Classification of Fluorescein Breakup Patterns: A Novel Method of Differential Diagnosis for Dry Eye

Yokoi, Norihiko; Georgiev, Georgi; Katô, Hiroaki; Komuro, Aoi; Sonomura, Yukiko; Sotozono, Chie; Ohta, Michio; Kinoshita, Shigeru

doi:10.1016/j.ajo.2017.05.022

Cited by 121 publications

(208 citation statements)

References 57 publications

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“…22 To assess the tear film mucin layer, a new diagnostic method based on the fluorescein breakup pattern can be used for subjects without contact lenses. 23 However, this method cannot be used for subjects wearing contact lenses. Further studies should be done in this field.…”

Section: Tear Film-oriented Diagnosis Of Cladementioning

confidence: 99%

Contact Lens-Associated Dry Eye Disease: Recent Advances Worldwide and in Japan

Kojima

2018

Invest. Ophthalmol. Vis. Sci.

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Contact lens wearers complain of various types of contact lens discomfort (CLD), which may result in the discontinuation of contact lenses. CLD is often associated with dry eye disease. A contact lens divides the tear film into two layers: the pre-and post-lens tear film. This change leads to instability of the pre-lens tear film, thinning of pre-and post-lens tear film thickness, and increased friction between the contact lens and the ocular surface. The Japanese Dry Eye Society recommends the diagnosis of tear film abnormality first (tear film-oriented diagnosis [TFOD]) and the treatment of dry eye disease based on TFOD (tear film-oriented therapy [TFOT]). These concepts can be applied for contact lens-associated dry eye disease (CLADE). Noninvasive tear film breakup time, tear volume evaluation, vital staining, and assessment of Meibomian glands are performed to evaluate the tear film. On vital staining analysis of CLADE, lid wiper epitheliopathy and conjunctival edge staining are major findings. In TFOT of CLADE, secretagogues of water or mucins, such as diquafosol and rebamipide, have been first used in Japan. Material, design, wettability, and friction coefficient of the contact lens could affect CLADE. Changes of contact lens may be an option in TFOD. However, the effects of contact lens properties on the tear film and ocular surface are still unclear. Further controlled studies are needed in the future.

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Section: Tear Film-oriented Diagnosis Of Cladementioning

confidence: 99%

Contact Lens-Associated Dry Eye Disease: Recent Advances Worldwide and in Japan

Kojima

2018

Invest. Ophthalmol. Vis. Sci.

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“…The phenomenon of tear breakup and its impact on dry eye symptoms have been investigated 38–42. A recent study has proposed five different fluorescein tear film breakup patterns based on the tear film dynamics after the eye is opened and kept open 42. This classification can aid in differential diagnosis of dry eye and subsequent selection of the optimal treatment for each individual case, regardless of the inherent variability of BUT measurements and breakup observations 43 44.…”

Section: Quality/quantity Of the Tear Film And Qov: Dry Eyementioning

confidence: 99%

“…This classification can aid in differential diagnosis of dry eye and subsequent selection of the optimal treatment for each individual case, regardless of the inherent variability of BUT measurements and breakup observations 43 44. According to this approach, each breakup pattern roughly corresponds to a severe or mild/moderate case of ADDE, dry eye with decreased wettability of the corneal surface (described as short BUT-type dry eye) and evaporative dry eye42 (figure 1). Area breakup pattern : severe ADDE, line breakup pattern : mild-to-moderate ADDE, spot breakup pattern : severe short BUT-type dry eye and dimple breakup pattern : mild-to-moderate short BUT-type dry eye.…”

Section: Quality/quantity Of the Tear Film And Qov: Dry Eyementioning

confidence: 99%

“…If the tear film is very stable and random breakup occurs after 10 s, a stable pattern would be observed sequential HOAs. Since the breakup region and shape sometimes differ with each blink in eyes with a random breakup pattern,42 such changes may lead to the manifestation of a small-fluctuation pattern in postblink sequential HOAs. Sequential HOAs in eyes with the sawtooth pattern are similar to those seen in eyes with the dimple breakup pattern.…”

Section: Quality/quantity Of the Tear Film And Qov: Dry Eyementioning

confidence: 99%

“…Although it is well known that there are considerable differences in the tear film breakup pattern between dry eyes and normal eyes,42 some similarities are also noted 40. Recent papers have reported on the relationship of tear breakup to the lipid layer rather than to the wettability of the corneal surface, specifically in eyes with the spot breakup pattern 47 48.…”

Section: Quality/quantity Of the Tear Film And Qov: Dry Eyementioning

confidence: 99%

See 2 more Smart Citations

Effects of tear film dynamics on quality of vision

Koh

Tung

Inoue³

et al. 2018

Br J Ophthalmol

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The precorneal tear film is maintained by blinking and exhibits different phases in the tear cycle. The tear film serves as the most anterior surface of the eye and plays an important role as a first refractive component of the eye. Alterations in tear film dynamics may cause both vision-related and ocular surface-related symptoms. Although the optical quality associated with the tear film dynamics previously received little attention, objective measurements of optical quality using wavefront sensors have enabled us to quantify optical aberrations induced by the tear film. This has provided an objective method for assessing reduced optical quality in dry eye; thus, visual disturbances were included in the definition of dry eye disease in the 2007 Dry Eye Workshop report. In addition, sequential measurements of wavefront aberrations have provided us with valuable insights into the dynamic optical changes associated with tear film dynamics. This review will focus on the current knowledge of the mechanisms of wavefront variations that are caused by different aspects of tear film dynamics: specifically, quality, quantity and properties of the tear film, demonstrating the respective effects of dry eye, epiphora and instillation of eye drops on the quality of vision.

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New Developments in Dry Eye Research

Tsubota

Yokoi

2019

Foundations of Corneal Disease

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Classification of Fluorescein Breakup Patterns: A Novel Method of Differential Diagnosis for Dry Eye

Cited by 121 publications

References 57 publications

Contact Lens-Associated Dry Eye Disease: Recent Advances Worldwide and in Japan

Contact Lens-Associated Dry Eye Disease: Recent Advances Worldwide and in Japan

Effects of tear film dynamics on quality of vision

New Developments in Dry Eye Research

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