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Hiroaki Kato, Norihiko Yokoi, Aoi Komuro, Yukiko Sonomura, Yuichi Uchino, Miki Uchino, Dogru Murat, Motoko Kawashima, Kazuo Tsubota, Shigeru Kinoshita; The Relationship between Ocular Surface Epithelial Damage and Tear Abnormalities: Osaka Study. Invest. Ophthalmol. Vis. Sci. 2013;54(15):939.
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© ARVO (1962-2015); The Authors (2016-present)
In the pathophysiology of dry eye, tear abnormalities result in epithelial damage of the cornea and conjunctiva. The purpose of this present study was to investigate the relationship between ocular surface epithelial damage and tear abnormalities.
This study involved 279 eyes of 173 subjects (132 eyes of 72 males, 147 eyes of 101 females, mean age: 49 years) from normal subjects and dry eye patients. In all eyes, tear meniscus radius (TMR, mm), spread grade of the tear film lipid layer (SG, 1-4: 1 being the best), non-invasive breakup time (NIBUT, seconds), fluorescein breakup time (FBUT, seconds) and ocular surface epithelial damage (OSED) score (cornea: 15 points maximum, conjunctiva: 6 points maximum), Schirmer 1 test (ST1, mm) were measured, and the factors determining OSED score were investigated by multiple regression analysis in which the parameters were chosen using the stepwise procedure.
The corneal OSED score was found to be determined by TMR, SG, and FBUT, and was described as: -0.363 - (3.997 x TMR) - (3.284 x SG) - (0.189 x FBUT) (R2=0.54, p<0.0001). The conjunctival OSED score was found to be determined by TMR, SG, and ST1, and was described as: 0.834 - (2.933 x TMR) + (1.320 x SG) - (0.025 x ST1) (R2=0.41, p<0.0001).
The findings of this study show that TMR and SG, factors related to aqueous tear volume and aqueous tear film thickness, respectively, were significantly related to both corneal and conjunctival epithelial damage, while FBUT, a factor related to tear film stability, was significantly related to the corneal OSED score and ST1, a factor related to lacrimal gland function, was related to the conjunctival OSED score.
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