Ophthalmology in China ›› 2014, Vol. 23 ›› Issue (6): 375-379.doi: 10.13281/j.cnki.issn.1004-4469.2014.06.005

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Application of noninvasive tear film function examinations on dry eye diagnosis

LIANG Qing-feng1, YAO Wei-lan1, ZHANG Yang1, WANG Zhi-qun1, LABBE Antoine2   

  1. 1. Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Key Laboratory of Ophthalmology and visual sciences, Beijing 100005, China; 2. University of Versailles Saint-Quentin en Yvelines, France
  • Received:2013-11-10 Online:2014-11-25 Published:2014-12-01
  • Contact: LIANG Qing-feng, Email:lqflucky@163.com E-mail:lqflucky@163.com

Abstract:  Objective To analyze tear film function and the location of first breakup point in dry eye patients using Oculus Keratograph. Design Prospective comparative case series. Participants Fifty-one patients with dry eye and eighty-six healthy age- and sex-matched control subjects were included from July to September 2013. Methods The dry eye symptoms in all subjects were evaluated with the Ocular Surface Disease Index (OSDI) questionnaire. Noninvasive tear breakup time (NITBUT) and tear meniscus height (TMH) were tested with Oculus Keratograph. One eye of each subject was included in the study. Differences of OSDI scores, first NITBUT (NITBUTf), average NITBUT (NITBUTav) and TMH between dry eye group and control group were compared. The correlations of these parameters were assessed. Locations of first tear film breakup point were observed and differences between two groups were analyzed. Main Outcome Measures OSDI scores, NITBUTf, NITBUTav, TMH and first tear film breakup point location. Results Differences of OSDI scores, NITBUTf, NITBUTav between dry eye group and control group were significant(P=0.000, 0.000, 0.016, respectively). No significant difference of TMH between two groups was found (P=0.217). There were linear negative correlations between NITBUTf, NITBUTav and OSDI scores (r=-0.760, -0.490, respectively; P=0.000). Linear positive correlation was found between NITBUTf and NITBUTav (r=0.671,P=0.000). There was no correlation between OSDI scores, NITBUTf, NITBUTav and TMH(r=-0.099,0.116,0.019; P=0.252, 0.178, 0.824, respectively). The occurrence of first tear film breakup point of dry eye group and control group was mainly emerged in loop 2 to 5 (73.08% and 75.42%, respectively). The occurrence has significant difference among different loops in both groups (χ2=13.897, 30.017; P=0.031, 0.000, respectively). There was no significant difference between different quadrants in both groups (χ2=2.103, 5.186; P=0.551, 0.159, respectively). Conclusion Oculus Keratograph could be used to analyze noninvasive tear film function. NITBUT was related to the OSDI. It showed that the first tear film breakup point of dry eye patients occurred in the pupil area of cornea most frequently.

Key words:  dry eye/diagnosis, tear film function examination, tear breakup time, first tear film breakup point