Abstract
PurposeComparing the clinical characteristics of dry eye secondary to primary biliary cholangitis (PBC), drug-induced liver injury (DILI) and viral hepatitis B(HBV) to evaluate the ocular surface damage caused by different types of liver diseases.Methods32 patients with secondary dry eye, included 10 cases of PBC, 10 cases of DILI and 12 cases of HBV. All patients were evaluated by SPEED questionnaire, corneal fluorescein staining(CFS), non-invasive tear breakup time(NIBUT), Schirmer I test(SIt), tear meniscus height test(TMH), the area of meibomian glands dropout(MG dropout) , partial blinking rate(PBR) and lipid layer thickness(LLT).ResultsCompared with DILI and HBV groups, PBC group had a lower SPEED questionnaire score, but the difference was not statistically significant (F=0.83, P=0.45); the CFS score was higher (c2=7.16,P=0.03), the PBR was higher (F=14.34, P=0.00), the SIt was lower (F=4.30,P=0.02), and the differences were statistically significant. The TMH of PBC and DILI groups was significantly lower than HBV group, and the difference was statistically significant (F=4.15, P=0.02). Compared with PBC group, the LLT of DILI group decreased, the difference was statistically significant (P=0.03). The NIBUT of three groups was lower than normal, but there was no statistical difference between groups (Ff=1.35,Pf=0.27;Fa=2.03,Pa=0.14).The area of meibomian glands dropout of three groups had mild to moderate defects, but there was no significant statistical difference between groups (F=0.32, P=0.73).ConclusionsThe PBC group was more prone to aqueous-deficient dry eye. The DILI group was more prone to obstructive meibomian gland dysfunction (MGD).The HBV group was more prone to non-obstructive MGD. The symptoms of dry eye in the PBC group are mild to moderate discomfort, but the degree of corneal damage is higher, indicating that the corneal sensitivity is reduced, which may be related to the high rate of partial blinking.