88 mm/min; strip meniscometry test, 10.01 ± 2.35 mm/5 sec; and tear film breakup time, 25.82 ± 5.47 sec. In the keratoconjunctivitis sicca group, the results were as follows: Schirmer tear test 1, 6.10 ± 4.44 mm/min; strip meniscometry test, 3.03 ± 2.62 mm/5 sec; and tear film breakup time, 10.78 ± 4.23 sec. The Spearman correlation coefficient in the keratoconjunctivitis sicca group was very high, with a significant difference between the strip meniscometry test and Schirmer tear test 1 (r=0.848, p<0.001), and moderate and significant between the strip meniscometry test and tear film breakup time (r=0.773, p<0.001). The cutoff for the strip meniscometry test for keratoconjunctivitis sicca was 7.0 mm/5 sec. Keratoconjunctivitis sicca was suspected when the values were <10 mm/5 sec. Conclusions: This study provided strip meniscometry test values from dogs with normal eyes and eyes with keratoconjunctivitis sicca, with high sensitivity and specificity compared with those of the Schirmer tear test 1. In the future, the strip meniscometry test may be another important quantitative test and could complement the gold standard Schirmer tear test for the diagnosis of keratoconjunctivitis sicca in dogs, an excellent animal model for the study of the disease.

RESUMO Objetivo: Comparar o teste de meniscometria em tira com o teste lacrimal de Schirmer 1 e o tempo de ruptura do filme lacrimal, em cães com olhos normais e cães com diagnóstico de ceratoconjuntivite seca. Métodos: Cento e cinquenta e seis olhos de 78 cães, 88 olhos normais e 68 olhos com diagnóstico de ceratoconjuntivite seca. Os testes foram realizados na seguinte sequência: o teste lacrimal de Schirmer 1 foi utilizado para alocar os cães no grupo normal ou no grupo ceratoconjuntivite seca, seguido pelo teste de meniscometria em tira e tempo de ruptura do filme lacrimal. Resultados: As médias e desvios-padrão para os olhos normais foram: teste lacrimal de Schirmer 1 = 22,75 ± 3,88 mm / min; teste de meniscometria em tira = 10,01 ± 2,35 mm / 5 seg; tempo de ruptura do filme lacrimal = 25,82 ± 5,47 seg; e para os olhos do grupo ceratoconjuntivite seca foram: teste lacrimal de Schirmer 1 = 6,10 ± 4,44 mm / min; teste de meniscometria em tira = 3,03 ± 2,62 mm / 5 seg; tempo de ruptura do filme lacrimal = 10,78 ± 4,23 seg. O teste de correlação de Spearman no grupo ceratoconjuntivite seca foi muito alto, com diferença significativa entre teste de meniscometria em tira e teste lacrimal de Schirmer 1 (r=0,848, p<0,001), moderada e significativa entre teste de meniscometria em tira e tempo de ruptura do filme lacrimal (r=0,773, p<0,001). O cut-off para teste de meniscometria em tira para ceratoconjuntivite seca foi identificado em 7,0 mm / 5 seg, valores abaixo de 10 mm / 5 seg podem ser considerados suspeitos para KCS. Conclusões: Este estudo forneceu valores de teste de meniscometria em tira em olhos normais e com ceratoconjuntivite seca em cães, revelando alta sensibilidade e especificidade em comparação com o teste lacrimal de Schirmer 1. No futuro, o teste de meniscometria em tira pode ser outro teste quantitativo importante e pode complementar o teste lacrimal de Schirmer padrão ouro para o diagnóstico de ceratoconjuntivite seca em cães, um excelente modelo animal para o estudo de ceratoconjuntivite seca.

Comparing the efficacy of sodium hyaluronate eye drops and carboxymethylcellulose eye drops in treating mild to moderate dry eye disease

Purpose: Aim of this study was to compare the efficacy of sodium hyaluronate (SH) and carboxymethyl cellulose (CMC) eye drops in treating mild to moderate dry eye disease in terms of relief of symptoms, mean change in tear film breakup time, Schirmer’s test, and impression cytology of conjunctiva from baseline. Methods: An observational study was carried out during a 2?year period in our tertiary referral hospital. The study consisted of 60 patients randomly allotted to two groups to receive SH and CMC eye drops for an 8?week period. Ocular surface disease index, tear film breakup time, and Schirmer’s test were performed at baseline visit and 4 and 8 weeks of treatment, and impression cytology of conjunctiva was performed at baseline and 8 weeks. Results: Significant improvement in patient symptoms, tear film breakup time, and Schirmer’s test from baseline was seen in both SH and CMC groups at 8 weeks posttreatment, whereas impression cytology of conjunctiva in both groups did not show significant improvement at 8 weeks of treatment. Data analysis using unpaired t?test showed comparable results. Conclusion: Both CMC and SH demonstrated equal efficacy in treating mild to moderate dry eye disease.

