Automated Measurement of Tear Film Dynamics and Lipid Layer Thickness for Assessment of Non-Sjogren Dry Eye Syndrome With Meibomian Gland Dysfunction

作者：Ji Yong Woo; Lee Jeihoon; Lee Hun; Seo Kyoung Yul; Kim Eung Kweon; Kim Tae im

来源：Cornea, 2017, 36(2): 176-182.

DOI：10.1097/ICO.0000000000001101

• dry eye
• meibomian gland dysfunction
• Keratograph
• meibography
• lipid layer thickness
• LipiView interferometer

Purpose: To investigate automated values from an advanced corneal topographer with a built-in real keratometer, color camera, and ocular surface interferometer for the evaluation of non-Sjogren dry eye syndrome (NSDES) with meibomian gland dysMGD).
Methods: Sixty-four patients (64 eyes) diagnosed with NSDES with MGD were enrolled. All eyes were evaluated using the Ocular Surface Disease Index (OSDI), fluorescence staining score, tear film breakup time (TBUT), Schirmer test, and MGD grade. Noninvasive Keratograph average tear film breakup time (NIKBUTav), tear meniscus height (TMHk), meibomian gland (MG) dropout grade, and lipid layer thickness (LLT) using interferometry were measured.
Results: Among automated indexes, NIKBUTav (mean 7.68 +/- 4.07 s) and the MG dropout grade (mean 1.0 +/- 0.5) significantly correlated with the OSDI (mean 40.6 +/- 22.9) (r = 20.337, P = 0.006; and r = 0.201, P = 0.023, respectively), as did all conventional indicators, except the Schirmer score (mean 9.1 +/- 5.9 mm). TMHk (mean 0.21 +/- 0.18 mm) had significant correlation with the Schirmer score, the staining score (mean 1.2 +/- 0.7), TBUT (mean 3.8 +/- 1.8 s), and NIKBUTav (r = 0.298, P = 0.007; r = 20.268, P = 0.016; r = 0.459, P < 0.001; and r = 0.439, P < 0.001, respectively), but not any MGD indicator, even the MG dropout grade. NIKBUTav showed significant correlations with all clinical parameters and other automated values, except the Schirmer score and LLT (mean 83.94 +/- 20.82 nm) (all vertical bar r vertical bar >= 0.25 and P < 0.01). The MG dropout grade highly correlated with all indexes except TMHk (all vertical bar r vertical bar >= 0.25 and P < 0.05). LLT was significantly associated with TBUT, MGD grade (mean 2.0 +/- 0.7), and MG dropout grade (r = 0.219, P = 0.047; r = -0.221, P = 0.039; and r = 0.433, P < 0.001, respectively), although it was not related to patient symptoms.
Conclusions: Automated noninvasive measurements using an advanced corneal topographer and LLT measured with an ocular surface interferometer can be alternatives to conventional methods to evaluate tear conditions on the ocular surface; the former device can provide information about conformational MG changes in NSDES with MGD.

• 出版日期2017-2