Lower Tear Meniscus Measurements Using a New Anterior Segment Swept-Source Optical Coherence Tomography and Agreement With Fourier-Domain Optical Coherence Tomography

Arriola‐Villalobos, Pedro; Fernández‐Vigo, José Ignacio; Díaz-Valle, D.; Almendral-Gómez, Jaime; Fernández-Pérez, Cristina; Benítez-del-Castillo, J.M.

doi:10.1097/ico.0000000000001086

Cited by 19 publications

(16 citation statements)

References 22 publications

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“…The mean 6 SD value of TMH obtained with DR-1a in healthy subjects was 245.57 6 61.33 lm, which corresponds well with previous measurements obtained by OCT or with the Keratograph 5M instrument. 10,15,[27][28][29][30][31][32] One of the most common methods for TMH measurement currently applied is fluorescein staining of the meniscus, but this is an invasive approach and shows high interobserver variability. 4 An eyepiece scale for measurement of TMH has also been developed, 8 but again such measurements show not insubstantial variation among examiners, possibly because the scale is not fine enough for precise measurements.…”

Section: Discussionmentioning

confidence: 99%

Automated Measurement of Tear Meniscus Height with the Kowa DR-1α Tear Interferometer in Both Healthy Subjects and Dry Eye Patients

Arita

Yabusaki

Hirono

et al. 2019

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. To develop and assess a method for quantitation of lower tear meniscus height (TMH) with the Kowa DR-1a tear interferometer. METHODS. Sixty-nine eyes of 49 men and 20 women (36 healthy volunteers, 33 patients with aqueous-deficient dry eye [ADDE]; mean age 6 SD, 50.0 6 14.0 years) were enrolled. TMH of each subject was measured by two observers both with DR-1a and newly developed software and with anterior-segment swept-source optical coherence tomography (SS-OCT). Intraoperator repeatability and interoperator and intersession reproducibility of measurements were assessed based on the within-subject SD (Sw), coefficient of variation (CV), and intraclass correlation coefficient (ICC). Agreement between the two devices was assessed by regression and Bland-Altman analysis. RESULTS. The CV for system repeatability of DR-1a was <2.0%. The CV for intraoperator repeatability and interoperator and intersession reproducibility for DR-1a measurements was 9.6%, 4.5%, and 4.4% in healthy subjects, respectively, and 16.8%, 9.8%, and 10.3% in ADDE patients. All corresponding ICC values were ‡0.87 in healthy subjects and ‡0.48 in ADDE patients. Bland-Altman plots indicated a high level of agreement between the two devices. Schirmer test value was significantly correlated with interferometric TMH in both healthy subjects (b ¼ 0.59, P < 0.001) and ADDE patients (b ¼ 0.47, P ¼ 0.017). CONCLUSIONS. Tear interferometry allows measurement of TMH as reliably as does SS-OCT. DR-1a may inform not only the diagnosis of dry eye disease but also identification of disease subtype.

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Section: Discussionmentioning

confidence: 99%

Automated Measurement of Tear Meniscus Height with the Kowa DR-1α Tear Interferometer in Both Healthy Subjects and Dry Eye Patients

Arita

Yabusaki

Hirono

et al. 2019

Invest. Ophthalmol. Vis. Sci.

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“…97,110–120 Some studies suggest there is good repeatability and reproducibility of TMH measurements in DED and normals. 101,114,115,118,120–122 However, TMH taken with different machines may not be comparable. 111,115,121 …”

Section: Point Of Care Biomarkersmentioning

confidence: 99%

“…101,114,115,118,120–122 However, TMH taken with different machines may not be comparable. 111,115,121 …”

Section: Point Of Care Biomarkersmentioning

confidence: 99%

The Growing Need for Validated Biomarkers and Endpoints for Dry Eye Clinical Research

Roy

Wei

Kuklinski

et al. 2017

Invest. Ophthalmol. Vis. Sci.

