Cynthia I Tung1, Andrew F Perin1, Koray Gumus1, Stephen C Pflugfelder2. 1. Department of Ophthalmology, Cullen Eye Institute, Baylor College of Medicine, Houston, Texas. 2. Department of Ophthalmology, Cullen Eye Institute, Baylor College of Medicine, Houston, Texas. Electronic address: stevenp@bcm.edu.
Abstract
PURPOSE: To evaluate relationships between tear meniscus dimensions and parameters of ocular surface disease in a variety of tear dysfunction conditions. DESIGN: Single-institution prospective observational study. METHODS: This study from the Baylor College of Medicine included 128 eyes of 64 subjects. Cross-sectional lower tear meniscus height and tear meniscus area were measured using optical coherence tomography and were compared with tear break-up time (TBUT), corneal staining, conjunctival staining, and an irritation symptom questionnaire (Ocular Surface Disease Index). Study groups included meibomian gland disease (MGD), aqueous tear deficiency (ATD), Sjögren syndrome, non-Sjögren syndrome ATD, and control subjects. Statistical analyses were performed using the Pearson correlation and Student's t test. RESULTS: When compared with mean tear meniscus height in controls (345 μm), mean tear meniscus height was lower in all tear dysfunction (234 μm; P = .0057), ATD (210 μm; P = .0016), and Sjögren syndrome groups (171 μm; P = .0054). For tear meniscus height ≤210 μm, relative risk ratio for developing corneal staining ≥10 was 4.65. Tear meniscus height correlated with corneal staining for all subjects (R = -0.32; P = .0008), MGD (R = +0.40; P = .059), and ATD (R = -0.36; P = .04). Tear meniscus area showed similar trends in MGD (R = +0.55; P = .006) and ATD (R = -0.40; P = .018). Tear meniscus height correlated with TBUT for all subjects (R = +0.39; P < .0001) and ATD (R = +0.37; P = .018). CONCLUSIONS: In tear dysfunction conditions, lower tear volume correlates with worse corneal epithelial disease in ATD and Sjögren syndrome, conditions with lacrimal gland dysfunction. In contrast, higher tear volume is associated with corneal epithelial disease in MGD. These findings may improve the ability to identify patients at risk for corneal epithelial disease.
PURPOSE: To evaluate relationships between tear meniscus dimensions and parameters of ocular surface disease in a variety of tear dysfunction conditions. DESIGN: Single-institution prospective observational study. METHODS: This study from the Baylor College of Medicine included 128 eyes of 64 subjects. Cross-sectional lower tear meniscus height and tear meniscus area were measured using optical coherence tomography and were compared with tear break-up time (TBUT), corneal staining, conjunctival staining, and an irritation symptom questionnaire (Ocular Surface Disease Index). Study groups included meibomian gland disease (MGD), aqueous tear deficiency (ATD), Sjögren syndrome, non-Sjögren syndrome ATD, and control subjects. Statistical analyses were performed using the Pearson correlation and Student's t test. RESULTS: When compared with mean tear meniscus height in controls (345 μm), mean tear meniscus height was lower in all tear dysfunction (234 μm; P = .0057), ATD (210 μm; P = .0016), and Sjögren syndrome groups (171 μm; P = .0054). For tear meniscus height ≤210 μm, relative risk ratio for developing corneal staining ≥10 was 4.65. Tear meniscus height correlated with corneal staining for all subjects (R = -0.32; P = .0008), MGD (R = +0.40; P = .059), and ATD (R = -0.36; P = .04). Tear meniscus area showed similar trends in MGD (R = +0.55; P = .006) and ATD (R = -0.40; P = .018). Tear meniscus height correlated with TBUT for all subjects (R = +0.39; P < .0001) and ATD (R = +0.37; P = .018). CONCLUSIONS: In tear dysfunction conditions, lower tear volume correlates with worse corneal epithelial disease in ATD and Sjögren syndrome, conditions with lacrimal gland dysfunction. In contrast, higher tear volume is associated with corneal epithelial disease in MGD. These findings may improve the ability to identify patients at risk for corneal epithelial disease.
Authors: A A Afonso; L Sobrin; D C Monroy; M Selzer; B Lokeshwar; S C Pflugfelder Journal: Invest Ophthalmol Vis Sci Date: 1999-10 Impact factor: 4.799
Authors: José M Benítez del Castillo; Mohamed A S Wasfy; Cristina Fernandez; Julian Garcia-Sanchez Journal: Invest Ophthalmol Vis Sci Date: 2004-09 Impact factor: 4.799
Authors: Rahul Yadav; Kye-Sung Lee; Jannick P Rolland; James M Zavislan; James V Aquavella; Geunyoung Yoon Journal: Biomed Opt Express Date: 2011-10-06 Impact factor: 3.732
Authors: Mark S Milner; Kenneth A Beckman; Jodi I Luchs; Quentin B Allen; Richard M Awdeh; John Berdahl; Thomas S Boland; Carlos Buznego; Joseph P Gira; Damien F Goldberg; David Goldman; Raj K Goyal; Mitchell A Jackson; James Katz; Terry Kim; Parag A Majmudar; Ranjan P Malhotra; Marguerite B McDonald; Rajesh K Rajpal; Tal Raviv; Sheri Rowen; Neda Shamie; Jonathan D Solomon; Karl Stonecipher; Shachar Tauber; William Trattler; Keith A Walter; George O Waring; Robert J Weinstock; William F Wiley; Elizabeth Yeu Journal: Curr Opin Ophthalmol Date: 2017-01 Impact factor: 3.761
Authors: Ziwei Wu; Carolyn G Begley; Nicholas Port; Arthur Bradley; Richard Braun; Ewen King-Smith Journal: Invest Ophthalmol Vis Sci Date: 2015-07 Impact factor: 4.799
Authors: Effie Z Rahman; Peter K Lam; Chia-Kai Chu; Quianta Moore; Stephen C Pflugfelder Journal: Am J Ophthalmol Date: 2015-08-06 Impact factor: 5.258