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Laura Elizabeth Downie, Ji-hyun Lee, Eve Makrai, Amarin McDonnell, Leslie Yeo; A novel approach to identifying dry eye disease using acoustically-driven microfluidic extensional rheometry. Invest. Ophthalmol. Vis. Sci. 2019;60(9):4189.
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© ARVO (1962-2015); The Authors (2016-present)
A major barrier to people with dry eye disease (DED) receiving optimal clinical care is the challenge in reliably diagnosing and assessing the severity of the condition. We investigated a novel approach, involving quantification of tear effective extensional viscosity, using acoustically-driven microfluidic extensional rheometry for identifying DED, relative to current standards of assessment.
This prospective, cross-sectional study involved 103 participants (n=43 with healthy tears (controls) and n=60 with DED). DED was diagnosed using the currently-accepted consensus Tear Film and Ocular surface Society (TFOS) International Dry Eye WorkShop II (DEWS II) criteria. A composite severity score (from 0.0 to 4.0) was derived based upon a comprehensive anterior eye assessment, including quantification of dry eye symptoms (Ocular Surface Disease Index (OSDI) score), tear osmolarity, corneal sodium fluorescein and conjunctival lissamine green staining (Oxford scale), meibomian gland integrity, non-invasive tear break-up time and Schirmer test score. Basal tear samples (2 µl/eye) were non-invasively collected and tear effective extensional viscosity was quantified by a separate masked examiner. Following data normality testing, inter-group comparisons were analyzed using a student’s t-test. Correlations were determined using Pearson’s correlation coefficient (r).
Control and DED participants had similar age and sex distributions (p>0.05). Tears from eyes with DED had significantly (p<0.0001) lower effective extensional viscosity (mean ± SEM: 0.007 ± 0.0003 Pa.s) than healthy tears (0.01 ± 0.001 Pa.s). Tear extensional viscosity was negatively correlated with DED severity (r=-0.46, p<0.0001), indicating that a lower effective extensional viscosity is associated with more severe DED. There was a moderate positive correlation between effective tear film extensional viscosity and non-invasive tear break-up time (r=0.32, p=0.001).
Tear effective extensional viscosity is compromised in DED. More severe DED, based upon clinical classification, is associated with a greater reduction in tear extensional viscosity. These findings support the utility of this novel parameter as a means for identifying and stratifying DED.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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