Efficacy of the Fluorescein Tear Breakup Time Test in Dry Eye

Paugh, Jerry R.; Tse, June; Nguyên, Toàn; Sasai, Alan; Chen, Elaine; Jesus, Melinda Thomas De; Kwan, Justin; Nguyen, Andrew; Farid, Marjan; Garg, Shuchita; Jester, James V.

doi:10.1097/ico.0000000000002148

Cited by 29 publications

(25 citation statements)

References 30 publications

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“…Although non-invasive TBUT (NIBUT) has been recommended for the measurement of TBUT [ 16 ], FBUT is still widely used in clinical practice due to its simplicity. A recent study confirmed that FBUT has valid diagnostic accuracy [ 17 ]. In addition, when FBUT is tested, simultaneous judgment of FBUPs can be performed.…”

Section: Introductionmentioning

confidence: 84%

Characteristics and Utility of Fluorescein Breakup Patterns among Dry Eyes in Clinic-Based Settings

et al. 2020

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(1) Background: To evaluate the characteristics of fluorescein breakup patterns (FBUPs) among patients with dry eye disease (DED) and efficacy of FBUPs as a diagnostic test for DED subgroups. (2) Methods: The study enrolled 449 patients with DED. FBUPs were categorized as follows: area break (AB), line break (LB), spot break (SB), dimple break (DB), and random break (RB). Schirmer value, fluorescein breakup time (FBUT), keratoconjunctival score, DED subgroups and subjective symptoms were examined. (3) Results: LB patients presented with short FBUT and high keratoconjunctival score. AB patients presented with short FBUT, high cornea and keratoconjunctival scores. SB patients were young with short FBUT. DB patients exhibited low keratoconjunctival score. RB patients were young, with long FBUT and low keratoconjunctival scores. Among DED subgroups, LB and AB constituted 74.7% of aqueous-deficiency dry eye (ADDE). SB and DB constituted 42.4% of short FBUT dry eye (short FBUT-DE). Post-test probabilities and positive likelihood ratios for ADDE were 58.7% and 1.63, respectively; those for short FBUT-DE were 46.3% and 2.02, respectively. Patients with SB and AB exhibited significantly severe subjective symptoms than other FBUPs. (4) Conclusions: FBUPs are associated with both objective findings and symptoms of DED and may be a clinical tool for identification of DED subgroups.

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Section: Introductionmentioning

confidence: 84%

Characteristics and Utility of Fluorescein Breakup Patterns among Dry Eyes in Clinic-Based Settings

et al. 2020

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“…However, it is susceptible to factors such as environment, filter paper and examinee, which can easily lead to false-positive or false-negative results of misdiagnosis and misjudgment. 6 At present, there are still some shortcomings in the diagnosis and treatment of dry eye syndrome in China, mainly manifested in the following aspects: (1) Diagnostic standards are not uniform. 15 (2) The treatment of dry eye is more confusing.…”

Section: Discussionmentioning

confidence: 99%

“…5 In recent years, there are various diagnostic methods for dry eye syndrome, but it is currently the focus of attention to seek a diagnostic method that has both high practical value and economical. 6…”

Section: Introductionmentioning

confidence: 99%

Discovery of microRNA expression profiles involved in regulating TGF-β2 expression in the tears of dry eye patients

