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Analysis of Factors Associated With the Tear Film Lipid Layer Thickness in Normal Eyes and Patients With Dry Eye Syndrome

 Ji Won Jung  ;  Si Yoon Park  ;  Jin Sun Kim  ;  Eung Kweon Kim  ;  Kyoung Yul Seo  ;  Tae-im Kim 
 Investigative Ophthalmology & Visual Science, Vol.57(10) : 4076-4083, 2016 
Journal Title
 Investigative Ophthalmology & Visual Science 
Issue Date
Adult ; Aged ; Aged, 80 and over ; Dry Eye Syndromes/diagnosis ; Dry Eye Syndromes/metabolism* ; Female ; Follow-Up Studies ; Humans ; Interferometry ; Lipids/analysis* ; Male ; Meibomian Glands/metabolism* ; Middle Aged ; Prospective Studies ; Risk Factors ; Severity of Illness Index ; Tears/chemistry* ; Young Adult
PURPOSE: To determine the effects of clinical variables, including age, sex, history of refractive or cataract surgery, contact lens use, and ocular surface and meibomian gland parameters on the lipid layer thickness (LLT) in normal subjects and patients with dry eye syndrome (DES). METHODS: A total of 64 normal subjects and 326 patients with DES were enrolled, and they underwent measurements of LLT with a LipiView interferometer and tear meniscus height using optical coherence tomography, tear film break-up time (TBUT) determination, ocular surface staining, Schirmer's test, examination of the lid margins and meibomian glands, and assessment using the Ocular Surface Disease Index (OSDI). RESULTS: In normal subjects, the median (range) LLT was 67 (33-100) nm, and age was the only factor that was significantly associated with LLT (β = 0.678, P = 0.028). In patients with DES, the median (range) LLT was 84 (20-100) nm, and 79.0% of the participants fulfilled the diagnostic criteria for meibomian gland dysfunction (MGD). In a multivariate analysis, increased age and female sex were significantly related to increased LLT (β = 0.282, P = 0.005 and β = 11.493, P < 0.001), and hypersecretory MGD and lid margin inflammation were independently associated with increased LLT (β = 11.299, P = 0.001 and β = 12.747, P = 0.001). CONCLUSIONS: Lipid layer thickness measurements using a new interferometer are significantly affected by demographic factors such as age, sex, ocular surgical history, and MGD type. Therefore, all of these factors must be considered in the diagnosis of ocular surface diseases.
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1. College of Medicine (의과대학) > Dept. of Ophthalmology (안과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Eung Kweon(김응권) ORCID logo https://orcid.org/0000-0002-1453-8042
Kim, Jin Sun(김진선)
Kim, Tae Im(김태임) ORCID logo https://orcid.org/0000-0001-6414-3842
Park, Si Yoon(박시윤)
Seo, Kyuong Yul(서경률) ORCID logo https://orcid.org/0000-0002-9855-1980
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