Optical Coherence Tomography Reveals Changes to Corneal Reflectivity and Thickness in Individuals with Tear Hyperosmolarity

Deinema, Laura Adelaide; Vingrys, Algis J.; Chinnery, Holly R.; Downie, Laura E

doi:10.1167/tvst.6.3.6

Cited by 13 publications

(7 citation statements)

References 46 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Tear film-corner interface reflectivity has been shown to be higher in eyes with hyperosmolar tears compared to control eyes. 29 Other studies involving dry eye and OCT have shown that there is a positive correlation between tear film measurements from OCT and the Schirmer's test, as well as, showing high reproducibility of tear film measurements using OCT. 30 , 31 …”

Section: Discussionmentioning

confidence: 91%

Comparison of Autonomous AS-OCT Deep Learning Algorithm and Clinical Dry Eye Tests in Diagnosis of Dry Eye Disease

Chase¹,

Elsawy²,

Eleiwa³

et al. 2021

OPTH

View full text Add to dashboard Cite

Objective To evaluate a deep learning-based method to autonomously detect dry eye disease (DED) in anterior segment optical coherence tomography (AS-OCT) images compared to common clinical dry eye tests. Methods In this study, 27,180 AS-OCT images were prospectively collected from 151 eyes of 91 patients. Images were used to train and test the deep learning model. Masked cornea specialist ophthalmologist diagnoses were used as the gold standard. Clinical dry eye tests were performed on patients in the DED group to compare the results of the model. The dry eye tests performed were tear break-up time (TBUT), Schirmer's test, corneal staining, conjunctival staining, and Ocular Surface Disease Index (OSDI). Results Our deep learning model achieved an accuracy of 84.62%, sensitivity of 86.36%, and specificity of 82.35% in the diagnosis of DED. The positive likelihood ratio was 4.89, and the negative likelihood ratio was 0.17. The mean DED probability score was 0.81 ± 0.23 in the DED group and 0.20 ± 0.27 in the healthy group (P < 0.01). The deep learning model accuracy in the diagnosis of DED was significantly better than that of corneal staining, conjunctival staining, and Schirmer's test (P < 0.05). There was no significant difference between the deep learning diagnostic accuracy and that of the OSDI and TBUT. Conclusion Based on preliminary results, reliable autonomous diagnosis of DED with our deep learning model was achieved, when compared with standard dry eye clinical tests that correlated significantly more or similarly to diagnoses made by cornea specialist ophthalmologists.

show abstract

Section: Discussionmentioning

confidence: 91%

Comparison of Autonomous AS-OCT Deep Learning Algorithm and Clinical Dry Eye Tests in Diagnosis of Dry Eye Disease

Chase¹,

Elsawy²,

Eleiwa³

et al. 2021

OPTH

View full text Add to dashboard Cite

show abstract

“…25 Another study of symptomatic, hyperosmolar patients (327.6 ± 2.8 mOsm/L, 34.6 ± 2.1 OSDI, 0.51 ± 0.1 staining, 8.1 ± 0.8 TBUT, 11.8 ± 1.5 Schirmers) found significantly lower corneal stromal reflectivity as measured by OCT in hyperosmolar eyes relative to controls (p < 0.05) and significantly thinner central corneal thickness in the upper quartile of hyperosmolar eyes (539.1 ±7.4 µm than in control eyes (583.1 ±15.0 µm, P = 0.02) or in the lower quartile of hyperosmolar subjects (622.7 ± 5.8 µm, P < 0.0001). 47 In the absence of other observable signs of dry eye disease, hyperosmolarity is, by itself, predictive of surgical complications and altered corneal phenotypes.…”

Section: Discussionmentioning

confidence: 99%

Impact of Clinician Subjectivity on the Assessment of Dry Eye Disease Prevalence in a UK Public Health Care Patient Population