Evaluation of the ocular surface in asymptomatic glaucoma patients on topical medications and following trabeculectomy - A cross-sectional study

Purpose: This present prospective, cross-sectional study aims to comprehensively evaluate the ocular surface in asymptomatic patients with diffuse blebs after trabeculectomy versus chronic anti?glaucoma medication use and compare it with the age?matched normal population. Methods: Objective clinical evaluation was done by tear film break?up time (TBUT) and Schirmer’s test (ST) in the three groups– trabeculectomy >6 months with a diffuse bleb (Wurzburg bleb classification score ?10), chronic anti?glaucoma medication (AGM >6 months) group, and normal population. In all groups, tear film osmolarity was checked with the TearLab® device (TearLab Corp., CA, USA), and subjective evaluation was performed by administering Ocular Surface Disease Index (OSDI) questionnaire. Patients already on chronic lubricants or any other drug for the treatment of dry eyes (viz. steroids, cyclosporin) or having symptoms suggestive of an abnormal ocular surface, who had undergone refractive or intraocular surgery, and contact lens users were excluded. Results: In total, 104 subjects/eyes were recruited over 6 weeks. Thirty?six eyes recruited in the trab group were compared with 33 eyes studied in the AGM group, and both these groups were compared to 35 normal eyes. When compared to normals, TBUT and ST were significantly lower (P = 0.003 and 0.014) and osmolarity and OSDI were statistically significantly higher (P = 0.007 and 0.003) in the AGM group, whereas only TBUT was statistically significantly different (P = 0.009) when the trab group was compared to normals. Also, when the trab group was compared to the AGM group, ST was found to be higher (P = 0.003) and osmolarity was lower (P = 0.034). Conclusion: To conclude, ocular surface is affected even in asymptomatic patients on AGM but near normalcy is possible following trabeculectomy when blebs are diffuse.

A simple technique of meibography for morphological and functional evaluation of meibomian glands in dry eye conditions

Purpose: Dry eye disease (DED) is because of a decrease in the tear film’s volume or a change in the composition of tears. Evaporative dry eye is the most common type, which is due to meibomian gland dysfunction (MGD). In this study, the morphology of meibomian glands was evaluated in all kinds of dry eyes to look for any loss of meibomian glands, assess the function of remaining glands, and investigate the relationship between anatomy, function, and severity of DED. Methods: A total of 300 patients were included in the study, with 150 eyes in the study group and 150 in the control group. Meibomian gland morphology was assessed by examining the tarsal plate after everting the eyelids. Tear film function was evaluated using tear film break?up time (TBUT) and Schirmer’s test (SCH I and II). Meibomian gland morphology was examined with a slit?lamp under magnification, a transilluminator using a small light emitting diode (LED) bulb, and non?contact meibography using an auto refracto?keratometer (ARK). Results: Females had a higher prevalence of dry eyes in our study. In all, 103 eyes (68.6%) in the study group had evaporative dry eye, making it the most prevalent type. Among the 150 controls, 104 controls with 69.3% had no dry eye symptoms, and in those with symptoms, the evaporative type was the most common, with a 28% prevalence. Conclusion: TBUT should be performed in all patients with detectable MG abnormality. Meibography has high specificity and sensitivity to diagnose MGD and in turn dry eyes and should be considered a routine screening modality.

Different concentrations of fluorometholone eye drops on the treatment of children with severe mixed vernal keratoconjunctivitis / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To observe the clinical effect of different concentration of fluorometholone eye drops on severe mixed vernal keratoconjunctivitis in children.METHODS: A total of 50 cases(100 eyes)of children with severe mixed vernal keratoconjunctivitis treated in the outpatient department of our hospital from March to September, 2022 were selected and randomly divided into two groups. Group A consisted of 25 cases(50 eyes)who were treated with 0.1% fluorometholone eye drops combined with 0.05% cyclosporine eye drops(Ⅱ), while 25 patients(50 eyes)in group B were treated with 0.02% fluorometholone eye drops combined with 0.05% cyclosporine eye drops(Ⅱ). After 1mo of treatment, SPEED questionnaire score, corneal fluorescein staining(FL)score, tear break-up time(TBUT), Schirmer I test(SⅠt), R-scan, non-invasive tear meniscus height(NIKTMH), corneal optical density and other ocular parameters of the two groups were observed, and the occurrence of adverse reactions were recorded.RESULTS: After 1mo of treatment, there were significant differences in SPEED score, FL score and R-scan results between the two groups(all P&#x003C;0.05), and no differences in TBUT, SⅠt and NIKTMH results(all P&#x003E;0.05). However, there were statistical significance in corneal optical density in different corneal depth and diameter ranges(all P&#x003C;0.05). After 1mo of treatment, there was no significant difference in intraocular pressure between the two groups(16.21±2.90mmHg vs. 16.05±2.75mmHg, P&#x003E;0.05), and no obvious adverse reactions occurred during treatment.CONCLUSION: The 0.1% fluorometholone eye drops can effectively treat severe mixed vernal keratoconjunctivitis in children, and its effect is better than 0.02% fluorometholone eye drops.

