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Cynthia Tung, Andrew Perin, Koray Gumus, Stephen Pflugfelder; Correlation of Tear Meniscus Dimensions with Clinical Parameters of Ocular Surface Disease in Subgroups of Dry Eye. Invest. Ophthalmol. Vis. Sci. 2013;54(15):970.
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© ARVO (1962-2015); The Authors (2016-present)
Evaluate the relationship between tear meniscus dimensions and parameters of ocular surface disease in subcategories of dry eye.
Prospective analysis comparing tear meniscus dimensions to clinical ocular surface parameters was performed for 128 eyes from 64 subjects. Tear meniscus height (TMH) and tear meniscus area (TMA) were measured using optical coherence tomography (Optovue). Ocular surface parameters included tear break-up time (TBUT), corneal staining, conjunctival staining, and Ocular Surface Disease Index (OSDI). Study groups included meibomian gland dysfunction (MGD) (n=23; OSDI>20; TBUT<=7); aqueous tear deficient dry eye (ATDDE) (n=34; OSDI>20; TBUT<=7; Schirmer I<10); autoimmune disease (AD) including Sjogren's syndrome (n=16; OSDI>20; TBUT<=7; Schirmer I<10); and normal age-matched controls (n=34; OSDI<=20; TBUT>7; Schirmer I>=10). Statistical analysis was performed using Pearson's correlation and Student's t-test.
In comparing TMH with corneal staining, correlation was moderately negative for all comers (R=-0.34; p=0.013) and all dry eyes (R=-0.31; p=0.015), strongly positive for MGD eyes (R=+0.40; p=0.059), moderately negative for ATDDE eyes (R=-0.36; p=0.04), and weakly negative for AD eyes (R=-0.16; p>0.05). Comparison of TMA with corneal staining showed similar trends with strong correlation in MGD eyes (R=+0.55; p=0.006), in ATDDE eyes (R=-0.40; p=0.018), and in AD eyes (R=-0.43; p>0.05). In comparing TMH with TBUT, correlation was strongly positive for all comers (R=+0.41; p<0.0001) and all dry eyes (R=+0.42; p<0.0001), weakly negative for MGD eyes (R=-0.17; p>0.05), moderately positive for ATDDE eyes (R=+0.37; p=0.018), and very weakly positive for AD eyes (R=+0.044, p>0.05). Correlations of tear meniscus dimensions (TMH, TMA) to conjunctival staining and OSDI in any group were non-significant. Mean TMH was higher in age-matched controls (344 µm) compared to all dry eyes (234 µm; p=0.012), MGD eyes (302 µm; p>0.05), ATDDE eyes (210 µm; p=0.003), and AD eyes (172 µm; p<0.001).
In ATDDE and AD subjects, lower tear volume is associated with worse corneal epithelial disease. In MGD subjects, higher tear volume is associated with corneal epithelial disease, perhaps due to altered tear composition.
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