Abstract
Purpose :
To evaluate if there is a difference in the geographical pattern of non-invasive tear film rupture in healthy patient’s vs with evaporative dry eye (DED).
Methods :
Retrospective, cross-sectional and observational study. Patients with evaporative dry eye and healthy individuals who had dry eye assessments included Ocular Surface Disease Index questionnaire, meibum expressibility, lid margin abnormality, ocular staining, non-invasive tear film break-up time, and meibography were included.
Healthy patients were defined as OSDI<13, NIKBUT>10 seconds, and no ocular staining. Patients with DED were included according to the criteria of the International Workshop on MG Dysfunction (OSDI score>12 points, NIKBUT<10 seconds, degrees of expressibility 1 to 3, and liquid secretion score MGYLS>3).
The NIKBUT was calculated using the Antares topographer according to the manufacturer's protocols. The topographic definition of the tear film rupture was carried out by dividing the 12 rings projected into 6 central and 6 peripherals. In addition, for the definition of the lower and upper quadrants, and line was drawn from 1 to 180 grades of the tear rupture map, as well as from 90 to 270 grades for the identification of the nasal, and temporal quadrant. The evaluation was made by two independent observers.
Results :
Seventy-two eyes of 72 patients were studied, with an average age of 34.94 ± 25.07 (range 18 to 77), 51.4% of the male sex, 36 with DED, and 36 healthy patients. 100% of the patients with DED had some rupture vs 50% of the healthy patients. We found that the initial rupture of the tear film in the lower temporal quadrant is more frequent in patients with DED compared to healthy patients. (22 vs 9, p=0.003), with an OR of 4.17 (95% CI 1.75,13.15). In addition, there was a difference in the initial NIKBUT (13.83±3.84 and 5.43 ± 2.13, p = 0.003), age, (40.44 ± 16.89 vs 29.42± 13.13 years, p= 0.003), thickness of the tear film (67.08 ± 18.80 vs 82.92 ± 31.97 microns, p=0.005), loss of meibomian glands in the upper eyelid (21.89±9.17 vs 16.43±6.33%, p=0.005) and lid margin abnormality (1.77±0.86 vs 1.00±0.75, p=0.0003) between the patients with DED and the healthy ones respectively
Conclusions :
In our population, the tear film ruptured more frequently in the lower temporal quadrant in patients with evaporative dry eye than in healthy patients.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.