Efficacy of optimal pulse technology in the treatment of demodex blepharitis and its effect on ocular surface function / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the efficacy of optimal pulse technology(OPT)in the treatment of demodex blepharitis and its influence on ocular surface function.METHODS: A retrospective study was conducted from February 2018 to October 2020. A total of 127 patients(254 eyes)with demodex blepharitis were assigned to the observation group and the control group according to the treatment method. The control group(63 patients, 126 eyes)were given conventional hot compress, eye cleansing and drug therapy. On this basis, the observation group(64 patients, 128 eyes)was treated with OPT. Both groups were given 6wk of continuous treatment. Demodex count, Marx's line scores, meibum character scores, ocular surface disease index(OSDI)scores, non-invasive tear break-up time(NIBUT), non-invasive tear meniscus height(NITMH)and lipid layer thickness(LLT)were compared between the two groups, and safety was evaluated.RESULTS: After 6wk of treatment, demodex count, Marx's line scores, meibum character scores and OSDI scores of the two groups decreased. NIBUT, NITMH and LLT increased. Meanwhile, demodex count, Marx's line scores, meibum character scores and OSDI scores of the observation group were significantly lower than those in the control group. NIBUT, NITMH and LLT were longer/larger than those in the control group(P<0.001). No obvious abnormality of intraocular pressure or conjunctival/corneal injury was observed in either group.CONCLUSION:OPT is effective and safe in the treatment of demodex blepharitis.

Postoperative ocular surface changes in acute attack eye and contralateral eye with angle-closure glaucoma and cataract / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the postoperative ocular surface changes in acute attack eye and contralateral eye with primary angle-closure glaucoma(PACG)and cataract.METHODS: A total of 40 patients with monocular acute PACG combined with cataract who admitted to Zhengzhou Central Hospital Affiliated to Zhengzhou University from January 2021 to January 2022 were selected. Trabeculectomy combined with phacoemulsification and intraocular lens implantation was carried out in the acute attack eyes, and phacoemulsification and intraocular lens implantation were carried out in the contralateral eyes. The ocular surface disease index(OSDI)questionnaire, noninvasive first tear film break-up time(NifBUT), noninvasive average tear film break-up time(NiaBUT)and tear meniscus height(TMH)were assessed preoperatively and 1, 3 and 6mo postoperatively.RESULTS: The OSDI scores of the included patients at 1 and 3mo postoperatively(14.72±3.07, 11.39±2.24)were significantly higher than those preoperatively(9.68±1.98; all P&#x003C;0.0083), and there was no significant difference between 6mo postoperatively(10.18±1.84)and preoperatively. NifBUT of the acute attack eyes at 1 and 3mo postoperatively was significantly lower than that preoperatively, and NiaBUT of the acute attack eyes at 1, 3 and 6mo postoperatively was significantly lower than that preoperatively(all P&#x003C;0.0083). The NifBUT and NiaBUT of the contralateral eyes at 1mo postoperatively were significantly lower than those preoperatively(all P&#x003C;0.0083), and there was no significant difference between 3 and 6mo postoperatively and preoperatively. There was no significant difference in TMH of the attack eyes and the contralateral eyes postoperatively and preoperatively(P&#x003E;0.05).CONCLUSION: The stability of tear film after surgery of PACG and cataract is decreased. The acute attack eye needs 6mo or even longer to recover, while the contralateral eye needs roughly 3mo.