Sullivan,

Smith,

Gupta

et al. 2024

OPTH

View full text Add to dashboard Cite

Purpose To understand the impact of subjectivity on diagnosis rates of dry eye disease (DED) in an unbiased population. Patients and Methods A multicenter study enrolled 818 subjects with complete report forms (465 females, 67.1 ± 16.7 years, 353 males, 65.0 ± 15.9 years). Subjects were evaluated for staining, TBUT, tear osmolarity, meibomian gland disease, and OSDI. Results Physicians diagnosed 48.7% of subjects as having DED, ranging from 42.9% to 62.3% between sites. Positivity rates for staining (≥ grade 1) ranged from 41.3% to 84.1% (mean = 0.8 ± 0.9 grade), TBUT (<10s) ranged from 39.1% to 61.6% (mean = 10.4 ± 6.6 seconds), osmolarity (>308 mOsm/L) ranged from 63.7% to 72.4% (mean = 319.7 ± 20.8), MGD grading ranged from 28.9% to 51.3% (mean = 0.5 ± 0.7), and symptoms measured by OSDI ranged from 57.6% to 71.0% (mean = 23.5 ± 20.5) between sites. Tear osmolarity was the most consistent between sites (max/min positivity = 114%), followed by OSDI (123%), TBUT (158%), MGD (178%), and staining (204%). DED markers were uncorrelated (average r 2 = 0.05 ± 0.07). A substantial number of subjects (N = 110) exhibited positive symptoms (OSDI = 32.4 ± 15.7) and hyperosmolarity (338.1 ± 20.1 mOsm/L) but no other obvious signs of DED (MGD grade = 0.2 ± 0.4, TBUT = 13.5 ± 7.0 seconds, staining grade = 0.4 ± 0.5). Conclusion Subjective signs of DED varied considerably, whereas objective measurements of OSDI and osmolarity were the most consistent between sites. A large proportion of subjects exhibited high symptoms and hyperosmolarity but no other obvious signs of dry eye disease, most of whom were undiagnosed by clinical assessment without access to the osmolarity measurement.

show abstract

“…In humans, dry eye disease is associated with reduced corneal thickness . This relationship between corneal thickness and dry eye disease has been confirmed in dry eye patients with elevated tear osmolarity, with a negative linear relationship existing between central corneal thickness, as measured by Fourier‐domain OCT, and tear osmolarity greater than 316 mOsmol/l . To date, these findings have not yet been replicated in animal models of dry eye disease, possibly owing to the subtle nature of the response.…”

Section: As‐oct Imaging In Animalsmentioning

confidence: 99%

Anterior segment optical coherence tomography: its application in clinical practice and experimental models of disease

Jiao

Hill

Downie

et al. 2019

Clinical and Experimental Optometry

View full text Add to dashboard Cite

Optical coherence tomography (OCT) provides non-invasive, high-resolution in vivo imaging of the ocular surface and anterior segment. Over the years, it has become an essential tool for evaluating the anterior segment of the eye to monitor ocular development and ocular pathologies in both the clinical and research fields of ophthalmology and optometry. In this review, the clinical applications relating to the use of anterior segment OCT for imaging and quantifying normal and pathological features of the ocular surface, cornea, anterior chamber, and aqueous outflow system are summarised in a range of human ocular diseases. Applications of anterior segment OCT technology that have improved imaging and quantitation of ocular inflammation in experimental animal models of ocular diseases, such as anterior uveitis, microbial keratitis and glaucoma, are also described. The capacity to longitudinally evaluate anterior segment anatomical changes during development, and inflammation facilitates the understanding of the dynamics of tissue responses, and further enhances the intra-operative in vivo imaging during procedures, such as corneal transplantation and drug delivery. Future developments including in vivo ultrahigh-resolution anterior segment OCT, automated analyses of anterior segment OCT images and functional extensions of the technique, may revolutionise the clinical evaluation of anterior segment, corneal and ocular surface diseases.

show abstract

Optical Coherence Tomography Reveals Changes to Corneal Reflectivity and Thickness in Individuals with Tear Hyperosmolarity

Cited by 13 publications

References 46 publications

Comparison of Autonomous AS-OCT Deep Learning Algorithm and Clinical Dry Eye Tests in Diagnosis of Dry Eye Disease

Comparison of Autonomous AS-OCT Deep Learning Algorithm and Clinical Dry Eye Tests in Diagnosis of Dry Eye Disease

Impact of Clinician Subjectivity on the Assessment of Dry Eye Disease Prevalence in a UK Public Health Care Patient Population

Anterior segment optical coherence tomography: its application in clinical practice and experimental models of disease

Contact Info

Product

Resources

About