Combination of the Schirmer I and Phenol Red Thread Tests as a Rescue Strategy for Diagnosis of Ocular Dryness Associated with Sjögren's Syndrome

Monchy, I. De; Gendron, G.; Miceli, Corinne; Pogorzalek, N.; Mariette, Xavier; Labétoulle, Marc

doi:10.1167/iovs.10-6671

Cited by 43 publications

(22 citation statements)

References 26 publications

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“…Schirmer test I was performed with validated sterile strips (ContaCare Ophthalmics and Diagnostics, Gujarat, India) placed in the inferior fornix of both eyes at the same time: pathological values were considered <10 mm wetting after 5 minutes. 13 TFBUT was carried out to evaluate tear film stability and was measured and recorded (average of three measurements) after instillation of 2 µL unpreserved fluorescein sodium 2% (galenic preparation from Fluoralfa 0.25%, Alfa Intes, Casoria, NA, Italy). TFBUT was considered pathological with values <10 seconds.…”

Section: Methodsmentioning

confidence: 99%

Trehalose/hyaluronate eyedrop effects on ocular surface inflammatory markers and mucin expression in dry eye patients

Fariselli¹,

Giannaccare

Fresina

et al. 2018

OPTH

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AimTo assess the ocular surface parameters, inflammatory marker level in tears, and mucin expression in conjunctival epithelium before and after treatment with trehalose/hyaluronate tear substitute in dry eye (DE) patients.Patients and methodsFifteen DE patients were evaluated in an open-label, pilot study at enrollment, after 2 days of washout (baseline) and after 1 and 2 months (endpoint) of treatment with a trehalose/hyaluronate tear substitute (one drop/eye/three times daily). Data for symptoms of discomfort (Ocular Surface Disease Index and Visual Analogue Scale pain score), tear film (Schirmer test I, tear film breakup time), ocular surface damage (corneal National Eye Institute) and conjunctival van Bijsterveld scores, impression cytology scored by Nelson’s grade and goblet cells (GCs) number/mm2 analysis, and MUC4 immunostaining, and inflammation (interleukin [IL]-1β, IL-6, and IL-8 levels) were measured.ResultsSignificant changes at endpoint as compared to baseline were found for Ocular Surface Disease Index score (respectively, mean±SD, 22.2±2.9 vs 38.7±12.7), Visual Analogue Scale score (3.4±1.3 vs 6.6±1.4), tear film breakup time (8.6±1.28 vs 6.17±1.9 seconds), corneal staining (National Eye Institute grade 1.23±0.64 vs 3.37±0.49), conjunctival staining (1.73±1.14 vs 4.17±0.91), impression cytology (Nelson grade 1.10±0.20 vs 1.63±0.54), and GC density (139.9±22.0 vs 107.8±16.2 GC/mm2). IL-1β, IL-6, and IL-8 tear levels showed a significant decrease at endpoint as compared to baseline (respectively, pg/mL tears: 12.3±6.9, 26.6±25.2, 743.5±477.7 vs 33.6±17.3, 112.0±24.3, 1,139.2±671.7).ConclusionsA decrease in ocular discomfort symptoms, surface damage, and tear cytokine levels was shown after 2 months’ treatment with trehalose/hyaluronate tear substitute in DE patients, along with a significant GC density recovery. These results may be associated with the synergic action of both trehalose and hyaluronic acid in targeting different entries of the DE vicious loop.