Observation of tear film stability in dry eye patients with different lipid layer thickness / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To explore the difference of tear film stability among different lipid layer thickness.METHOD: A total of 194 dry eye patients(384 eyes)admitted to our hospital from June 2020 to December 2021 were enrolled in this study. The tear meniscus height, the first tear film break-up time and lipid layer thickness were measured by corneal topographer. The tear meniscus height and the first tear film break-up time among different lipid layer thickness were compared and the correlation between them was analyzed.RESULTS: The included patients(384 eyes)were divided into lipid rich group(49 eyes), lipid balance group(27 eyes), slight lipid deficiency group(266 eyes)and significant lipid deficiency group(42 eyes)according to the lipid layer thickness. The differences of the tear meniscus height were statistically different(P=0.022), while the differences of the first tear film break-up time were not statistically different(P=0.322). The lipid layer thickness was positively correlated with tear meniscus height(rs=0.143, P=0.006). There was no correlation between lipid layer thickness and the first tear film break-up time(rs=-0.090, P=0.083), nor was there correlation between tear meniscus height and the first tear film break-up time(rs=0.038, P=0.460).CONCLUSION: There was no significant difference in tear film stability in dry eye patients with different lipid layer thickness.

Ocular manifestations in moderate-to-severe psoriasis in India: A prospective observational study

Purpose: Ocular manifestations in psoriasis are due to direct eye involvement with psoriatic plaques or psoriasis?related, immune?mediated inflammatory processes. The commonly reported pathologies are blepharitis, conjunctivitis, keratitis, dry eyes, and uveitis. Limited data is available on the ocular findings in psoriasis patients in India. In this study, we evaluated various ocular changes associated with moderate-to-severe psoriasis. Methods: In this prospective cohort study, treatment?naive psoriasis patients with Psoriasis Area Severity Index (PASI) score of more than 10 were included. The Ocular Surface Disease Index (OSDI) score, Schirmer’s score, tear film breakup time (TBUT), corneal and conjunctival staining score, and meibomian gland dysfunction score were noted. All these parameters were re?evaluated at 8 weeks of follow?up after systemic treatment. Results: Sixty-eight patients were enrolled in the study. The most common ocular pathologies observed in this study were tarsal hyperemia and anterior blepharitis in 128 (94.1%) and 64 (47%) eyes, respectively. Mild, moderate, and severe dry eyes were seen in 26 (19.1%), 14 (10.2%), and 34 (25%) eyes, respectively. Thirty?nine (57.3%) patients complained of significant difficulty watching television or digital screen. In 21 patients evaluated on follow?up at 8 weeks, cornea and conjunctiva’s ocular surface staining score increased and TBUT decreased significantly. Conclusion: The most common ocular pathologies observed in this study were anterior blepharitis and moderate dry eye, which significantly affected most patients’ daily routines. Screening patients with greater severity of psoriasis would help in early management of such problems.

Correlations between Quality of Vision, Higher Order Aberrations and Non-Invasive Keratographic Tear Film Break-Up Time in Pseudophakic Eyes after Uncomplicated Phacoemulsification

Aims: In this study, we aimed to investigate the intercorrelations between tear film break up time, measured non-invasively using non-invasive keratographic break-up time (NIKBUT), higher order aberrations (HOA) and quality of vision (QoV) in pseudophakic patients.Study Design: Cross-sectional.Methods: Thirty-five pseudophakic aged patients aged 50 years or older, and 35 control phakic patients aged 17 to 23 years with corrected visual acuity of 20/20 were included in this study. All subjects underwent similar examination including QoV questionnaire, aberrometry to measure HOA, and NIKBUT. HOA was measured with the OPD-Scan/ ARK 10000 corneal analyzer (Nidek CO. Ltd), expressed as Root Mean Square (RMS) HOA and NIKBUT was assessed using non-invasive TF-Scan module Keratograph 5M (K5M), equipped with modified tear film scanning function (Oculus, Wetzlar, Germany). Statistical analysis was performed to find the correlation between NIKBUT, HOA and QoV.Results: Patients in the pseudophakic group were significantly older (median age 66 vs. 20 years; P<0.01), had shorter NIKBUT (10.5 vs. 17.2; P<0.01), lower QoV score (1.63 vs. 0.68; P=0.04), and higher RMS HOA (0.5 vs. 0.26; P<0.01) compared to control group. NIKBUT was inversely correlated with RMS HOA (r = -0.19; p = 0.03) and RMS HOA was significantly correlated with QoV, even after adjustment for age and gender (r = -0.21; P0.04). NIKBUT <9.93s was correlated with lower QoV. The area under the curve was 0.81 (95% CI = 0.67 � 0.95, p = 0.012), and had 100% sensitivity and 61% specificity.Conclusion: Shorter NIKBUT was correlated with greater HOA and greater HOA was correlated with lower QoV. NIKBUT value of shorter than 9.93s could potentially predict pseudophakic patients who will likely experience visual symptoms leading to decreased QoV; thus, the use of artificial tears might be beneficial.

