scholarly journals Reliability and efficacy of maximum fluorescein tear break-up time in diagnosing dry eye disease

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yujie Mou ◽  
Huan Xiang ◽  
Lin Lin ◽  
Kelan Yuan ◽  
Xin Wang ◽  
...  

AbstractThis study aims to investigate the reliability and efficacy of maximum fluorescein tear break-up time (FTBUTmax) in diagnosing dry eye disease (DED). 147 participants were enrolled in this study. Ocular symptoms were assessed by Ocular Surface Disease Index (OSDI). The fluorescein tear break-up time (FTBUT) examination, corneal fluorescein staining (CFS), and Schirmer I test were performed on both eyes. Each participant underwent 3 consecutive FTBUT tests, and five types of FTBUT values including FTBUTmax, the minimum FTBUT (FTBUTmin), the first FTBUT (FTBUT1), the average of three FTBUTs (FTBUT123) and the average of the first and second FTBUT (FTBUT12) were recorded. FTBUTmax was larger than the other FTBUT values, but no differences were found among the values of FTBUT1, FTBUT123, FTBUT12 and FTBUTmin. In the ROC analysis, FTBUTmax had the largest or the second largest area under the ROC (AUROC) in all three DED diagnostic criteria, while FTBUTmin had the least AUROC of them. ROC efficacy of FTBUTmax was significantly higher than that of FTBUT123, FTBUT12, FTBUT1 and FTBUTmin in the OSDI criteria and higher than that of FTBUT1 and FTBUTmin in Schirmer I test and CFS tests. FTBUTmax has a close correlation with OSDI, Schirmer I test and CFS, and is an effective tool for the DED diagnosis.

2021 ◽  
Author(s):  
Yujie Mou ◽  
Huan Xiang ◽  
Lin Lin ◽  
Kelan Yuan ◽  
Xin Wang ◽  
...  

Abstract This study aims to investigate the reliability and efficacy of maximum fluorescein tear break-up time (FTBUTmax) in diagnosing dry eye disease (DED). 147 participants were enrolled in this study. Ocular symptoms were assessed by Ocular Surface Disease Index (OSDI). The fluorescein tear break-up time (FTBUT) examination, corneal fluorescein staining (CFS), and Schirmer I test were performed on both eyes. Each participant underwent 3 consecutive FTBUT tests, and five types of FTBUT values including FTBUTmax, the minimum FTBUT (FTBUTmin), the first FTBUT (FTBUT1), the average of three FTBUTs (FTBUT123) and the average of the first and second FTBUT (FTBUT12) were recorded. FTBUTmax was larger than the other FTBUT values, but no differences were found among the values of FTBUT1, FTBUT123, FTBUT12 and FTBUTmin. In the ROC analysis, FTBUTmax had the largest or the second largest area under the ROC (AUROC) in all three DED diagnostic criteria, while FTBUTmin had the least AUROC of them. ROC efficacy of FTBUTmax was significantly higher than that of FTBUT123, FTBUT12, FTBUT1 and FTBUTmin in the OSDI criteria and higher than that of FTBUT1 and FTBUTmin in Schirmer and CFS tests. FTBUTmax has a close correlation with OSDI, Schirmer I test and CFS, and is an effective tool for the DED diagnosis.


2020 ◽  
Vol 9 (11) ◽  
pp. 3791
Author(s):  
Gerhard Garhöfer ◽  
Valentin Aranha Dos Santos ◽  
Hannes Stegmann ◽  
Doreen Schmidl ◽  
Narine Adzhemian ◽  
...  

Purpose: To determine the association between tear film thickness (TFT) as measured with ultra-high resolution optical coherence tomography (UHR-OCT) and signs and symptoms of dry eye disease (DED). Methods: A total of 450 eyes from 225 patients with DED from six different randomized clinical trials were included in this pooled analysis. In all subjects, TFT was measured with a custom-built UHR-OCT system. Symptoms of DED were quantified using a standardized Ocular Surface Disease Index (OSD)I questionnaire and clinical signs including tear film break up time (TFBUT) and Schirmer I test were assessed. Associations of the average TFT with OSDI, TFBUT, and Schirmer I test were calculated using a linear regression analysis. Results: The average TFT of the included sample (mean age, 45.0 ± 13.3 years; 65% female) was 4.2 ± 0.5 µm and the OSDI 36.2 ± 10.4. A significant negative correlation was found between TFT and OSDI (r = −0.36 to −0.31; p < 0.001). Tear break up time and Schirmer I test were not correlated with OSDI. Significant albeit weak correlations were found between TFT and TFBUT (r = 0.17 to 0.25; p < 0.01) as well as Schirmer I (r = 0.36 to 0.37; p < 0.001). Subgroup analysis revealed that the correlation was stronger in the subjects with abnormal Schirmer I (<15 mm; r = 0.50 to 0.54; p < 0.001). Conclusions: The present study demonstrates an objective measurement of TFT using a novel OCT approach for DED that correlates with symptoms and signs of DED. Our data are consistent with the idea that TFT represents the aqueous-deficient component of DED.


2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Kunihiko Hirosawa ◽  
Takenori Inomata ◽  
Jaemyoung Sung ◽  
Masahiro Nakamura ◽  
Yuichi Okumura ◽  
...  

Abstract Various symptoms of the dry eye disease (DED) interfere with the quality of life and reduce work productivity. Therefore, screening, prevention, and treatment of DED are important. We aimed to investigate the potential diagnostic ability of the maximum blink interval (MBI) (the length of time participants could keep their eyes open) with disease-specific questionnaire for DED. This cross-sectional study included 365 patients (252 with DED and 113 without DED) recruited between September 2017 and December 2019. Discriminant validity was assessed by comparing the non-DED and DED groups based on the MBI with a Japanese version of the Ocular Surface Disease Index (J-OSDI) and tear film breakup time (TFBUT) with J-OSDI classifications. The MBI with J-OSDI showed good discriminant validity by known-group comparisons. The positive and predictive values of MBI with J-OSDI were 96.0% (190/198 individuals) and 37.1% (62/167 individuals), respectively. The area under the receiver operating characteristic curve (AUC) of MBI with J-OSDI was 0.938 (95% confidence interval 0.904–0.971), the sensitivity was 75.4% (190/252 individuals), and the specificity was 92.9% (105/113 individuals), which are similar to the diagnostic ability of TFBUT with J-OSDI (AUC 0.954). In conclusion, MBI with J-OSDI may be a simple, non-invasive screening test for DED.


2019 ◽  
Vol 44 (9) ◽  
pp. 941-947 ◽  
Author(s):  
Mazyar Yazdani ◽  
Xiangjun Chen ◽  
Behzod Tashbayev ◽  
Øygunn A. Utheim ◽  
Sten Ræder ◽  
...  

Author(s):  
Suwarna Suman ◽  
Prachi Goyal

Aims:  To evaluate and compare the diagnostic values and clinical utility of the Ocular Surface Disease Index (OSDI) questionnaire, the tear film break-up time test (TBUT), and the Schirmer’s test in diagnosing dry eye disease in patients presenting with dry eye symptoms. Study Design: A prospective observational study. Place and Duration of Study: Department of Ophthalmology, AIIMS Jodhpur, Rajasthan, India. Two-month period between July 2016 and September 2016. Methodology: We have included 100 patients aged >20 years having foreign body sensations, burning sensations, pain, dryness, blurred vision, photophobia, redness in the study. Routine ophthalmological examination was performed after OSDI questionnaire, followed by TBUT and Schirmer’s test and outcomes were evaluated. Results: The mean age of 100 participants was 43 ± 15.97years (range 20–78 years). The mean OSDI, TBUT, and Schirmer’s test scores were 58.67± 12.12 (range 30.0–88.9), 5.77 ± 3.49 seconds (range 0–17 seconds), and 09.78 ± 7.93 mm (range 0–32.5 mm), respectively. There was a statistically highly significant inverse correlation between the OSDI and TBUT (r = −0.597, P = <0.0001), statistically significant correlation between TBUT and Schirmer test (r= -0.227, p= 0.023), whereas no significant correlation noted between the OSDI and Schirmer’s test (r= -0.142, p= 0.158).  Conclusion: The prevalence of dry eye disease (DED) is increasing these days. For early recognition and treatment, we need rapid, reliable and less invasive diagnostic test in daily practice. The OSDI together with the TBUT is less time consuming, easy to perform and can be useful in diagnosis of DED.


