One-Minute Schirmer Test for Basal Tear Secretion

利用一分鐘Schirmer檢查測量基礎淚液分泌量

崔永平(Yung-Ping Tsui) ； 陳文祿(Wen-Lu Chen) ； 江鈞綺(Chun-Chi Chiang) ； 黃釋綠(Shih-Yuan Huang) ； 黃久珍(Chiu-Chen Huang) ； 蔡宜佑(Yi-Yu Tsai)

《中華民國眼科醫學會雜誌》 47卷1期 (2008/03) Pp. 5-11

https://doi.org/10.30048/ACTASOS.200803.0002

摘要

目的：標準的Schirmer檢查需要費時五分鐘，在臨床應用上較費時。本篇目的為重訂檢查所需時間。
方法：此為一前瞻性的研究設計，我們收錄50個病人的100隻眼睛，包含乾眼症和沒有乾眼症的正常病人，分別測試及紀錄1, 2, 3, 4及5分鐘時的Schirmer試紙的溼度，比較相同病人在不同時問所紀錄的試紙溼度和五分鐘時所得到的結果之問的相關性，利用ROC曲線比較期敏感度和特異度。
結果：在50個病人的100隻眼睛中，有31個是重度乾眼症，30個為輕中度，39個為正常，依據ROC曲線，如果在第一分鐘得到的Schirmer數值小於3時，定義為重度乾眼症，其敏感度為0.935，特異度為0.754，若在第二分鐘得到的數值為4以下，定義為重度乾眼症，則其敏感度為0.968，特異度為0.826。故第二分鐘得到數值結果，其敏感度和特異度遠高於第一分鐘的Schirmer檢查結果。
結論：此研究結果顯示，一分鐘及兩分鐘的Schirmer檢查可以取代傳統5分鐘的檢查，重度乾眼症的標準可以取其一分鐘的Shirmer數值低於3mm，及兩分鐘的Schirmer檢查數值低於4mm。

並列摘要

Purpose: It takes 5 minutes for the standard Schirmer test and is time-consuming in clinic practice. The purpose of this study is to restore the time spending on this test.
Methods: This was a prospective study. We collected 100 eyes of 50 patients, including dry eye groups and normal subjects. The wetting of Schirmer strips were recorded at 1, 2, 3, 4 and 5 minutes. The correlation of 1-, 2-, 3- and 4- minute test compared with the standard 5-minute test in the same group of patients and the reliability of this test were checked. The sensitivity and specificity was tested by ROC curve.
Results: In 100 eyes of 50 patients, there were 31 severe dry eyes, 30 mild-moderate dry eyes, and 39 normal eyes. According to the ROC curve, if the results of 1-minute Schirmer test less than 3 mm were the criteria for the severe dry eye, the sensitivity was 0.935, and the specificity was 0.754. If the results of 2-minute Schirmer test less than 4 mm were the criteria for the severe dry eye, the sensitivity was 0.968, and the specificity was 0.826. The sensitivity and specificity at the 2-minute Schirmer test is higher than those in the 1-minute Schirmer test.
Conclusion: This study showed that the 1-minute and 2-minute Schirmer test can be used to replace the 5-minute Schirmer test. It is suggested the cutoff points of 3mm at the 1-minute and 4 mm at the 2-minute Schirmer test can be used to diagnose the severe dry eyes.

並列關鍵字

dry eye ； one minute ； schirmer test