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MM Fahim, M Fuhrman, I Dualan, SA Haji, sM Ahmad, PA Asbell; Fluorophotometry of Corneal Epithelial Permeability as an Objective Diagnostic Tool for the Evaluation of Dry Eye Patients . Invest. Ophthalmol. Vis. Sci. 2002;43(13):3889.
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Purpose: Current diagnostic tests used in dry eye disease are often neither sensitive nor reproducible (Schirmer's test and corneal staining, etc.) making diagnosis and end points difficult in clinical trials in the evaluation of the usefulness of different medications for dry eye disease. We evaluated the use of corneal fluorescein penetration measured by the fluorophotometer, as a diagnostic tool in the evaluation of dry eye patients. Methods: Dry eye patients (16 eyes) who presented with a chief complaint of ocular irritation, had a low Schirmer's one test (<10 mm after 5 minutes) and corneal fluorescein staining scores were included in the study. Normal subjects (14 eyes) served as controls that came for other reasons i.e. glasses. Fluorophotometry of the central corneal epithelium was done utilizing the Fluortron MasterTM. Each eye received 50µl of 1% sodium fluorescein dye. Three minutes later the fluorescein was washed with 50c.c of normal saline. Fluorescein scans where started immediately after washing. The scans were repeated at a rapid sequence for both eyes for the initial 30 minutes, and one at 45 and 60 minutes. The corneal peak values of fluorescein concentration were recorded within central cornea in dry eyes and controls. Results: Ten minutes after fluorescein installation, patients with dry eye disease had on average a five fold increase in corneal tissue fluorescein concentration (mean = 493 + 319.7 ng/ml), compared with that of normal subjects (mean = 74.9 + 45.5 ng/ml). Sixty minutes after dye installation, patients with dry eye disease had on average a four fold increase in corneal tissue fluorescein concentration (mean = 140.8 + 42.0 ng/ml) compared with that of controls (mean = 41.8 + 12.6 ng/ml). Further statistical analysis of the data will be presented and correlation with clinical tests will be discussed. Conclusion: Patients with dry eye disease showed an increased corneal permeability and a slower rate of elimination from the cornea to topically administered fluorescein, suggesting fluorophotometry may be a quantitative and objective tool for the diagnosis of dry eye disease and helpful in evualuating new.
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