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R. W. Yee, J. Spindle, H. Sperling, A. Z. Chuang; A Scale for Confocal Tear Film Images Correlating With Clinical Tests for Dry Eye. Invest. Ophthalmol. Vis. Sci. 2008;49(13):5312. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
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.
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.
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.
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.
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