Repeatability and Reproducibility of Noninvasive Keratograph 5M Measurements in Patients with Dry Eye Disease

Purpose. To determine the intraexaminer repeatability and interexaminer reproducibility of tear meniscus height (TMH) and noninvasive Keratograph tear breakup time (NIKBUT) measurements obtained with the Keratograph 5M (K5M) in a sample of healthy and dry eye populations.Methods. Forty-two patients with dry eye disease (DED group) and 42 healthy subjects (healthy group) were recruited in this prospective study. In all subjects, each eye received 3 consecutive measurements using the K5M for the TMH and NIKBUTs (NIKBUT-first and NIKBUT-average). And then a different examiner repeated the measurements. The repeatability and reproducibility of measurements were assessed by the coefficient of variation (CV) and intraclass correlation coefficient (ICC).Results. The repeatability and reproducibility of TMH and NIKBUTs were good in both DED and healthy groups (CV% ≤ 26.1% and ICC ≥ 0.75 for all measurements). Patients with DED showed better intraexaminer repeatability for NIKBUTs, but worse for TMH than healthy subjects. Average TMH, NIKBUT-first, and NIKBUT-average were significantly lower in DED group than in healthy group (allPvalues < 0.05).Conclusions. Measurements of TMH and NIKBUTs obtained with the K5M may provide a simple, noninvasive screening test for dry eye with acceptable repeatability and reproducibility. The NIKBUTs were more reliable, but TMH was less reliable in patients with DED.

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Application of Visante Optical Coherence Tomography Tear Meniscus Height Measurement in the Diagnosis of Dry Eye Disease

Ophthalmology ◽

10.1016/j.ophtha.2010.01.057 ◽

2010 ◽

Vol 117 (10) ◽

pp. 1923-1929 ◽

Cited By ~ 109

Author(s):

Osama M.A. Ibrahim ◽

Murat Dogru ◽

Yoji Takano ◽

Yoshiyuki Satake ◽

Tais Hitomi Wakamatsu ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Dry Eye ◽

Dry Eye Disease ◽

Eye Disease ◽

Optical Coherence ◽

Height Measurement ◽

Meniscus Height ◽

Tear Meniscus ◽

Tear Meniscus Height

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Treatment of Dry Eye With Intracanalicular Injection of Hydroxybutyl Chitosan: A Prospective Randomized Clinical Trial

Frontiers in Medicine ◽

10.3389/fmed.2021.769448 ◽

2021 ◽

Vol 8 ◽

Author(s):

Tong Lin ◽

Wushuang Wang ◽

Yang Lu ◽

Lan Gong

Keyword(s):

Clinical Trial ◽

Dry Eye ◽

Dry Eye Disease ◽

Eye Disease ◽

Phenol Red ◽

Efficacy And Safety ◽

Fluorescence Staining ◽

Meniscus Height ◽

Tear Meniscus ◽

Tear Meniscus Height

Background: Punctal/intracanalicular plugs on the market nowadays are all designed before clinical use in treating dry eye disease (DED). To provide an individualized lacrimal drainage system occlusion method and reduce the complications, we developed a “liquid plug” strategy by intracanalicular injection of hydroxybutyl chitosan (HBC) solution, a thermosensitive, phase-changing biomaterial. This study evaluated the efficacy and safety of the HBC plug in treating dry eye disease by comparing it with the VisiPlug absorbable intracanalicular plug.Methods: A monocenter, randomized, controlled clinical trial was performed. Fifty patients with DED were randomized 1:1 to undergo either the HBC injection treatment or the VisiPlug treatment. Ocular Surface Disease Index (OSDI) questionnaire, tear break-up time (TBUT), corneal fluorescence staining (CFS), tear meniscus height (TMH), and phenol red thread test were evaluated at Day 0 (baseline, before treatment) and Weeks 1, 4, and 12.Results: The two groups had a balanced baseline of age, gender, and DED-related characteristics. Both occlusion methods could relieve the symptoms and signs of DED. Significant improvement was found in OSDI, phenol red thread test, and tear meniscus height (P < 0.05 compared to baseline) but not in corneal fluorescence staining and tear break-up time (P > 0.05). There is no statistically significant difference between HBC injection and VisiPlug at Weeks 1 and 4 (P > 0.05). However, at week 12, the HBC injection was not as effective as the VisiPlug in maintaining phenol red thread test (HBC: 5.35 ± 3.22 mm, VisiPlug: 8.59 ± 4.35 mm, P = 0.009) and tear meniscus height (HBC: 206.9 ± 47.95 μm, VisiPlug: 242.59 ± 60.30 μm, P = 0.041). The numbers of ocular adverse events were relatively low in both groups.Conclusions: The HBC injection showed similar efficacy and safety compared to VisiPlug. The intracanalicular injection of HBC solution proves to be a promising, individualizing method to treat DED.Clinical Trial Registration: This study is registered with the Chinese Clinical Trial Registry (https://www.chictr.org.cn/enindex.aspx), Identifier: ChiCTR1800016603.

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An investigation of non-invasive tear break up time and tear meniscus height of keratoconic versus non-keratoconic individuals

African Vision and Eye Health ◽

10.4102/aveh.v75i1.339 ◽

2016 ◽

Vol 75 (1) ◽

Author(s):

Deanne L. Nicholas ◽

Wayne D.H. Gillan

Keyword(s):

Dry Eye ◽

Tear Film ◽

Dry Eye Disease ◽

Eye Disease ◽

Non Invasive ◽

Control Subjects ◽

Tear Meniscus ◽

Break Up ◽

Tear Meniscus Height ◽

And Control

Keratoconus is a debilitating condition where the cornea develops a conical shape rather than the characteristic round shape due to various physiological and structural changes taking place within the layers of the cornea. As a result of the pathogenesis of keratoconus, there are numerous changes that may occur within the tears of these patients. Research has shown changes in the tear metabolome, the presence of degradation products as well as loss of goblet cells into the tears. Could the changes occurring within the tear structure of these patients affect the results of various tear quantity and quality tests? Non-invasive tear break up time (NTBUT) is a diagnostic test used to determine the quality of the tear film and has been used extensively when diagnosing dry eye disease. This test is utilised in order to determine the time taken for the tear film to begin breaking apart, signalling thinning of the tears. Shorter break up times are therefore indicative of instability or changes occurring within the tear film which could be diagnostic of dry eye disease. Tear meniscus height (TMH) measurements have also been utilised in clinical practice, where these measurements provide an indication of the volume of tears contained within the upper and lower menisci. Lower tear volumes have been shown to be present in cases of dry eye disease where either tear production or tear drainage may be affected. Changes in the quality and quantity of the tear film in subjects with dry eye disease have been thoroughly investigated; however, the same cannot be said for subjects with keratoconus. Could the same findings be possible in subjects with keratoconus? Is it possible that the changes occurring within the tears of keratoconic subjects could lead to abnormal NTBUT and TMH measurements when compared to those of control subjects? Could the results of the NTBUT and TMH tests be related to one another? This study compares the NTBUT and TMH measurements of both keratoconic and control subjects by making use of a single type of instrumentation, namely the Oculus Keratograph 4 (OK4). The results of this study reveal that the values obtained for each of the two subject groups are not shown to be statistically significantly different and that there is no significant correlation between the NTBUT and TMH measurements when comparing keratoconic and control subjects.

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Evaluation of strip meniscometry, tear meniscus height and depth in the diagnosis of dry eye disease in asian Indian eyes

The Ocular Surface ◽

10.1016/j.jtos.2019.07.002 ◽

2019 ◽

Vol 17 (4) ◽

pp. 747-752 ◽

Cited By ~ 2

Author(s):

Archita Singh ◽

Murugesan Vanathi ◽

Alisha Kishore ◽

Noopur Gupta ◽

Radhika Tandon

Keyword(s):

Asian Indian ◽

Dry Eye ◽

Dry Eye Disease ◽

Eye Disease ◽

Meniscus Height ◽

Tear Meniscus ◽

Tear Meniscus Height

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Repeatability and Reproducibility of SMTube Measurement in Dry Eye Disease Patients

Journal of Ophthalmology ◽

10.1155/2021/1589378 ◽

2021 ◽

Vol 2021 ◽

pp. 1-7

Author(s):

Yiran Hao ◽

Lei Tian ◽

Kai Cao ◽

Ying Jie

Keyword(s):

Dry Eye ◽

Rank Order ◽

Intraclass Correlation ◽

Rank Correlation ◽

Dry Eye Disease ◽

Eye Disease ◽

Ocular Surface Disease Index ◽

Spearman Rank ◽

Repeatability And Reproducibility ◽

Schirmer I Test

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.