Clinical observation of Tiaoshen acpuncture for dry eye syndrome with yin deficiency of liver and kidney / 中国针灸

OBJECTIVE@#To compare the curative effect of Tiaoshen acupuncture combined with artificial tears and artificial tears alone for dry eye syndrome with yin deficiency of liver and kidney.@*METHODS@#A total of 70 patients of dry eye syndrome with yin deficiency of liver and kidney were randomized into an acupuncture combined with medication group (35 cases, 2 cases dropped off) and a medication group (35 cases, 3 cases dropped off). In the medication group, 0.1% sodium hyaluronate eye drop was applied, 3 times a day, 1 drop each time. On the basis of the treatment as the medication group, Tiaoshen acupuncture was applied at Shenting (GV 24), Shenmen (HT 7), Benshen (GB 13), Taixi (KI 3), Taichong (LR 3), Guangming (GB 37), Fengchi (GB 20), Tongziliao (GB 1), Yuyao (EX-HN 4) in the acupuncture combined with medication group, Tongziliao (GB 1) and Yuyao (EX-HN 4) were connect with electroacupuncture, the needles were retained for 30 min, once a day, 6 times a week. Both groups were treated for 2 weeks. Before and after treatment, the clinical symptom score, SchirmerⅠtest (SⅠT), break-up time (BUT), corneal fluorescein staining (FL) score and Hamilton anxiety scale (HAMA) score were observed in the two groups, and the clinical efficacy was compared in the two groups.@*RESULTS@#Compared before treatment, the clinical symptom scores, corneal FL and HAMA scores were decreased (P<0.05), the levels of SⅠT and BUT were increased after treatment in the two groups (P<0.05). After the treatment, the clinical symptom score, FL and HAMA scores in the acupuncture combined with medication group were lower than the medication group (P<0.05), the levels of SⅠT and BUT in the acupuncture combined with medication group were higher than the medication group (P<0.05). The total effective rate in the acupuncture combined with medication group was 90.9% (30/33), which was higher than 71.9% (23/32) in the medication group (P<0.05).@*CONCLUSION@#Tiaoshen acupuncture combined with artificial tears could promote the secretion of tears for patients of dry eye syndrome with yin deficiency of liver and kidney, repair corneal defect and prolong tear film break-up time, and alleviate anxiety state, its curative effect is better than simple artificial tears.

Efficacy and safety of tea tree essential oil with different concentrations in the treatment of Demodex blepharitis / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To analyze the effectiveness and safety of different concentrations of tea tree essential oil in the treatment of Demodex blepharitis. <p>METHODS: The clinical data of 120 patients(240 eyes)with blepharitis caused by Demodex infection in our hospital from June 2017 to June 2019 were retrospectively analyzed. According to the use of tea tree essential oil concentrations of 10%, 15%, 20% and 25%, patients were divided into 4 groups(group A, group B, group C, group D), each group with 30 people. All patients were given meibomian gland massage, eyelid margin cleaning, and then scrubbed with different concentrations of tea tree oil to clean the eyelid margin. The number of demodex mites, clinical symptom score, clinical sign score, tear film break-up time(BUT), corneal fluorescein staining(FL)and SchirmerⅠtest(SⅠt)were compared before and 2, 4wk after treatment.<p>RESULTS: The number of Demodex mites, clinical symptom score, clinical sign score, BUT, FL and SⅠt were not statistically significant in the four groups before treatment(<i>P</i>>0.05). After treatment, the number of Dmodex mites, clinical symptom score, and clinical sign score in each group were lower than those before treatment, and the number of Demodex mites, clinical symptom score, and clinical sign score after 4wk of treatment in each group were lower than those after 2wk of treatment(all <i>P</i><0.008). After 2 and 4wk of treatment, the number, clinical symptom score and clinical signs score of Demodex mites in group A were the highest, while those in group D were the lowest(all <i>P</i><0.008). After treatment, the BUT of each group was higher than before treatment, and reached the peak in the 4wk. After 2 and 4wk of treatment, BUT among groups was highest in group D and lowest in group A(all <i>P</i><0.008). After treatment, FL and S I t of each group were lower than before treatment, and reached the lowest value in the 4wk. After 2 and 4wk of treatment, FL among the groups was the lowest in group D and the highest in group A(all <i>P</i><0.008). <p>CONCLUSION: Compared with 10% tea tree essential oil, 15% tea tree essential oil can effectively repel mites, relieve clinical symptoms and eye signs in patients with Demodex blepharitis, and is safer than 20% and 25% tea tree essential oils. As the preferred concentration of tea tree essential oil against Demodex blepharitis.

