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Yannick Nochez, Thomas Habay, David Bellicaud, Anne Favard, Pierre-Jean Pisella; Evaluation Of Tear Film Quality With A Double-Pass Scattering Index. Invest. Ophthalmol. Vis. Sci. 2011;52(14):3754.
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Persistent dryness, scratching and burning, foreign body sensation in eyes are signs of dry eye syndrome but are not completely correlated to biomicroscopic and clinical aspects. We need more precise dynamic tests to analyse drops efficiency, dry eye evolution, to prevent corneal or optical quality complications. The aim of this study was to compare clinical evaluation, break-up time analysis (BUT), biological evaluation (tear osmolarity), and aberrometric evaluation (Ocular Scattering Index) of the tear film.
This prospective study included 20 eyes: 10 eyes with normal BUT and 10 eyes with dry-eye syndrome. An Objective Scatter Index (OSI), estimated from the double pass images, quantifies scattering. We compared OSI as a function of time, between each blinking, during 10 and 20 seconds.
Patients with dry-eye syndrome have higher amounts of OSI compared to normal eyes (respectively OSI = 5,6 +/- 4 versus 1,2 +/- 2,3 with p<0,05). We analyse the slope of the line describing OSI evolution during 20 seconds. This slope coefficient is greater in patients with moderate dry-eye syndrome than in minimal dry eye (1,8 +/- 1,2 versus 0,4 +/- 0,5 with p<0,05). But, in severe clinical dry eye, slope coefficient decreased because of the number of blinking, first treatment of tear film instability.
This new objective method may quantify the blurry vision associated with dry-eye syndrome: greater variation of OSI, correlated with clinical or biological dry eye syndrome and greater number of blinking. This objective method may be useful to detect and follow-up tear-film related patient’s complaints particularly in moderate dry eye syndrome before corneal surface staining. At last, this dynamic analysis of the tear film could evaluate the effect of eye drops on tear-film quality and stability.
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