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Section: Methodsmentioning

confidence: 99%

Trehalose/hyaluronate eyedrop effects on ocular surface inflammatory markers and mucin expression in dry eye patients

Fariselli¹,

Giannaccare

Fresina

et al. 2018

OPTH

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“…Accordingly, a combination of tests should provide a more reliable diagnosis and increase the specificity and sensitivity of dry eye diagnosis [70]. The phenol red thread test (Hamano test) [71] is a measurement of tear volume or change in tear volume with time, by observation of the amount of wetting of a phenol red dye impregnated cotton thread placed over the inferior eyelid.…”

Section: Biophysical Measurements Of the Tear Filmmentioning

confidence: 99%

TFOS DEWS II Tear Film Report

et al. 2017

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The members of the Tear Film Subcommittee reviewed the role of the tear film in dry eye disease (DED). The Subcommittee reviewed biophysical and biochemical aspects of tears and how these change in DED. Clinically, DED is characterized by loss of tear volume, more rapid breakup of the tear film and increased evaporation of tears from the ocular surface. The tear film is composed of many substances including lipids, proteins, mucins and electrolytes. All of these contribute to the integrity of the tear film but exactly how they interact is still an area of active research. Tear film osmolarity increases in DED. Changes to other components such as proteins and mucins can be used as biomarkers for DED. The Subcommittee recommended areas for future research to advance our understanding of the tear film and how this changes with DED. The final report was written after review by all Subcommittee members and the entire TFOS DEWS II membership.

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“…The phenol red thread test (PRT) also quantifies the aqueous tear film and entails a shorter testing time (15 seconds) than that required for the STT (60 seconds for veterinary application) . The effectiveness of both tests for lacrimal quantification in humans and veterinary patients has been previously discussed …”

Section: Introductionmentioning

confidence: 99%

A novel strip meniscometry method for measuring aqueous tear volume in dogs: Clinical correlations with the Schirmer tear and phenol red thread tests

Miyasaka¹,

Kazama

Iwashita

et al. 2019

Veterinary Ophthalmology

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Objectives:The strip meniscometry test (SMT) is a novel method for quantitative measurement of tear volume with only five seconds. We aimed to evaluate clinical correlations of SMT with the gold standard Schirmer tear test (STT) and phenol red thread test (PRT) in dogs, including normal and tear-deficient eyes. Animals studied: Left eyes from 621 outpatient dogs with and without ocular disorders were evaluated. Procedures: Each subject underwent SMT, PRT, and STT without topical anesthesia in the described order with five-minute intervals. The total population was divided into four groups by classifying tear deficiency severity based on STT results:"severe" (0-5 mm/min), "moderate" (6-10 mm/min), "subclinical" (11-14 mm/min), and "normal" (15 or more mm/min). Results: The strongest correlation coefficient was found between SMT-STT (0.676), followed by PRT-STT (0.637) and SMT-PRT (0.600) pairs. Mean(SD) scores of SMT, PRT, and STT in total population were 9.47 (4.08) mm/5 s, 33.30 (8.52) mm/15 s, and 16.47 (7.01) mm/min. Significant differences were found among STTclassified groups, both using SMT and PRT results. Receiver operating characteristic (ROC) curves revealed that SMT better agreed with STT than PRT; agreement increased with increasing STT severity. A cutoff for SMT was identified at 10 mm/5 s to discriminate normal eyes from tear-deficient eyes, yielding high sensitivities and acceptable specificities. Conclusions: SMT could be superior to PRT for discriminating tear-deficient eyes.The high sensitivity of SMT could be useful as an initial diagnostic tool to rule out normal eyes with the short testing time. K E Y W O R D S ocular surface, phenol red thread, Schirmer tear test, SMTube, strip meniscometry, tear volume | 865 MIYASAKA et Al.

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Combination of the Schirmer I and Phenol Red Thread Tests as a Rescue Strategy for Diagnosis of Ocular Dryness Associated with Sjögren's Syndrome

Cited by 43 publications

References 26 publications

Trehalose/hyaluronate eyedrop effects on ocular surface inflammatory markers and mucin expression in dry eye patients

Trehalose/hyaluronate eyedrop effects on ocular surface inflammatory markers and mucin expression in dry eye patients

TFOS DEWS II Tear Film Report

A novel strip meniscometry method for measuring aqueous tear volume in dogs: Clinical correlations with the Schirmer tear and phenol red thread tests

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