Analysis of dynamic image features of tear film in dry eye patients / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the image features of dynamic changes of tear film break-up after corneal fluorescein staining(FL)combined with tear film lipid layer(TFLL)dynamic changes in patients with dry eye and its value of diagnosis in dry eye. METHODS: A prospective study. A total of 66 patients(132 eyes)with dry eye admitted to our hospital during September 2019 to December 2020 were divided area break-up group(17 cases, 28 eyes), circle break-up group(20 cases, 27 eyes), line break-up group(25 cases, 28 eyes), spot break-up group(21 cases, 24 eyes)and random break-up group(20 cases, 25 eyes)according to the different fluorescein tear film break-up patterns(BUPs). The image features of tear film break-up dynamic changes and the image features of TFLL dynamic changes were compared in each group, and the differences in the first non-invasive tear film break-up time(NIBUTf), average non-invasive tear film break-up time(NIBUTav), tear meniscus height(TMH)and fluorescein staining scores were compare,RESULTS:A statistically significant differences were observed in NIBUTf among the groups of patients(P&#x003C;0.001). Except that there was no difference between spot break-up group and random break-up group(7.56±1.54s vs 8.02±1.86s, P=0.881), other groups had significant differences in pairwise comparisons(P&#x003C;0.05). There were statistically differences among the groups for NIBUTav(P&#x003C;0.001). Except that there was no difference between spot break-up group and random break-up group(9.54±2.12s vs 9.73±1.94s, P=0.997), other groups had significant differences in pairwise comparisons(P&#x003C;0.05). There was statistically difference among the groups for TMH(P&#x003C;0.001). Except that there was no difference between circle break-up group and line break-up group(0.16±0.03mm vs 0.17±0.03mm, P=0.986), there was no difference between spot break-up group and random break-up group(0.22±0.03mm vs 0.21±0.05mm, P=0.993), other groups had significant differences in pairwise comparisons(P&#x003C;0.05). There were statistically significant differences among the groups for FL scores and TFLL grading(P&#x003C;0.001).CONCLUSION:It is shown that different fluorescein BUPs intuitively reflects the tear film structure of the pathological changes according to evaluation and analysis of images feature of dynamic changes of FL tear film and TFLL combined with the results of static examination of tear film. It is helpful for clinicians to identify subtypes of dry eye, which has potential clinical value for the diagnosis and classification of dry eye.

Efficacy observation of acupuncture for dry eye syndrome of lung-yin deficiency pattern / 针灸推拿医学（英文版）

Objective: To observe the clinical efficacy of combining two needling manipulations, Er Long Xi Zhu (two dragons playing with a pearl) and Guo Yan Re (heat produced to reach the eyes), in treating dry eye syndrome (DES) of lung-yin deficiency pattern. Methods: Fifty-six eligible DES patients of lung-yin deficiency were randomized into an observation group and a control group, with 28 cases in each group. Same acupoints were selected in the two groups: Cuanzhu (BL 2), Sizhukong (TE 23), Taiyang (EX-HN 5) and Fengchi (GB 20) were chosen as the major points and Feishu (BL 13) and Chize (LU 5) as the adjuvant. Er Long Xi Zhu and Guo Yan Re needling manipulations were applied in the observation group while twirling reinforcing manipulation was used in the control group. Treatment was conducted once per day in both groups, for two sets of 15 consecutive days at a 2-day interval. Changes in the symptom score, tear break-up time (BUT) and tear production were observed afterwards, and the clinical efficacy was also compared between the two groups. Results: The total effective rate was 92.8％ in the observation group, higher than 71.4％ in the control group, and the between-group difference was statistically significant (P<0.05). After treatment, the symptom score, tear BUT and tear production showed significant improvements in both groups (all P<0.05); the symptom score, BUT and tear production in the observation group were significantly different from those in the control group (all P<0.05). Conclusion: Given the same acupoint selection, combining Er Long Xi Zhu and Guo Yan Re needling manipulations can produce more significant clinical efficacy than twirling reinforcing manipulation in treating DES of lung-yin deficiency pattern.

