Purchase this article with an account.
E. Uchiyama, J.D. Aronowicz, W. Shine, J.P. McCulley; Relationship Between Vital Staining and Tear Parameters in Patients With KCS . Invest. Ophthalmol. Vis. Sci. 2005;46(13):4476.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Purpose: To correlate the degree of vital staining (VS) with aqueous tear volume and dynamics in patients with apparent aqueous deficient dry eye, Keratoconjuntivitis Sicca (KCS). Methods: Twenty–two patients, 9 males and 13 females, mean age 60 years with a diagnosis of aqueous deficient dry eyes, i.e., KCS, based on clinical appearance including interpaprebral fissure vital staining with lissamine green (LG) and graded by van Bjisterveld scale were enrolled. LGS was graded two to four minutes after installation of the drop. Tear volume (TV), tear flow (TF), and tear turnover (TO) was determined using a Fluorotron fluorophotometer. Schirmer testing without anesthetic was done in a closed eye–setting. Aqueous tear evaporation was determined with a custom made evaporimeter. Meibomian gland dropout was determined by infrared meibography. Results: No patient in this study had only medial or temporal bulbar conjunctival or corneal staining alone. Patients had either medial and temporal bulbar staining alone (Group A) or in association with corneal staining (Group B). Group A vs Group B results were as follows: VS: 3.5 ± 1.38 vs. 6.38 ± 1.93, P < 0.001; TO: 0.12 ± 0.07 µl/min vs. 0.11 ± 0.03 µl/min, P = 0.998; TV: 1.66 ± 0.75 µl vs. 1.45 ± 1.05 µl, P = 0.517; TF: 0.18 ± 0.12 vs. 0.26 ± 0.22, P = 0.619; Schirmer : 18.13 ± 8.79 mm vs. 6 ± 5.8 mm, P < 0.001, EV: 6.08 ± 2.42 g/cm2/s (x10–7) vs. 4.33 ± 1.1 g/cm2/s (x10–7), P = 0.053; DO : 43.9 ± 20.94 % vs. 42.6 ± 30.80 %, P = 0.887 Conclusions: Patients with VS involving the cornea as well as medial and temporal bulbar conjunctiva had a statistically significant lower Schirmer’s value but only a trend toward decreased tear volume and turnover with a slight increase in tear flow. There was a slight decrease in tear evaporative rate with the apparently more severe dry eye condition. There was no difference in meibomian gland dropout. Degree of ocular surface staining correlates with severity of dry eye. Fluorophotometry, evaporometry, and meibography appear to be useful tests for clinical investigation.
This PDF is available to Subscribers Only