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Yinxi Yu, Ellie Schmucker, Maureen G. Maguire, John E Sutphin, Penny A Asbell; Correlation of clinical and keratographic assessments of tear stability and tear production at baseline in the DRy Eye Assessment and Management (DREAM©) Study. Invest. Ophthalmol. Vis. Sci. 2018;59(9):3785. doi: https://doi.org/.
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Tear production and tear film stability are two key signs for dry eye assessment. Keratography enables non-invasive evaluation of the tears by measuring tear meniscus height (TMH) and tear break up time (NIKBUT). The purpose of this study was to examine the correlation between results from Schirmer’s test and TMH and between TBUT and NIKBUT at baseline among participants in the DREAM© study, a clinical trial to evaluate the effectiveness of omega-3 fatty acid supplements for the treatment of dry eye.
After instillation of fluorescein, three separate TBUTs were measured by stopwatch and their average was used for the analysis. The Schirmer’s test with anesthesia was performed after TBUT measurement. TMH and NIKBUT were evaluated in centers that had the Oculus Keratograph. TMH measured at the 6 o’clock position was used for the analysis. The Spearman correlation coefficients (ρ) between Schirmer’s test and TMH and between TBUT and NIKBUT were evaluated. 95% confidence intervals (95% CI) for ρ were calculated using a bootstrap procedure to account for the inter-eye correlation.
There were 292 participants (584 eyes) with a TBUT, NIKBUT, TMH and Schirmer’s test results available. The mean (± standard deviation [SD]) age was 56.7 ± 13.8, 78.4% were female, and the mean ± SD score on the Ocular Surface Disease Index was 44.3 ± 14.0. The mean ± SD TBUT was 2.9 ± 1.5 seconds and NIKBUT was 8.2 ± 5.7 seconds; their correlation was weak (ρ=0.18, 95% CI= (0.09, 0.28), Figure 1). The mean ± SD was 10.5 ± 7.6mm for Schirmer’s test, 0.3 ± 0.2mm for TMH at 6 o’clock; their correlation was weak (ρ=0.15, 95% CI= (0.04, 0.25), Figure 2).
In the DREAM© Study at baseline, NIKBUT and TMH, measured by keratography were weakly correlated with their traditional clinical counterparts. And the correlation of changes over time in these measures will be assessed when longitudinal data from DREAM© becomes available.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
Figure 1 Scatterplot of NIKBUT vs. TBUT
Figure 2 Scatterplot of TMH vs. Schirmer’s test
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