Experimental study on the diagnosis of dry eye tear film grading by Keratograph 5M ocular surface analyzer and conventional ocular surface examination / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the diagnostic value of Keratograph 5M for the diagnosis of dry eye(dry eye)tear film grading. <p>METHODS: Totally 100 eyes diagnosed with dry eye by conventional means and 40 non-dry eye eyes with suspected dry eye at the same time were enrolled through OPC. The immediate ocular surface parameters of the above cases were collected by the K5M ocular surface analyzer, including the first tear film rupture time(NIBUTf), the average tear film rupture time(NIBUTav), and the tear river height(TMH)which were utilized to evaluated the diagnostic efficacy of K5M compared to routine ocular surface examination on the index of dry eye tear film. <p>RESULTS: The comparison of NIBUTf, NIBUTav and TMH between dry eye group and non-dry eye group by K5M eye surface comprehensive analyzer showed statistically significant differences(all <i>P</i><0.05). The coincidence rate between the NIBUTf of K5M ocular surface analyzer and the BUT of routine diagnosis was 78.6%, and the area under the ROC curve as well as the standard error were 0.042 and 0.795(<i>P</i><0.01)with 95% confidence interval(0.712, 0.878); The coincidence rate between NIBUTav of K5M and BUT of routine examination diagnosis was 73.6%, and the area under the ROC curve as well as the standard error were 0.853 and 0.033(<i>P</i><0.01), with 95% confidence interval(0.788, 0.917).The coincidence rate between TMH of K5M and the SⅠt of conventional diagnosis was 87.9%, and the area under the ROC curve as well as the standard error were 0.795 and 0.044(<i>P</i><0.01), with the 95% confidence interval(0.709, 0.880). The sensitivity, specificity, correctness index, positive likelihood ratio, negative likelihood ratio, and odds ratio of the exploratory diagnosis of dry eye by NIBUTf combined with TMH were 98, 40, 38, 1.63, 0.05, and 32.6%, respectively. The sensitivity, specificity, correctness index, positive likelihood ratio, negative likelihood ratio, and odds ratio of the exploratory diagnosis of dry eye by NIBUTav combined with TMH were 86, 75, 61, 3.44, 0.187, 18.39%, respectively.<p>CONCLUSION: K5M ocular surface analyzer can provide accurate and reliable diagnostic value for single tear film index grading diagnosis of dry eye; compared with TMH combined with NIBUTav, TMH combined with NIBUTf was more sensitive but less specific in diagnosing dry eye.

Curative effect of phacoemulsification through clear corneal tunnel incision on cataract and the influences on dry eye symptom scores and break-up time / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To analyze curative effect of phacoemulsification through clear corneal tunnel incision on cataract and the influences on subjective sylptols of dry eye questionnaire scores(SDES)and break-up time(BUT).<p>METHODS: During the period from June 2015 to January 2019, 117 cataract patients(139 eyes)who underwent cataract surgery in the hospital were divided into group A(<i>n</i>=65, 72 eyes)and group B(<i>n</i>=52, 67 eyes)by random number table method. Groups A and B underwent phacoemulsification through 2.2mm and 3.0mm micro-incision, respectively. The general surgical status, SDES, BUT and curative effect indexes \〖best corrected visual acuity(BCVA), spherical equivalent(SE), endothelial cell density(ECD)\〗 were compared between the two groups.<p>RESULTS: There was no significant difference in ultrasound time, cumulative released energy, operation time or postoperative complications between two groups(<i>P</i>>0.05). After surgery, SDES scores in both groups were significantly increased, BUT was decreased compared with that at 1d before surgery. At 3mo after surgery, SDES and BUT recovered to preoperative levels. At 1d and 1wk after surgery, SDES score in group A was significantly lower than that in group B, while BUT was significantly higher than that in group B(<i>P</i><0.05). After surgery, BCVA LogMAR and ECD in both groups were significantly decreased, while SE and corneal diopter were significantly increased, without significant difference between the two groups(<i>P</i>>0.05). <p>CONCLUSION:The curative effect of phacoemulsification through clear corneal tunnel incision is reliable on cataract. The tear film function is better through 2.2mm micro-incision.

Ruptura de pareja en adultos jóvenes y salud mental: estrategias de afrontamiento ante el estrés del término de una relación / Couple breakup in young adults and mental health: coping strategies in the face of stress at the end of a relationship

Resumen El presente estudio tiene el propósito de establecer la relación entre las estrategias de afrontamiento, síntomas depresivos y satisfacción con la vida en adultos jóvenes tras una ruptura amorosa. Para esto, se encuestó a 220 personas, 66,8 % mujeres, en edades de entre 18 y 40 años. Se aplicaron las escalas Brief COPE de estrategias de afrontamiento, Escala SWLS de Satisfacción Vital, Escala de Depresión CES-D del Centro de Estudios Epidemiológicos, Cuestionario ERQ de Regulación Emocional, Escala RRS de Respuesta Rumiativa, sumado a un cuestionario sociodemográfico. Se observó que las mujeres poseen más síntomas depresivos que los hombres. Además, el tiempo transcurrido desde la ruptura, la aceptación, la supresión, el brooding y el uso de sustancias predicen una sintomatología depresiva, y, por otro lado, el brooding, la aceptación y la búsqueda de apoyo social predicen satisfacción con la vida. De este modo, es posible enfocarse en las líneas de acción para promover respuestas más adaptativas y modificar las respuestas menos adaptativas en personas afectadas por una ruptura.

