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M. C. Bujak, D. Huang, S. R. Sadda, Y. Li, P. Nguyen, R. K. Pappuru, S. Yiu; Serial Measurement of Tear Meniscus by Fourier-Domain Optical Coherence Tomography After Instillation of Artificial Tears in Patients With Dry Eyes. Invest. Ophthalmol. Vis. Sci. 2010;51(13):3374.
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To use Fourier-Domain Optical Coherence Tomography to study the longitudinal effect of instillation of artificial tears on tear meniscus volume in patients with dry eyes.
Four patients with significant dry eyes were recruited in a consecutive manner from a tertiary cornea practice. The lower tear meniscus of the right eye in each subject was imaged by vertical scans centered on the inferior cornea and the lower eyelid using a Fourier-domain optical coherence tomography system (RTVue; Optovue, Inc., Fremont, CA) with a corneal adaptor. Two baseline measurements were taken for each subject prior to administration of a drop of artificial tears (Optive). Five serial pairs of measurements were then taken after the instillation of artificial tears at 1 minute, 2 minutes, 5 minutes, 10 minutes, and 15 minutes. Each measurement was taken two seconds after a blink. The lower meniscus height, depth, and angle were measured with a computer caliper. The cross-sectional area was calculated using a two-triangle approximation.
The baseline tear measurements were 317 µm, 512.5 µm, 0.0695 mm2 for meniscus height, depth, and area respectively. At 1 minute after instillation of artificial tears the measurements increased by 212%, 488%, 2212%. The time to depletion of half of the gains in tear meniscus were 2.75 minutes, 4.75 minutes, and 2 minutes for height, depth, area respectively. The time to depletion of 75% of the tear meniscus gains was 3.5 minutes, 5.5 minutes, and 5.5 minutes.
Optical coherence tomography is able to quantify the increase in lower tear meniscus after installation of artificial tears in patients with dry eyes. This increase is transient, with a 50% reduction of both height and area within 3 minutes of drop instillation and a 75% reduction in all parameters by 6 minutes. Optical coherence tomography may serve as an invaluable tool in objectively quantifying the efficacy of dry eye treatments.
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