TFOS DEWS II Diagnostic Methodology report

Wolffsohn, James S.; Arita, Reiko; Chalmers, Robin L.; Djalilian, Ali R.; Doğru, Murat; Dumbleton, Kathy; Gupta, Preeya K.; Karpecki, Paul; Lazreg, Sihem; Pult, Heiko; Sullivan, Benjamin D.; Tomlinson, Alan; Tong, Louis; Villani, Edoardo; Yoon, Kyung Chul; Jones, Lyndon; Craig, Jennifer P.

doi:10.1016/j.jtos.2017.05.001

Cited by 1,478 publications

(2,076 citation statements)

References 523 publications

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“…Thus, while inter-instrument comparisons are likely to be difficult to interpret, data derived from a given instrument type appear reasonably reliable and offer quite good sensitivity and specificity in distinguishing dry-eyed individuals from normals (Table 1). Further details may be obtained from the Tear Film and Ocular Surface Society’s Dry Eye Workshop II (TFOS DEWS II) Diagnostic Methodology report [99]. …”

Section: Biophysical Measurements Of the Tear Filmmentioning

confidence: 99%

“…Sensitivity and specificity measurements of osmolarity for dry-eye diagnosis using a threshold of 294 mOsm/L were 67% and 46% respectively [143], 40% and 100% using a threshold of >310 mOsm/L and Sjögren syndrome patients [166]. For a more in-depth analysis of statistical measures of performance and potential selection bias of subjects included, please refer to the TFOS DEWS II Diagnostic Methodology report [99]. Future studies are required to establish consistent cut-off values for dry eye, which are ideally derived from a study population where osmolarity was not a diagnostic criterion and where the sensitivity and specificity are tested in an independent cohort.…”

Section: Biophysical Measurements Of the Tear Filmmentioning

confidence: 99%

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TFOS DEWS II Tear Film Report

et al. 2017

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The members of the Tear Film Subcommittee reviewed the role of the tear film in dry eye disease (DED). The Subcommittee reviewed biophysical and biochemical aspects of tears and how these change in DED. Clinically, DED is characterized by loss of tear volume, more rapid breakup of the tear film and increased evaporation of tears from the ocular surface. The tear film is composed of many substances including lipids, proteins, mucins and electrolytes. All of these contribute to the integrity of the tear film but exactly how they interact is still an area of active research. Tear film osmolarity increases in DED. Changes to other components such as proteins and mucins can be used as biomarkers for DED. The Subcommittee recommended areas for future research to advance our understanding of the tear film and how this changes with DED. The final report was written after review by all Subcommittee members and the entire TFOS DEWS II membership.

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Section: Biophysical Measurements Of the Tear Filmmentioning

confidence: 99%

Section: Biophysical Measurements Of the Tear Filmmentioning

confidence: 99%

TFOS DEWS II Tear Film Report

et al. 2017

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“…Baseline measures confirm all the patients would be diagnosed with dry eye disease according to the new TFOS DEWS II criteria (symptoms and tear film instability, hyperosmolarity or ocular surface staining) [27]. Tear film stability was generally above the cut off required for diagnosis, whereas tear volume as indicated by the TMH was low, suggesting the general cohort of patients' dry eye was more aqueous deficient than evaporative in nature.…”

Section: Discussionmentioning

confidence: 86%

Can the optimum artificial tear treatment for dry eye disease be predicted from presenting signs and symptoms?

Essa¹,

Laughton

Wolffsohn

2018

Contact Lens and Anterior Eye

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PurposeTo assess dry eye treatment with four preservative-free dry eye artificial tear treatments to facilitate evidence-based prescribing. Methods ResultsThe impact of each dry eye treatment on ocular signs and symptoms was similar, however OSDI (p=0.002), LIPCOF (p=0.014) and conjunctival staining (p<0.001) significantly improved from baseline. Clinitas Soothe and Hyabak were preferred by 34%/30% of participants, but only subjective comparison with the other drops influenced this choice. TheraTears was preferred (by 24%) by those with a lower baseline tear volume (p=0.01) and Tears Again (by 12%) by those with a thinner baseline lipid layer (p=0.04). The treatment that afforded the greatest improvement in clinical signs did not consistently match each individual's preferred treatment. ConclusionsIf prescribed to a general dry eye population, the artificial tears performed similarly, improving symptoms and conjunctival signs. However, osmolarity balanced artificial tears were the preferred treatment in individuals with low baseline tear volume and lipisomal spray for individuals with a baseline lipid layer deficiency. Key wordsDry eye; carboxymethylcellulose; liposomal spray; sodium hyaluronate; randomised control trial; artificial tears Highlights• In a general dry eye population, the artificial tears tested performed similarly• Treatment effects still evident after 4 months of treatment• Artificial tears provide more than transient relief to symptoms• Artificial tears aid in breaking the vicious dry eye disease cycle• Osmolarity balanced drops preferred by those with low baseline tear volume• Lipisomal spray preferred treatment by those with baseline lipid layer deficiency

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“…29 Shortly after sodium fluorescein instillation, fluorescein tear breakup time (FTBUT) was measured three times for each eye (with the mean value used for analysis), alternating between eyes, and with a 30-second break between each measurement. FTBUT measurement was done approximately 10 to 15 minutes after NITBUT, and enough time should have elapsed for the tear film to recover.…”

Section: Study Protocolmentioning

confidence: 99%

The Relationship of Lid Wiper Epitheliopathy to Ocular Surface Signs and Symptoms

Yeh

Leung

et al. 2018

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. There has been interest in determining whether lid wiper epitheliopathy (LWE) plays a key role in causing ocular discomfort. Conflicting reports have made it difficult to discern whether LWE is more prevalent in certain populations, what characteristics are associated with its severity, and what its role is in symptomology. This cross-sectional study on a large and diverse population attempts to answer these questions.METHODS. Subjects were asked to complete questionnaires related to dry eye and to ocular discomfort. A comprehensive set of ocular surface parameters were assessed, including LWE length and width, tear-film lipid layer thickness, fluorescein tear breakup time (FTBUT), lidparallel conjunctival folds (LIPCOF), and corneal staining. RESULTS.A total of 287 subjects participated in the study. LWE was observed in 45% of the study cohort and was twice as prevalent in Asians than non-Asians (P < 0.005). LWE was more likely to present in contact lens wearers than non-contact lens wearers (P ¼ 0.03). Decreased FTBUT was associated with increased LWE length and width (P < 0.005 and P ¼ 0.01, respectively), although only a small effect size was noted. Presence of LIPCOF was linked with a 0.25-grade increase in LWE width (P ¼ 0.01). Only LWE width was associated with greater symptoms in contact lens wearers.CONCLUSIONS. LWE was associated with decreased tear-film stability, contact lens wear, lid anatomy, and LIPCOF. LWE was not associated with symptoms in non-contact lens wearers. LWE width was associated with greater symptoms in contact lens wearers but was only clinically significant with moderate to severe LWE width.

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TFOS DEWS II Diagnostic Methodology report

Cited by 1,478 publications

References 523 publications

TFOS DEWS II Tear Film Report

TFOS DEWS II Tear Film Report

Can the optimum artificial tear treatment for dry eye disease be predicted from presenting signs and symptoms?

The Relationship of Lid Wiper Epitheliopathy to Ocular Surface Signs and Symptoms

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