Abstract The aim of this study has been to analyze the coping strategies used by young adults after a breakup and their relationship with depressive symptoms and satisfaction with life. For this, 220 people were surveyed, 66.8% women, aged between 18 and 40 years. The Brief-COPE coping strategies scale, SWLS Satisfaction with Life Scale, CES-D Depression Scale of Center for Epidemiological Studies, ERQ Emotional Regulation Questionnaire, RRS Rumination Response Scale, and a sociodemographic questionnaire were applied. It was observed that women have more depressive symptoms than men. In addition, the time elapsed since the rupture, acceptance, suppression, brooding and substance use, predict depressive symptoms and, on the other hand, brooding, acceptance and the search for social support, predict satisfaction with life. In this way, it is possible to focus on the lines of action to promote more adaptive responses and modify less adaptive responses in people affected by a rupture.

The impact of emotional attachment and culture on the breakup strategies perceived by the abandoned / El peso del apego y de la cultura en las estrategias de rompimiento amoroso percibidas por los abandonados

Abstract Considering the importance that has it been given to couple relationships, their breakdown has a negative impact on its members, especially on those who are victims (passive role) of the other's decision. Thus, from the cultural point of view, when a great value is attributed to romantic relationships, in terms of personal and family fulfillment, and this is transmitted to the members of the couple, facilitating the development of beliefs, norms, attitudes and expectations about the love experience, the search and consummation of that love becomes a guideline in people's lives. And if coupled with this, the attachment representing the means by which the biological needs for affection and security are met through the connection with another, it can be devastating to lose the source of such satisfactions. Based on the foregoing, the purpose of this study was to identify the relationship between the historic socio-cultural premises (PHSC, for its Spanish acronym) about romantic mourning and the attachment styles with the breakup strategies perceived by the passive subjects with a positive and negative romantic history. To do this, the study used a non-probabilistic sample of 547 residents of Mexico City who had been left by their partner. After performing some correlation analyzes, results indicated that the PHSC's have greater effects on the perception of negative breakup strategies in people with a positive or negative romantic history. The effects increased when dealing with PHSC's about feelings, mainly in passive members with a negative history and with an anxious attachment style followed by those with avoidant style. For their part, positive PHSCs are associated, but at a low level, with any perceived strategy.

Resumen Dada la importancia que se confiere a las relaciones de pareja, su rompimiento generalmente repercute de manera negativa en la vida de sus miembros, sobre todo en quien es víctima de la decisión del otro -es decir, quien ejerce un papel pasivo-. Así, desde el punto de vista cultural, cuando se le atribuye a la relación de pareja un valor importante como fuente de realización personal y familiar, y ello se transmite a través de los miembros -lo que facilita el desarrollo de creencias, normas, actitudes y expectativas del amor-, su búsqueda y consumación se vuelve una directriz en la vida de las personas. Adicional a esto, si el apego -que representa el medio por el cual se cubren las necesidades biológicas de afecto y seguridad- se ve satisfecho en la vinculación con el otro, puede que resulte devastador perder la fuente de tales satisfactores. Con base en lo anterior, el propósito de este estudio fue identificar la relación entre los estilos de apego y las premisas histórico-socioculturales (PHSC) del duelo romántico con las estrategias de rompimiento percibidas por los abandonados con historia romántica positiva o negativa. Para ello, se trabajó con una muestra no probabilística de 547 personas residentes de la Ciudad de México que habían sido dejadas por su pareja. Tras realizar algunos análisis de correlación, los resultados indicaron que las PHSC tienen mayores efectos sobre la percepción de estrategias de rompimiento negativo tanto en personas con historia romántica positiva como negativa. Los efectos incrementan cuando se trata de las PHSC sobre el sentir, principalmente en abandonados con historia negativa y con estilo de apego ansioso-ambivalente, seguido del evitativo. Por su parte, las PHSC positivas se asocian, pero en un nivel bajo, con cualquier estrategia percibida.