The Efficacy of Strip Meniscometry for Detection of Lacrimal Obstructive Diseases among Patients Complaining Epiphora

Abstract

Purpose : Strip meniscometry (SM) is a new technique for evaluation of tear-film volume using meniscometry strips designed to absorb the tear in meniscus without contacting conjunctiva. The aim of the present study is to evaluate the efficacy of SM for detection of lacrimal obstructive diseases (LOD) of the patients complaining epiphora.

Methods : Fifty-four patients with LOD and 89 patients without LOD, who visited Saitama Medical University with a complaint of epiphora from November 2017 to October 2018, were enrolled. The quantitative assessment of tear was performed in all patients by means of SM, tear meniscus height (TMH), tear meniscus area (TMA), and shirmer-1 test. We performed SM using SMTube^® (Echo Electricity Fukushima, Japan). TMH and TMA were measured in the optical coherence tomography (CASIA2^®, TOMEY, Nagoya, Japan) images.

Results :
The age of LOD group was 72.8±7.6 and non-LOD group was 72.9±7.5 years old. The SM values of LOD group (10.96±3.20mm) were significantly higher compared to non-LOD group (5.44±3.20mm). The TMH and TMA values of LOD group (0.53±0.25mm, 0.14±0.15mm²) were significantly higher than those of non-LOD group (0.30±0.18mm, 0.07±0.07mm²) but shirmer-1 values were not significantly different between LOD group (17.68±7.87mm) and non-LOD group (11.84±7.16mm). We calculated the area under the curve (AUC) for each parameter from the respective receiver operating characteristic curves, the AUC of SM values was 0.89 and the optimal cutoff value for SM was >10 mm, which yielded a sensitivity of 85% and specificity of 83%. Whereas, the AUC of shirmer-1, TMH, and TMA was 0.71, 0.81, and 0.78, sensitivity of the optimal cutoff value was 82%, 78%, and 73%, specificity of the optimal cutoff value was 56%, 67%, and 71%, respectively. The sensitivity and specificity of SM values were significantly higher than those of schirmer-1 (p < 0.001).

Conclusions : The present results showed that SM was useful to detect LODs with high sensitivity and specificity in the patients complaining epiphora.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.