Abstract
Purpose: :
To determine if a noninvasive digital scanning slit confocal microscope with a 20x lens (Nidek Confoscan 4), can quantatively imaged and correlate with the tear film of patients with dry eye complaints using a newly developed standardize scale.
Methods: :
A noninvasive digital scanning slit confocal microscope with a 20x lens (Nidek Confoscan 4) imaged the tear film of patients with dry eye complaints. Additionally, standard clinical tests for dry eye: lissamine green staining, meibomian gland secretion quantity and quality, and the basal tear test were measured. A ten-point scale for grading the tear film images captured by the ConfoScan 4 was developed based on the quantitative results from the standard clinical tests.
Results: :
Fifty eight eyes of 29 patients, (21 females and 8 males), ranged in age from 13-84 years. A 1-10 scale was developed 1=normal and 10= abnormal based on the relative smoothness and uniformity of the images. 1. Increasing ocular surface damage as measured by the lissamine green staining total moderately correlates (R=0.314) with more abnormal tear film images as represented by a higher confocal image score. 2. Increasing quantity of tears produced in a five minute period as measured by the basal tear test shows a moderate correlation (R=0.356) to decreasing abnormalities of the tear film as represented by a lower confocal image score. 3. Worsening quality of the meibum as measured on our 3-point quality scale is strongly correlated (R=0.539) with increasing abnormalities of the tear film as represented by a higher confocal image score.
Conclusions: :
Correlation of the clinical dry eye tests and confocal images suggest that the non contact comfocal imaging techniques may be a valuable tool for the study of the ocular surface disease.
Keywords: cornea: tears/tear film/dry eye • cornea: clinical science • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound)