J Korean Ophthalmol Soc.  2015 Mar;56(3):323-330. 10.3341/jkos.2015.56.3.323.

Tear Meniscus Evaluation Using Optical Coherence Tomography in Dry Eye Patients

• Jung NY
• Baek JW
• Shin SJ
• Chung SK

• KMID: 2339036
• DOI: http://doi.org/10.3341/jkos.2015.56.3.323

Abstract

PURPOSE
To evaluate the tear meniscus in aqueous tear-deficient dry eye patients using Fourier-domain optical coherence tomography (FD-OCT) and to investigate the clinical usefulness of tear meniscus values.
METHODS
The present study included 79 aqueous tear-deficient dry eyes and 50 normal eyes. Tear meniscus height (TMH), tear meniscus depth (TMD), and tear meniscus area (TMA) were imaged using FD-OCT and measured with computer calipers. Schirmer's test, tear break-up time, and corneal fluorescein staining were also performed and the correlations between the tests were analyzed. Additionally, the diagnostic power of tear meniscus values was compared using area under the receiver operating characteristic curve (AUROC).
RESULTS
Tear meniscus values were significantly decreased in the aqueous tear-deficient dry eye group (p < 0.05). TMH, TMD, and TMA were positively correlated with Schirmer's test and tear break-up time (p < 0.05), and TMH and TMD were negatively correlated with corneal fluorescein staining in the aqueous tear-deficient dry eye group (p < 0.05). The AUROCs of TMH, TMD, and TMA were 0.978, 0.788, and 0.957, respectively.
CONCLUSIONS
Tear meniscus values measured using FD-OCT were significantly lower in aqueous tear-deficient dry eyes and were correlated with Schirmer's test, tear break-up time, and corneal fluorescein staining. Tear meniscus measurements obtained using FD-OCT can be useful clinical parameters for the diagnosis and treatment of aqueous tear-deficient dry eye.

Keyword

Correlation; Dry eye; Optical coherence tomography; Tear meniscus

MeSH Terms

Diagnosis
Fluorescein
Humans
ROC Curve
Tears*
Tomography, Optical Coherence*
Fluorescein

Figure

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  Figure 1. (A) Image illustrating the 6 mm vertical scan path (arrowed line) of the optical coherence tomography beam to image the lower tear meniscus. (B) An optical coherence tomography vertical line scan cross-sectional image of the lower tear meniscus (arrow). (C) Optical coherence tomography image of the lower tear meniscus showing the tear meniscus height, depth and area. Measurements of TMH, TMD, TMA were performed using RTVue-100 software. TMH = tear meniscus height; TMD = tear meniscus depth; TMA = tear meniscus area.

• 

  Figure 2. (A) Scatter plot showing relationship between TMH versus Schirmer’s test (ST) and tear break-up time (tBUT) in aqueous tear-deficient dry eye patients. (B) Scatter plot showing relationship between TMD versus ST and tBUT in aqueous tear-deficient dry eye patients. (C) Scatter plot showing relationship between TMA versus ST and tBUT in aqueous tear-deficient dry eye patients. TMH = tear meniscus height; TMD = tear meniscus depth; TMA = tear meniscus area.

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  Figure 3. Receiver operator characteristic curves for TMH, TMD, and TMA. TMH = tear meniscus height; TMD = tear meniscus depth; TMA = tear meniscus area.

Reference

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