The Association between Tear Film Thickness as Measured with OCT and Symptoms and Signs of Dry Eye Disease: A Pooled Analysis of 6 Clinical Trials

Abstract

Purpose: To determine the association between tear film thickness (TFT) as measured with ultra-high resolution optical coherence tomography (UHR-OCT) and signs and symptoms of dry eye disease (DED). Methods: A total of 450 eyes from 225 patients with DED from six different randomized clinical trials were included in this pooled analysis. In all subjects, TFT was measured with a custom-built UHR-OCT system. Symptoms of DED were quantified using a standardized Ocular Surface Disease Index (OSD)I questionnaire and clinical signs including tear film break up time (TFBUT) and Schirmer I test were assessed. Associations of the average TFT with OSDI, TFBUT, and Schirmer I test were calculated using a linear regression analysis. Results: The average TFT of the included sample (mean age, 45.0 ± 13.3 years; 65% female) was 4.2 ± 0.5 µm and the OSDI 36.2 ± 10.4. A significant negative correlation was found between TFT and OSDI (r = −0.36 to −0.31; p < 0.001). Tear break up time and Schirmer I test were not correlated with OSDI. Significant albeit weak correlations were found between TFT and TFBUT (r = 0.17 to 0.25; p < 0.01) as well as Schirmer I (r = 0.36 to 0.37; p < 0.001). Subgroup analysis revealed that the correlation was stronger in the subjects with abnormal Schirmer I (<15 mm; r = 0.50 to 0.54; p < 0.001). Conclusions: The present study demonstrates an objective measurement of TFT using a novel OCT approach for DED that correlates with symptoms and signs of DED. Our data are consistent with the idea that TFT represents the aqueous-deficient component of DED.

Effect of hormonal contraceptives on the ocular surface and the tear film

“…The OSDI is a validated questionnaire that only measures the frequency of dry eye symptoms, but its correlation with clinical signs and tear film parameters is still weak. [24][25][26][27] Garhöfer et al, 28 and Song et al, 29 found weak negative correlation between OSDI score and tear film parameters such as Schirmer and TBUT tests. The higher OSDI score in the hormonal contraceptives group corresponds to its Schirmer and TBUT tests value reduction.…”

Anwendungsmöglichkeiten der optischen Kohärenztomographie beim trockenen Auge

“…Des Weiteren konnte gezeigt werden, dass die TFT negativ mit dem Ocular Surface Disease Index (OSDI), einem Symptomfragebogen, korreliert und es auch einen signifikanten Zusammenhang zwischen TFT und Schirmer-Test bzw. Tränenfilmaufreißzeit gibt [6,33].…”

“…themenschwerpunkt Die so ermöglichte Schnittbilddarstellung des vorderen Augenabschnittes bietet große Vorteile beispielsweise in der nichtinvasiven Beurteilung kornealer Strukturen [3], des Kammerwinkels [4] oder auch in der Biometrie im Rahmen von Kataraktoperationen [5]. Mit der immer höher werdenden axialen Auflösung ist es in den letzten Jahren gelungen, auch Strukturen des Vorderabschnittes im Bereich von wenigen Mikrometern, wie beispielsweise den Tränenfilm, darzustellen [3,[6][7][8].…”

Time-domain full-field optical coherence tomography (TD-FF-OCT) in ophthalmic imaging

“…Since the early days, in parallel to the spectral domain (Fourier domain) OCT, another class of en face OCT methods have been under development to increase en face imaging speed. Advances in camera technologies and light sources in recent years enabled the rise of en face OCT methods, such as Fourier-domain full-field OCT (FD-FF-OCT), [23][24][25][26] also known as swept-source full-field OCT (SS-FF-OCT), [27][28][29][30] line-field OCT (LF-OCT), [31][32][33][34][35] ultra-high-resolution OCT (UHR-OCT), [36][37][38][39][40][41][42] and so on. An excellent review of en face OCT methods can be found.…”