2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Yiran Hao ◽  
Lei Tian ◽  
Kai Cao ◽  
Ying Jie

Purpose. To evaluate the intraobserver repeatability and interobserver reproducibility of Strip Meniscometry Tube (SMTube) and determine the correlations among the SMTube measurements and other ocular examinations in dry eye disease (DED) patients. Methods. The study recruited 73 eyes of 49 DED patients. Every subject was subjected to the following five measurements sequentially: the Ocular Surface Disease Index (OSDI) questionnaire, Tear Meniscus Height (TMH) assessment, SMTube measurements, tear film breakup time (BUT) examination, and Schirmer I test (SIT). The repeatability and reproducibility of the measurements were assessed by the intraclass correlation coefficient (ICC) and the Bland–Altman analysis, and the correlations were evaluated by the Spearman rank-order correlation. Results. The repeatability and reproducibility of the SMTube measurements were good in DED patients. The ICCs between the repeatability and reproducibility of the SMTube measurements were 0.789 and 0.741, respectively, and the Bland–Altman 95% limits of the repeatability and the reproducibility were −1.726 to 1.658 and −0.967 to 1.474, respectively (all P < 0.01 ). The SMTube measurements had correlations with TMH, BUT, and SIT. The Spearman rank correlation coefficients between SMTube and TMH; SMTube and Schirmer I test; and SMTube and BUT were 0.632, 0.617, and 0.653, respectively (all P < 0.01 ). Conclusions. The measurements of the SMTube may provide a novel, swift, noninvasive, and convenient approach to screen and diagnose DED with acceptable repeatability and reproducibility and specific correlations with TMH, BUT, and SIT.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Miraf Sahlu ◽  
Abeba T. Giorgis

Abstract Background Dry eye disease is a multifactorial disease; causing various ocular symptoms with potential damage to the ocular surface. Applying hypotensive eye drops are presumed to initiate or exacerbate existing dry eye disease. The purpose of this study was to determine the frequency of signs and symptoms and severity of dry eye disease among glaucoma patients on topical hypotensive medications and controls. Methods A cross-sectional comparative study, involving 320 glaucoma patients and controls. Ocular Surface Disease Index (OSDI) symptoms score and Schirmer, tear breakup time and corneal staining tests were used to assess dry eye disease. Data was analyzed using SPSS version 24 software; p-value less than 0.05 was considered as statistically significant. Results Among the 160 study glaucoma patients, the mean duration of topical hypotensive medication use was 5.2 ± 5.21 years (range, 4 months - 32 years). Mild to severe level of OSDI score was found in 122 (76%) glaucoma patients and in 137 (86%) controls (p = 0.033). Mild to sever abnormal clinical tests in the glaucoma patients and control, respectively, were 106 (66%) vs 80 (50%) corneal staining (p = 0.045), 79 (49%) vs 72 (45%) TBUT (p = 0.021), and 91 (57%) vs 83 (52%) Schirmer test (p = 0.242). Test results at the level of sever: 2 (1%) vs 0 (0%) corneal staining, 50 (31%) vs 39 (24%) TBUT and 65 (41%) vs 60 (38%) Schirmer test in the glaucoma patents and controls, respectively. Corneal staining and TBUT had correlation with the number of drugs (p = 0.004 and 0.031, respectively), and more relationship of the two tests with total number of drops applied per day (p = 0.01 and p <  0.001, respectively). Patients on pilocarpine and timolol had more corneal staining and lower TBUT [(p = 0.011 and p <  0.001) and (p = 0.04 and 0.012), respectively]. Conclusions The study has identified glaucoma patients to be more affected by dry eye disease than non-glaucoma patients, and presence of significantly lower TBUT and higher corneal staining in the glaucoma patients on multidrops and multidose per day. We recommend consideration of evaluation and management of DED for glaucoma patients on multidrops and multidose hypotensive medications.


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