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T. Shimamoto, N. Yokoi, K. Maruyama, A. Komuro, M. Nishii, S. Kinoshita; Applicability of a New Tear Stability Analysis System for the Screening of Dry Eye. Invest. Ophthalmol. Vis. Sci. 2008;49(13):5316.
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The Tear Stability Analysis System (TSAS; Tomey Corporation, Nagoya, Japan) for evaluating time-dependent change of corneal topography has reportedly been applicable to assess tear film stability of cornea. Recently, a new program for the measurement of ring breakup time (RBUT) was incorporated into the system where time-dependent change of clarity for Meyer’s images from the cornea until 6 seconds while keeping the eye open can be assessed. In this study, we evaluate the relationship between TSAS-RBUT and the other parameters for the assessment of dry eye, as well as the possible applicability of TSAS-RBUT for dry eye screening.
Ninety eyes of 90 subjects were enrolled in this study. All eyes received examination by meniscometry [measurement of the radius of tear meniscus curvature (R) reflecting total tear volume at the ocular surface], TSAS-RBUT, fluorescein break-up time (FBUT), fluorescein staining score (FS, within 6mm of the central cornea), and the Schirmer I test. Eyes were divided into healthy non dry eyes [C (control) group], dry eye suspect eyes (DS group), and definite dry eyes (DD group), based on the 2006 Japanese dry eye diagnostic criteria.
Of the 90 eyes examined, 21, 24, and 45 eyes were classified into the C, DS, and DD groups, respectively, based on the aforementioned criteria. RBUTs had a good correlation with FBUT (R=0.450, p=0.000) and weak correlations with R (R=0.336, p=0.008), FS (R=-0.251, p=0.000), and the Schirmer I test (R=0.203, P=0.123). RBUTs in the DD group were significantly shorter than those in the DS group (P=0.019) and the C group (P=0.000). Sensitivity and specificity of TSAS-RBUT for the screening of dry eye with values of ≤5 seconds being abnormal were determined as 80% and 60%, respectively.
It was found that TSAS-RBUT can be a good indicator of tear film stability as well as tear volume and corneal surface damage. We expect it to become a useful parameter for the screening of dry eye.
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