Objective Imaging Diagnostics for Dry Eye Disease

Traditional diagnostic tests for dry eye disease (DED), such as fluorescein tear film break-up time and the Schirmer test, are often associated with poor reproducibility and reliability, which make the diagnosis, follow-up, and management of the disease challenging. Advances in ocular imaging technology enables objective and reproducible measurement of changes in the ocular surface, tear film, and optical quality associated with DED. In this review, the authors will discuss the application of various imaging techniques, such as, noninvasive tear break-up time, anterior segment optical coherence tomography, in vivo confocal microscopy, meibography, interferometry, aberrometry, thermometry, and tear film imager in DED. Many studies have shown these devices to correlate with clinical symptoms and signs of DED, suggesting the potential of these imaging modalities as alternative tests for diagnosis and monitoring of the condition.

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Advances in the Noninvasive Diagnosis of Dry Eye Disease

Applied Sciences ◽

10.3390/app112110384 ◽

2021 ◽

Vol 11 (21) ◽

pp. 10384

Author(s):

Luca Di Cello ◽

Marco Pellegrini ◽

Aldo Vagge ◽

Massimiliano Borselli ◽

Lorenzo Ferro Desideri ◽

...

Keyword(s):

Dry Eye ◽

Anterior Segment ◽

Tear Film ◽

Optical Quality ◽

Dry Eye Disease ◽

Diagnostic Tools ◽

Eye Disease ◽

Non Invasive ◽

Integrated Devices

Dry eye disease (DED) is a multifactorial disease that represents one of the most common ophthalmologic conditions encountered in everyday clinical practice. Traditional diagnostic tests for DED, such as subjective questionnaires, tear film break-up time and the Schirmer test, are often associated with poor reproducibility and reliability, which make the diagnosis, follow-up, and management of the disease challenging. New advances in imaging technologies enable objective and reproducible measurements of DED parameters, thus making the diagnosis a multimodal imaging-based process. The aim of this review is to summarize all the current and emerging diagnostic tools available for the diagnosis and monitoring of DED, such as non-invasive tear breakup time, thermography, anterior segment optical coherence tomography, meibography, interferometry, in vivo confocal microscopy, and optical quality assessment. Although there is not a gold standard imaging technique, new multi-imaging-integrated devices are precious instruments to help clinicians to better cope with the diagnostic complexity of DED.

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The Association between Tear Film Thickness as Measured with OCT and Symptoms and Signs of Dry Eye Disease: A Pooled Analysis of 6 Clinical Trials

Journal of Clinical Medicine ◽

10.3390/jcm9113791 ◽

2020 ◽

Vol 9 (11) ◽

pp. 3791

Author(s):

Gerhard Garhöfer ◽

Valentin Aranha Dos Santos ◽

Hannes Stegmann ◽

Doreen Schmidl ◽

Narine Adzhemian ◽

...

Keyword(s):

Clinical Trials ◽

Film Thickness ◽

Dry Eye ◽

Tear Film ◽

Pooled Analysis ◽

Dry Eye Disease ◽

Eye Disease ◽

Break Up ◽

Symptoms And Signs ◽

Schirmer I Test

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.

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Evaluation of self-report questionnaires as predictive tests for obtaining pathological schirmer i, tear film break-up time and ocular protection index scores in dry eye disease patients

Acta Ophthalmologica ◽

10.1111/j.1755-3768.2014.s047.x ◽

2014 ◽

Vol 92 ◽

pp. 0-0

Author(s):

R BADIAN ◽

TP UTHEIM ◽

S RAEDER ◽

Ø UTHEIM ◽

X CHEN ◽

...

Keyword(s):

Dry Eye ◽

Tear Film ◽

Dry Eye Disease ◽

Self Report ◽

Eye Disease ◽

Predictive Tests ◽

Break Up ◽

Protection Index

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Simplified Classification of Tear Film Break-Up Patterns and Their Clinicopathological Correlations in Patients With Dry Eye Disease

Eye & Contact Lens Science & Clinical Practice ◽

10.1097/icl.0000000000000706 ◽

2020 ◽

Vol 47 (1) ◽

pp. 15-19

Author(s):

Hee Dong Eom ◽

Jae Uk Jung ◽

Kyoung-Pil Lee ◽

Jeongho Kim ◽

Dong Hee Yoon ◽

...

Keyword(s):

Dry Eye ◽

Tear Film ◽

Dry Eye Disease ◽

Eye Disease ◽

Clinicopathological Correlations ◽

Break Up

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A New Non-Human Primate Model of Desiccating Stress-Induced Dry Eye Disease

10.21203/rs.3.rs-1079358/v1 ◽

2021 ◽

Author(s):

Li Gong ◽

Yilin Guan ◽

WonKyung Cho ◽

Baowen Li ◽

Lingzhen Pan ◽

...

Keyword(s):

Dry Eye ◽

Clinical Symptoms ◽

Disease Model ◽

Tear Film ◽

Corticosteroid Treatment ◽

Dry Eye Disease ◽

Eye Disease ◽

Primate Model ◽

Desiccating Stress ◽

Human Primate

Abstract Dry eye disease (DED), a multifactorial ocular surface disease, is estimated to affect up to 34% of individuals over 50 years old. Although numerous animal models, including rodents and rabbits, have been developed to mimic the pathophysiologic mechanisms involved in the dry eye, there is a lack of non-human primate (NHP) models, critical for translational drug studies. Here, we developed a novel desiccating stress-induced dry eye disease model using rhesus monkeys. The monkeys were housed in a controlled-environment room for 21 to 36 days under humidity, temperature, and airflow regulation. Following desiccating stress, NHPs demonstrated clinical symptoms similar to those of humans, as shown by increased corneal fluorescein staining (CFS) and decreased tear-film breakup. Moreover, corticosteroid treatment significantly reduced CFS scoring, restored TFBUT, and prevented upregulation of tear proinflammatory cytokines as observed in dry eye patients following steroid treatment. These close resemblance of clinical symptoms and treatment responses to those of human DED patients provides great translational value to the NHP model which could serve as a clinically relevant animal model to study the efficacy of the new potential treatment for DED.

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