J Korean Ophthalmol Soc.  2017 Jul;58(7):788-796. 10.3341/jkos.2017.58.7.788.

Correlation Analysis of Tear Film Lipid Layer Thickness and Ocular Surface Disease Index

• Kim RY
• Na KS
• Park YL
• Kim HS

• KMID: 2387152
• DOI: http://doi.org/10.3341/jkos.2017.58.7.788

Abstract

PURPOSE
To analyze the relationship between ocular surface disease index and tear film lipid layer thickness (LLT) using a LipiView II® (LipiView® Ocular Surface Interferometer, TearScience®, Morrisville, NC, USA) interferometer.
METHODS
Forty-nine patients diagnosed with dry eye syndrome were recruited for this prospective study. Patients completed ocular surface disease index questionnaires. We performed slit lamp examination, Schirmer test, corneal and conjunctival fluorescein staining, measured tear film break-up time, and graded meibomian gland dysfunction. Tear LLT, blinking time, and dynamic meibomian imaging were analyzed using a LipiView II® ocular interferometer. To control for missing data, we analyzed four sets of imputated data via the multiple imputation method and performed Pearson correlation analysis. Patients were assigned to one of two LLT categories (LLT < 60 or LLT ≥ 60) and Chi-square test was performed.
RESULTS
Among ocular surface disease parameters, tear film break-up time (tBUT) had a statistically significant correlation with average and maximum LLT (average LLT; p = 0.008, 0.035, 0.006, 0.049, maximum LLT; p = 0.006, 0.042, 0.020, 0.049, Pearson correlation analysis with multiple imputation) but there was no significant correlation with minimum LLT (minimum LLT; p = 0.048, 0.090, 0.079, 0.039). Of the patients with a relatively thick average LLT or maximum LLT (LLT ≥ 60 nm), 80% and 88% had a tBUT < 10, respectively. Conversely, 39% and 47% of patients with relatively thin average LLT (LLT < 60 nm) had a tBUT < 10 (average LLT; p = 0.013, maximum LLT; p = 0.039).
CONCLUSIONS
Average LLT and maximum LLT were significantly correlated with tBUT. Patients with a relatively thin average or maximum LLT tended to have a shorter tBUT. Based on these results, measuring tear film LLT using a LipiView II® interferometer may be useful in the diagnosis and follow-up of patients with evaporative dry eye.

Keyword

Dry eye syndrome; Interferometry; Lipid layer thickness; Lipiview; Meibomian gland dysfunction

MeSH Terms

Blinking
Diagnosis
Dry Eye Syndromes
Fluorescein
Follow-Up Studies
Humans
Interferometry
Meibomian Glands
Methods
Prospective Studies
Slit Lamp
Tears*
Fluorescein

Figure

• 

  Figure 1. Pearson correlation scatter plot of tear break-up time (tBUT) and average lipid layer thickness (LLT) using implanted data set 1 (A), 2 (B), 3 (C), and 4 (D). (A) r = 0.376, p-value = 0.008. (B) r = 0.220, p-value = 0.035. (C) r = 0.390, p-value = 0.006. (D) r = 0.276, p-value = 0.049. p-values were calculated by Pearson correlation test.

• 

  Figure 2. Pearson correlation scatter plot of tear break-up time (tBUT) and maximum lipid layer thickness (LLT) using implanted data set 1 (A), 2 (B), 3 (C), and 4 (D). (A) r = 0.390, p-value = 0.006. (B) r = 0.178, p-value = 0.042. (C) r = 0.331, p-value = 0.020. (D) r = 0.279, p-value = 0.049. p-values were calculated by Pearson correlation test.

• 

  Figure 3. The percentage of patients with shorten (<10 sec) or normal (≥10 sec) tear break-up time (tBUT) in each relatively thin lipid layer thickness (LLT) (<60 nm) or relatively thick LLT (≥60 nm) (A: average LLT, B: maximum LLT). The percentage of patients with shorten (<5 mm) or normal (≥5 mm) Schirmer test in each relatively thin LLT (<60 nm) or relatively thick LLT (≥60 nm) (C: average LLT, D: maximum LLT). p-values were calculated by Chi-square test.

Reference

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