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E Goto, SC G Tseng; Kinetic Analysis of the Tear Interference Image for Dry Eye . Invest. Ophthalmol. Vis. Sci. 2002;43(13):3891.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: Previously, we have developed kinetic analysis of tear interference image to distinguish lipid tear deficiency (LTD) from the normal. We extended the same analysis to patients with aqueous tear deficiency (ATD) before and after punctal occlusion (PO). Methods: Using the instrument of DR-1 (Kowa, Tokyo, Japan), we captured sequential images of the tear interference pattern in the central 8 mm in diameter of the cornea during consecutive normal complete blinks. These kinetic data were then analyzed by an image analysis software. Using this technique, we compared 11 normal volunteers and 11 patients with ATD, and also compared the changes in 3 ATD patients before and after PO. Results: In normal subjects, we noted that the lipid film spread in a horizontally propagating pattern, and reached a stable image within 0.36 .22 sec. The thickness was thin and uniform and the subsequent images remained stable during the rest of the normal inter-blink time. In contrast, patients with ATD showed a retarded spread of the lipid film to 1.73 0.42 sec (p < 0.0001) resulting in a thicker lipid film with horizontal pattern on the inferior cornea, while the thickness of the lipid film on the remaining cornea was thinner than normal and distributed at times in a vertical streaking pattern (p = 0.0004). After PO, this abnormal image reverted to a pattern closer to the normal than ATD, with more horizontal pattern spreading to the central cornea, and the distribution being more even and the spread time shortened to 0.71 0.11 sec (p = 0.25). More patients following PO were being enrolled. Conclusion: Kinetic analysis of the tear interference image also helps distinguish the lipid film of ATD from those of LTD and normal with respect to the spread pattern, time, and stability. In ATD, such abnormalities could be reverted to some extent to a normal pattern after PO. This information may not only help diagnosis of ATD but also future development of an individually tailored therapy based on interaction of lipids with the mucin-containing aqueous tear fluid.
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