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Automated Measurement of Tear Film Dynamics and Lipid Layer Thickness for Assessment of Non-Sjögren Dry Eye Syndrome With Meibomian Gland Dysfunction

Authors
 Yong Woo Ji  ;  Jeihoon Lee  ;  Hun Lee  ;  Kyoung Yul Seo  ;  Eung Kweon Kim  ;  Tae-im Kim 
Citation
 Cornea, Vol.36(2) : 176-182, 2017 
Journal Title
 Cornea 
ISSN
 0277-3740 
Issue Date
2017
MeSH
Adult ; Aged ; Aged, 80 and over ; Cornea/metabolism* ; Corneal Topography ; Dry Eye Syndromes/diagnosis* ; Dry Eye Syndromes/metabolism ; Eyelid Diseases/diagnosis* ; Eyelid Diseases/metabolism ; Female ; Fluorophotometry ; Humans ; Interferometry ; Lipid Metabolism/physiology* ; Male ; Meibomian Glands/metabolism ; Meibomian Glands/pathology* ; Middle Aged ; Prospective Studies ; Surveys and Questionnaires ; Tears/metabolism* ; Young Adult
Keywords
Keratograph ; LipiView interferometer ; dry eye ; lipid layer thickness ; meibography ; meibomian gland dysfunction
Abstract
PURPOSE: To investigate automated values from an advanced corneal topographer with a built-in real keratometer, color camera, and ocular surface interferometer for the evaluation of non-Sjögren dry eye syndrome (NSDES) with meibomian gland dysfunction (MGD). METHODS: Sixty-four patients (64 eyes) diagnosed with NSDES with MGD were enrolled. All eyes were evaluated using the Ocular Surface Disease Index (OSDI), fluorescence staining score, tear film breakup time (TBUT), Schirmer test, and MGD grade. Noninvasive Keratograph average tear film breakup time (NIKBUTav), tear meniscus height (TMHk), meibomian gland (MG) dropout grade, and lipid layer thickness (LLT) using interferometry were measured. RESULTS: Among automated indexes, NIKBUTav (mean 7.68 ± 4.07 s) and the MG dropout grade (mean 1.0 ± 0.5) significantly correlated with the OSDI (mean 40.6 ± 22.9) (r = -0.337, P = 0.006; and r = 0.201, P = 0.023, respectively), as did all conventional indicators, except the Schirmer score (mean 9.1 ± 5.9 mm). TMHk (mean 0.21 ± 0.18 mm) had significant correlation with the Schirmer score, the staining score (mean 1.2 ± 0.7), TBUT (mean 3.8 ± 1.8 s), and NIKBUTav (r = 0.298, P = 0.007; r = -0.268, P = 0.016; r = 0.459, P < 0.001; and r = 0.439, P < 0.001, respectively), but not any MGD indicator, even the MG dropout grade. NIKBUTav showed significant correlations with all clinical parameters and other automated values, except the Schirmer score and LLT (mean 83.94 ± 20.82 nm) (all (Equation is included in full-text article.)≥ 0.25 and P < 0.01). The MG dropout grade highly correlated with all indexes except TMHk (all (Equation is included in full-text article.)≥ 0.25 and P < 0.05). LLT was significantly associated with TBUT, MGD grade (mean 2.0 ± 0.7), and MG dropout grade (r = 0.219, P = 0.047; r = -0.221, P = 0.039; and r = 0.433, P < 0.001, respectively), although it was not related to patient symptoms. CONCLUSIONS: Automated noninvasive measurements using an advanced corneal topographer and LLT measured with an ocular surface interferometer can be alternatives to conventional methods to evaluate tear conditions on the ocular surface; the former device can provide information about conformational MG changes in NSDES with MGD.
Full Text
http://www.ingentaconnect.com/content/wk/ico/2016/00000036/00000002/art00012
DOI
10.1097/ICO.0000000000001101
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Ophthalmology (안과학교실) > 1. Journal Papers
Yonsei Authors
김응권(Kim, Eung Kweon) ORCID logo https://orcid.org/0000-0002-1453-8042
김태임(Kim, Tae Im) ORCID logo https://orcid.org/0000-0001-6414-3842
서경률(Seo, Kyuong Yul) ORCID logo https://orcid.org/0000-0002-9855-1980
지용우(Ji, Yong Woo)
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/154126
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