Reliability and efficacy of maximum fluorescein tear break-up time in diagnosing dry eye disease

Abstract

This study aims to investigate the reliability and efficacy of maximum fluorescein tear break-up time (FTBUTmax) in diagnosing dry eye disease (DED). 147 participants were enrolled in this study. Ocular symptoms were assessed by Ocular Surface Disease Index (OSDI). The fluorescein tear break-up time (FTBUT) examination, corneal fluorescein staining (CFS), and Schirmer I test were performed on both eyes. Each participant underwent 3 consecutive FTBUT tests, and five types of FTBUT values including FTBUTmax, the minimum FTBUT (FTBUTmin), the first FTBUT (FTBUT1), the average of three FTBUTs (FTBUT123) and the average of the first and second FTBUT (FTBUT12) were recorded. FTBUTmax was larger than the other FTBUT values, but no differences were found among the values of FTBUT1, FTBUT123, FTBUT12 and FTBUTmin. In the ROC analysis, FTBUTmax had the largest or the second largest area under the ROC (AUROC) in all three DED diagnostic criteria, while FTBUTmin had the least AUROC of them. ROC efficacy of FTBUTmax was significantly higher than that of FTBUT123, FTBUT12, FTBUT1 and FTBUTmin in the OSDI criteria and higher than that of FTBUT1 and FTBUTmin in Schirmer I test and CFS tests. FTBUTmax has a close correlation with OSDI, Schirmer I test and CFS, and is an effective tool for the DED diagnosis.

Artificial intelligence to estimate the tear film breakup time and diagnose dry eye disease

“…First, in terms of the interobserver reliability of TFBUT, Mou et al reported that the reliability of the TFBUT in AUC was 0.695–0.792, and the correlation coefficient was 0.244–0.556 among the 147 DED and non-DED participants 37 . Moreover, Paugh et al demonstrated an AUC of 0.917, sensitivity of 0.870, and specificity of 0.810 using the same 2.0 μl of fluorescent solution in 174 cases 38 .…”

“…In terms of the interobserver reliability of TFBUT, Mou et al reported that the reliability of the TFBUT in AUC was 0.695-0.792, and the correlation coe cient was 0.244-0.556 among the 147 DED and non-DED participants. 37 41 These AI models are not DED diagnostic models and do not provide exact TFBUT estimation. However, these imaging methods applied a similar logic for diagnosis.…”

Effects of indoor low humidity on eye discomfort and associated physiological responses in soft contact lens and non-lens wearers

“…First, for interference imaging of the tear film, the subjects were instructed to keep their eyes open for up to 30 s until tear-film break-up occurred, following a natural blink. After a 30-s recovery, 51 they were asked to look directly at the video camera for 1 min to record the blink pattern. They were then instructed to keep their eyes open for 10 s to measure the ocular surface temperature.…”

Advances in Dry Eye Disease Examination Techniques

“…The average value provides a more reliable result ( 104 ). A recent study showed that the maximum TBUT may also be considered to diagnose dry eye ( 105 ). The sensitivity and specificity of the TBUT test are 72 and 61%, respectively.…”

“…The sensitivity and specificity of the TBUT test are 72 and 61%, respectively. The diagnostic criteria for fluorescein TBUT in diagnosing dry eye are <10 s ( 105 ). Generally, fluorescein TBUT values can be expected to be shorter than the values of noninvasive TBUT.…”