Wang

Xie

et al. 2020

Ann Clin Biochem

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Background: To date, the difference in microRNA (miR) expression profiles in tears of dry eye patients and healthy people has not been reported. In current study, we evaluated the significance of miRs and transforming growth factor beta2 (TGF-β2) in distinguishing dry eye. Methods: 138 patients with dry eye from October 2017 to October 2018 were selected. During the same period, 138 healthy persons were collected. All patients were followed up for 12 months through outpatient, telephone or medical records, and the time of corneal injury was recorded. Results: Compared with healthy people, TGF-β2 levels in dry eye patients were significantly decreased (P<0.05). Array analysis, predictive software, and dual-luciferase reporter assays showed that miR-450b-5p, miR-1283, and miR-3671 can target TGF-β2 expression. Tear miR-450b-5p, miR-1283, and miR-3671 levels were significantly higher in dry eye patients than healthy people. A logistic regression model combining miR-450b-5p, miR-1283, miR-3671, and TGF-β2 was performed. This model presented a high discriminating value (AUC: 0.907, 0.876-0.939, P<0.001) than any single indicator, and the sensitivity and specificity were 77.7% and 92.7%, respectively. Compared with the low miR-450b-5p, low miR-1283, low miR-3671 and high TGF-β2 groups, the high miR-450b-5p, high miR-1283, high miR-3671 and low TGF-β2 groups had a significantly higher probability of corneal injury (TGF-β2: χ2=5.762, P=0.016; miR-450b-5p: χ2=13.267, P<0.001; miR-1283: χ2=19.431, P<0.001; miR-3671: χ2=8.131, P=0.004). Conclusion: Current model combining tear miR-450b-5p, miR-1283, miR-3671, and TGF-β2 had important values in the identification of dry eye and was of great value in evaluating the risk of corneal injury.

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“…The subject blinked naturally three times 2 and the mean of three measurements recorded. Subjects were considered to have dry eye disease if the mean TBUT was ≤6.0 seconds 7 or Level 2 severity.…”

Section: Methodsmentioning

confidence: 99%

Validation of the Modified Schein Dry Eye Symptom Questionnaire and Comparison With the Ocular Surface Disease Index

Paugh

Chen

Kwan

et al. 2022

Trans. Vis. Sci. Tech.

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Purpose This study evaluated the validity and diagnostic efficacy of a modified Schein dry eye questionnaire and compared it to the Ocular Surface Disease Index (OSDI). Methods The original Schein survey was modified to allow numerical scoring on a 0 to 24 scale and evaluated in prospective studies in normal and dry eye subjects. Receiver operating characteristic (ROC) analysis for test efficacy in aqueous deficient dry eye (ADDE) and evaporative dry eye (EDE) related to meibomian gland dysfunction was determined. Results Dry eye subtype, age and gender were statistically significant in explaining variation in modified Schein scores (n = 377; general linear model; all P values < 0.006) whereas for Ocular Surface Disease Index (OSDI) only age and gender were significant, but not dry eye subtype. The modified Schein ROC curve had an area under the curve (AUC) of 0.693 (95% confidence interval [CI], 0.635–0.753), with cutpoint of 7.5 (sensitivity of 0.75, specificity of 0.55). Similarly, the OSDI had an AUC of 0.685 (95% CI, 0.610–0.760), at a cutpoint of 10.4 (sensitivity of 0.75, specificity of 0.55). Modified Schein and OSDI correlated well (Pearson r = 0.81; P < 0.001). Symptom change for the modified Schein with artificial tear treatment was significant in EDE subjects (Dunnet's tests, P value < 0.001). Conclusions The modified Schein questionnaire is rapid to administer and score and compares well with the OSDI for test efficacy. Moreover, it differentiates normals from ADDE and EDE subtypes and is responsive to dry eye treatment. These attributes make the modified Schein survey an attractive dry eye symptom characterization instrument. Translational Relevance The modified Schein symptom survey, validated against clinical diagnosis and an existing survey, provides a new, efficacious diagnostic and treatment monitoring instrument in dry eye disease.

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Efficacy of the Fluorescein Tear Breakup Time Test in Dry Eye

Cited by 29 publications

References 30 publications

Characteristics and Utility of Fluorescein Breakup Patterns among Dry Eyes in Clinic-Based Settings

Characteristics and Utility of Fluorescein Breakup Patterns among Dry Eyes in Clinic-Based Settings

Discovery of microRNA expression profiles involved in regulating TGF-β2 expression in the tears of dry eye patients

Validation of the Modified Schein Dry Eye Symptom Questionnaire and Comparison With the Ocular Surface Disease Index

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