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Tae-im Kim, Si Yoon Park, Ji Won Jung, Kyoung Yul Seo, Hun Lee, Yong woo Ji, Eung Kweon Kim; Evaluation of factors affecting the tear-film lipid layer thickness. Invest. Ophthalmol. Vis. Sci. 2016;57(12):5674. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To determine the effects of age, sex, history of ocular surgery and contact lens use, and ocular surface and meibomian gland parameters on the lipid layer thickness (LLT) in normal subjects and patients with dry eye syndrome.
Cross-sectional, observational case series.Patients with dry eye syndrome and subjects with a healthy ocular surface were enrolled. All participants underwent LLT measurement with a LipiView interferometer, tear meniscus height measurement using optical coherence tomography, tear film break-up time (TBUT) determination, corneal and conjunctival staining, Schirmer's test, examination of the lid margins and meibomian glands, and assessment using the Ocular Surface Disease Index (OSDI) questionnaire. Univariate and multivariate linear regression analyses were performed to assess the impact of clinical variables, including age, sex, history of refractive surgery, cataract surgery, contact lens use, and ocular surface and meibomian gland parameters, on the LLT in normal subjects and patients with dry eye syndrome.
A total of 96 eyes of 96 normal subjects and 326 eyes of 326 patients with dry eye syndrome were enrolled.In normal subjects, the median (range) LLT was 65 (33-100), and age (β = 0.691, P = 0.042) was the only factor that was significantly associated with the LLT. In patients with dry eye syndrome, 79.14% of the participants fulfilled the diagnostic criteria for meibomian gland dysfunction (MGD). MGD was classified as obstructive (79.07%) or hypersecretory (20.93%), and the median (range) LLT was 84 (20-100) interferometric color units (ICU). In a multivariate analysis, increased age and female sex were significantly related to increased LLT (β =0.298, P = 0.001 for age and β = 11.330, P ≤ 0.001 for female sex), and hypersecretory MGD and lid margin inflammation were independently associated with increased LLT (β = 11.296, P = 0.001 and β = 9.808, P =0.004, respectively).
LLT measurements using a new interferometer are significantly affected by demographic factors such as age, sex, ocular surgical history, and MGD type. Therefore, all of these factors must be considered in the diagnosis of ocular surface diseases, including dry eye syndrome.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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