A decrease of the Tear Meniscus Height (TMH) has been proposed as a useful indicator for Aqueous Deficient Dry Eye (ADDE) categorization. The present study aimed to calculate a TMH cut-off criterion for the categorization or severity assessment of ADDE with the Tearscope. 200 participants with a previous Dry Eye Disease (DED) diagnosis according to TFOS DEWS-II criteria were recruited. TMH by slit-lamp illumination and Lipid Layer Pattern (LLP) with Tearscope were assessed to categorise the participants into the ADDE or the Evaporative Dry Eye (EDE) group. The ADDE group was also subdivided into Mild-moderate ADDE and Moderate-severe ADDE based on TMH with slit-lamp. Additionally, the TMH was measured by Tearscope (TMH-Tc). Receiver Operating Characteristics showed that the TMH-Tc have a diagnostic capability to differentiate between ADDE and EDE participants, and between Mild-moderate or Moderate-severe ADDE, with a cut-off value of 0.159 mm (AUC = 0.843 ± 0.035, p < 0.001; sensitivity: 86.4%; specificity: 75.4%) and 0.105 mm (AUC = 0.953 ± 0.025, p < 0.001; sensitivity: 98.1%; specificity: 80.0%), respectively. The present study proposed a cut-off criterion to differentiate between ADDE and EDE participants, or between ADDE severities through TMH assessed by Tearscope.
Clinical relevance: Variation with time in the tear film parameters should be considered by the clinician, since the time when measurements are made can influence in a proper diagnosis. Background: A hallmark of dry eye is an unstable tear film associated with variability in objective daily measures. The purpose of the present study was to evaluate the inter-week repeatability of meibometry, Break-up Time (BUT) and Maximum Blink Interval (MBI) in healthy subjects. Methods: Forty healthy subjects were recruited for the study. Meibometry, BUT and MBI were performed two times in two sessions one-week apart. Meibum from the lower eyelid was collected and quantified with the Meibometer® MB550. Five meibomian curves were generated by tape and each peak value was averaged as a mean value per session. BUT and MBI were performed after fluorescein instillation three times recorded by a DV-3 camera attached to the slit-lamp. BUT and MBI videos were analysed by a second masked observer who quantified their values in frames. Both BUT and MBI values were calculated by averaging only the two most similar measurements of the three evaluated. Results: No statistical difference between inter-week sessions was obtained for the meibometry (p >0.340; Wilcoxon test), BUT (p >0.326; Wilcoxon test) and MBI values (p ≥0.248; Wilcoxon test). Inter-week differences were low for BUT and MBI when times analysed were no longer than 15 seconds (both p ≥0.586; Wilcoxon test). There was found a correlation between BUT and MBI (r ≥0.668, p <0.001; Spearman Rho), while a no statistical correlation was obtained between Meibometry results and BUT or MBI (all p ≥0.194; Spearman Rho).
Conclusion:The present study showed that meibum secretion and the tear film stability present good intersession repeatability, and are stable along with sessions in healthy patients.
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