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An Association Rule Analysis of Combined Acupoints for the Treatment of Patients with Dry Eye Disease

Complementary Medicine Research ◽

10.1159/000512674 ◽

2020 ◽

pp. 1-8

Author(s):

Ya-Hsuan Lin ◽

Hsein-Chang Wu ◽

Po-Chun Hsieh ◽

I-Shiang Tzeng ◽

Shu-Ya Wu ◽

...

Keyword(s):

Dry Eye ◽

Association Rule ◽

Binary Data ◽

Meta Analysis ◽

Poor Quality ◽

Dry Eye Disease ◽

Eye Disease ◽

Film Instability ◽

Breakup Time

Background: Dry eye disease (DED) has a higher incidence in old age and is seen predominantly in females worldwide. Neurosensory abnormalities, ocular surface inflammation and damage, film instability, and hyperosmolarity are major and proven pathologies responsible for a poor quality of life. Tear breakup time and Schirmer’s I test are predominantly used for the evaluation of primary outcomes in patients undergoing conventional treatment. A previous meta-analysis of some relevant studies proved that combination of acupoints could be more effective than single acupoint treatment. Objectives: The present study aimed to undertake association rule mining and examined the potential kernel acupoint combination in DED treatment constructed from the extracted randomized controlled trials (RCTs) based on a previous meta-analysis. Methods: We summarized 32 acupoints as binary data from the 12 eligible RCTs and analyzed them based on the Apriori algorithm. Results: TE23, BL2, ST2, ST1, EX-HN5, BL1, LI4, ST36, SP6, and KI3 were the 10 most frequently selected acupoints. The major associated rules in combination of acupoints were {TE23, LI4} ≥ {ST1} and {TE23, ST1} ≥ {LI4}, as inferred from 23 association rules. Conclusions: For acupuncture treatment of DED, combined TE23, LI4, and ST1 acupoints could be settled as the kernel of acupoint combination.

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Maximum blink interval is associated with tear film breakup time: A new simple, screening test for dry eye disease

Scientific Reports ◽

10.1038/s41598-018-31814-7 ◽

2018 ◽

Vol 8 (1) ◽

Cited By ~ 15

Author(s):

Takenori Inomata ◽

Masao Iwagami ◽

Yoshimune Hiratsuka ◽

Keiichi Fujimoto ◽

Yuichi Okumura ◽

...

Keyword(s):

Dry Eye ◽

Screening Test ◽

Tear Film ◽

Dry Eye Disease ◽

Eye Disease ◽

Breakup Time ◽

Simple Screening

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Characteristics and Utility of Fluorescein Breakup Patterns among Dry Eyes in Clinic-Based Settings

Diagnostics ◽

10.3390/diagnostics10090711 ◽

2020 ◽

Vol 10 (9) ◽

pp. 711

Author(s):

Chika Shigeyasu ◽

Masakazu Yamada ◽

Norihiko Yokoi ◽

Motoko Kawashima ◽

Kazuhisa Suwaki ◽

...

Keyword(s):

Diagnostic Test ◽

Dry Eye ◽

Dry Eye Disease ◽

Eye Disease ◽

Subjective Symptoms ◽

Clinical Tool ◽

Likelihood Ratios ◽

Dry Eyes ◽

Post Test ◽

Breakup Time

(1) Background: To evaluate the characteristics of fluorescein breakup patterns (FBUPs) among patients with dry eye disease (DED) and efficacy of FBUPs as a diagnostic test for DED subgroups. (2) Methods: The study enrolled 449 patients with DED. FBUPs were categorized as follows: area break (AB), line break (LB), spot break (SB), dimple break (DB), and random break (RB). Schirmer value, fluorescein breakup time (FBUT), keratoconjunctival score, DED subgroups and subjective symptoms were examined. (3) Results: LB patients presented with short FBUT and high keratoconjunctival score. AB patients presented with short FBUT, high cornea and keratoconjunctival scores. SB patients were young with short FBUT. DB patients exhibited low keratoconjunctival score. RB patients were young, with long FBUT and low keratoconjunctival scores. Among DED subgroups, LB and AB constituted 74.7% of aqueous-deficiency dry eye (ADDE). SB and DB constituted 42.4% of short FBUT dry eye (short FBUT-DE). Post-test probabilities and positive likelihood ratios for ADDE were 58.7% and 1.63, respectively; those for short FBUT-DE were 46.3% and 2.02, respectively. Patients with SB and AB exhibited significantly severe subjective symptoms than other FBUPs. (4) Conclusions: FBUPs are associated with both objective findings and symptoms of DED and may be a clinical tool for identification of DED subgroups.

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