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H. Watanabe, S. Koh, Y. Hori, K. Nishida, N. Maeda, Y. Tano; Efficacy of Using a Blue-free Barrier Filter with Fluorescein Staining in Classifying the Degree of Damage of the Conjunctival Epithelium in Dry Eyes . Invest. Ophthalmol. Vis. Sci. 2003;44(13):2493.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To determine whether the use of a blue-free barrier filter to examine the fluorescein staining in the conjuctiva is valuable for the diagnosis of dry eyes. Methods: Forty-two eyes with Sjögren’s syndrome and 11 eyes with non-Sjögren dry eyes were studied. Fluorescein staining was performed on the temporal and nasal conjunctiva and the staining was scored into four grades (0 to 3) with a blue-free barrier filter (BF score) and without it (FL score). Rose bengal staining was also scored (RB score) with a similar scoring system. Results: For temporal or nasal site of the conjunctiva with FL scores of 0, 1, and 2, the BF scores were significantly higher at 0.85±0.37, 1.74±0.65, 20.65±0.48, respectively (Wilcoxon signed rank test: score 0, P= 0.031; score 1, P= 0.001; score 2, P= 0.001). In contrast, for conjunctiva with a FL score of 3, the BF score was the same at 3 at all sites. The higher BF score was found in 66.6% of conjunctiva with a FL score of 0 and 1, and 65.2% in cases with a FL score of 2. In cases with a RB score of 0, 1, and 2, the BF scores were significantly higher at 1.88±0.92, 1.78±0.79, 2.57±0.50, respectively (Wilcoxon signed rank test, P= 0.001 for each score). However, in cases with a RB score of 3, the BF score was 2.97±0.16 (P>0.05). The higher BF scores was found in 75.5% of cases with a RB score of 0 and 1, and 57.8% of cases with a RB score of 2, but only 2.6% with a RB score of 3. Conclusions: The use of a BF barrier filter during slit-lamp examination is of benefit in recognizing the damage of the conjunctival epithelium stained by fluorescein especially in mild to moderate dry eyes. Therefore, the BF filter system provides a better recognition of the damage in dry eyes even at the initial stage that cannot be found by conventional observational techniques.
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