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PurposeBiomarkers with minimally invasive and reproducible objective metrics provide the key to future paradigm shifts in understanding of the underlying causes of dry eye disease (DED) and approaches to treatment of DED. We review biomarkers and their validity in providing objective metrics for DED clinical research and patient care.MethodsThe English-language literature in PubMed primarily over the last decade was surveyed for studies related to identification of biomarkers of DED: (1) inflammation, (2) point-of-care, (3) ocular imaging, and (4) genetics. Relevant studies in each group were individually evaluated for (1) methodological and analytical details, (2) data and concordance with other similar studies, and (3) potential to serve as validated biomarkers with objective metrics.ResultsSignificant work has been done to identify biomarkers for DED clinical trials and for patient care. Interstudy variation among studies dealing with the same biomarker type was high. This could be attributed to biologic variations and/or differences in processing, and data analysis. Correlation with other signs and symptoms of DED was not always clear or present.ConclusionsMany of the biomarkers reviewed show the potential to serve as validated and objective metrics for clinical research and patient care in DED. Interstudy variation for a given biomarker emphasizes the need for detailed reporting of study methodology, including information on subject characteristics, quality control, processing, and analysis methods to optimize development of nonsubjective metrics. Biomarker development offers a rich opportunity to significantly move forward clinical research and patient care in DED.OverviewDED is an unmet medical need — a chronic pain syndrome associated with variable vision that affects quality of life, is common with advancing age, interferes with the comfortable use of contact lenses, and can diminish results of eye surgeries, such as cataract extraction, LASIK, and glaucoma procedures. It is a worldwide medical challenge with a prevalence rate ranging from 8% to 50%. Many clinicians and researchers across the globe are searching for better answers to understand the mechanisms related to the development and chronicity of DED. Though there have been many clinical trials for DED, few new treatments have emerged over the last decade. Biomarkers may provide the needed breakthrough to propel our understanding of DED to the next level and the potential to realize our goal of truly personalized medicine based on scientific evidence. Clinical trials and research on DED have suffered from the lack of validated biomarkers and less than objective and reproducible endpoints. Current work on biomarkers has provided the groundwork to move forward. This review highlights primarily ocular biomarkers that have been investigated for use in DED, discusses the methodologic outcomes in providing objective metrics for clinical research, and suggests recommendations for further work.

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“…), as well as evaluated by the anterior segment OCT (Arriola‐Villalobos et al. ), which has been verified to be the most accurate and could be a valid protocol for DED screening purposes (Pena‐Verdeal et al. ).…”

Section: Discussionmentioning

confidence: 99%

“…) and anterior segment OCT (Arriola‐Villalobos et al. ). The merits and demerits of the methods above vary, with the slit lamp being the most widely used method of TMH evaluation in routine ocular assessments and ImageJ software commonly applied to measure TMH in photographs capture from slit lamps (Pena‐Verdeal et al.…”

Section: Introductionmentioning

confidence: 99%

TMIS: a new image‐based software application for the measurement of tear meniscus height

Yang

Zhu

Liu

et al. 2019

Acta Ophthalmologica

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Purpose To present a new automated image recognition software for the measurement of tear meniscus height (TMH) and investigate its correlation and efficacy compared with an open‐source software (NIH ImageJ) and manual evaluation. Methods A total of 520 slit lamp photographs, among which 276 were in ×16 magnification and 244 were ×40 magnified, captured from 138 eyes of 69 healthy subjects were assessed for TMH by the new automated Tear Meniscus Identification Software (TMIS), ImageJ and human graders. Images processing of TMIS included filtration, recognition and measurement of slit lamp photographs under certain algorithm, which output two measurement patterns, TMISMax and TMISMean. TMH measured by ImageJ software, considered as the reference value, was conducted by a masked observer while four masked ophthalmologists performed the manual evaluation. Results In both magnifications, TMH measured by TMISMean showed similar values with ImageJ while manual evaluation demonstrated underestimated results, and a strong correlation was detected between TMIS and ImageJ. In ×16 magnified photographs, manually obtained TMH revealed a higher correlation with ImageJ, whereas a notably stronger correlation of TMIS with ImageJ was observed in ×40 photographs. Correspondingly, the accuracy for both TMISMax and TMISMean appeared to be lower than most doctors in ×16 slit lamp images, in contrast to a better precision of TMISMean in ×40 ones. Conclusion The new software displayed high accuracy and efficacy in ×40 magnification and TMISMean pattern, suggesting the possibility of this automated TMH measurement platform to be a valid tool in dry eye screening and follow‐up practice.

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Lower Tear Meniscus Measurements Using a New Anterior Segment Swept-Source Optical Coherence Tomography and Agreement With Fourier-Domain Optical Coherence Tomography

Abstract: SS-OCT LTMH measurements showed excellent interobserver and intersession repeatability along with good intraobserver reproducibility. Agreement between the devices was poor.

Cited by 19 publications

References 22 publications

Automated Measurement of Tear Meniscus Height with the Kowa DR-1α Tear Interferometer in Both Healthy Subjects and Dry Eye Patients

Automated Measurement of Tear Meniscus Height with the Kowa DR-1α Tear Interferometer in Both Healthy Subjects and Dry Eye Patients

The Growing Need for Validated Biomarkers and Endpoints for Dry Eye Clinical Research

TMIS: a new image‐based software application for the measurement of tear meniscus height

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