Jennifer K Mooi1, Michael T M Wang2, Joevy Lim2, Andreas Müller3, Jennifer P Craig4. 1. Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, New Zealand; Warringal Private Hospital, Heidelberg, VIC, Australia. 2. Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, New Zealand. 3. Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, New Zealand; Centre for Eye Research Australia (CERA), Melbourne, VIC, Australia. 4. Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, New Zealand. Electronic address: jp.craig@auckland.ac.nz.
Abstract
PURPOSE: To compare clinical tear film break-up time measurements obtained non-invasively, with those measured following minimal and conventional volumes of fluorescein instillation. METHODS: Forty-one subjects (20 male, 21 female, mean±SD age 34±11years), with or without dry eye, participated in a prospective cross-over study. Tear film break-up time was measured by the Tearscope Plus™ with fine grid insert. Measurements were made in triplicate, with no fluorescein instillation (NIBUT), then following application of a minimal volume of 1μl fluorescein from the Dry Eye Test™ (mTBUT), and finally with 15-30μl of fluid instilled via a conventional fluorescein strip (TBUT). A fifteen-minute interval between each set of measurements minimised the risk of residual contamination effects. RESULTS: All three techniques displayed statistically significant pairwise correlation (all p<0.001). TBUT values were significantly shorter than both NIBUT (geometric mean 8.6s versus 10.9s, p=0.03) and mTBUT (geometric mean 8.6s versus 10.6s, p=0.03), and demonstrated narrower spread (both p<0.05). No significant differences were detected between NIBUT and mTBUT (all p>0.05). CONCLUSIONS: Tear film break-up time values measured with conventional fluorescein instillation were shortened, while minimal fluorescein instillation and non-invasive methods produced comparable readings. This suggests that minimising instilled volumes can reduce the impact of fluorescein on clinical measurements of tear film stability.
PURPOSE: To compare clinical tear film break-up time measurements obtained non-invasively, with those measured following minimal and conventional volumes of fluorescein instillation. METHODS: Forty-one subjects (20 male, 21 female, mean±SD age 34±11years), with or without dry eye, participated in a prospective cross-over study. Tear film break-up time was measured by the Tearscope Plus™ with fine grid insert. Measurements were made in triplicate, with no fluorescein instillation (NIBUT), then following application of a minimal volume of 1μl fluorescein from the Dry Eye Test™ (mTBUT), and finally with 15-30μl of fluid instilled via a conventional fluorescein strip (TBUT). A fifteen-minute interval between each set of measurements minimised the risk of residual contamination effects. RESULTS: All three techniques displayed statistically significant pairwise correlation (all p<0.001). TBUT values were significantly shorter than both NIBUT (geometric mean 8.6s versus 10.9s, p=0.03) and mTBUT (geometric mean 8.6s versus 10.6s, p=0.03), and demonstrated narrower spread (both p<0.05). No significant differences were detected between NIBUT and mTBUT (all p>0.05). CONCLUSIONS: Tear film break-up time values measured with conventional fluorescein instillation were shortened, while minimal fluorescein instillation and non-invasive methods produced comparable readings. This suggests that minimising instilled volumes can reduce the impact of fluorescein on clinical measurements of tear film stability.
Authors: Jonatan Olafsson; Xiaoran Lai; Erlend Christoffer Sommer Landsend; Snorri Olafsson; Eric Parissi; Øygunn A Utheim; Sten Raeder; Reza A Badian; Neil Lagali; Darlene A Dartt; Tor P Utheim Journal: Sci Rep Date: 2021-11-17 Impact factor: 4.379