Noninvasive Tear Film Break-Up Time Assessment Using Handheld Lipid Layer Examination Instrument

Abstract

SUMMARY The aim was to determine feasibility and reliability of noninvasive tear break-up time (NIBUT) assessment using handheld lipid layer examination instrument, and to compare it with standard tear break-up time (TBUT) test. Fifty patients were enrolled, 31 with and 19 without dry eye symptoms. Schein questionnaire was used to assess dry eye symptoms. During examination, three NIBUT measurements were performed on each eye using handheld instrument, followed by three TBUT measurements. Receiver operating characteristic curves, sensitivity, specificity and logistic regression analysis were generated. Median NIBUT values were significantly shorter in dry eye symptom group than in control group in all three measurements (9, 8 and 8 s vs . 21, 22 and 21 s; p<0.001). TBUT values showed no significant difference between the groups in the first measurement (p=0.053), but the values were significantly shorter in dry eye symptom group in second and third measurements (p=0.020). The cutoff value to distinguish patients with symptoms of dry eye from control group was 12 seconds for NIBUT and 8 seconds for TBUT, with NIBUT having significantly higher sensitivity, specificity, area under the receiver operating characteristic curve and positive predictive value. NIBUT, measured by handheld lipid layer examination instrument, was superior to TBUT in detecting dry eye.

Intense pulsed light for the treatment of Meibomian gland dysfunction: A systematic review and meta‑analysis

“…Given the reduced sensitivity and specificity of TBUT, non-invasive methods of tear film assessment, including NIBUT, have been developed, which do not require instillation of fluorescein. NIBUT is considered to be more precise in assessing tear film stability compared with TBUT (37). In the present analysis, no significant difference in the SPEED scores between the IPL and control group was obtained.…”

“…The SPEED questionnaire is an easy to use, repeatable, valid and subjective tool to quantify the symptoms of a patient with dry eye disease (36). Other objective techniques of dry eye assessment included TBUT and NIBUT (37). TBUT is an invasive method requiring instillation of fluorescein solution in the eye, which disturbs the tear film equilibrium, causing increased evaporation and tear film destabilization.…”

Comparaci�n del tiempo de rotura de la pel�cula lagrimal entre el top�grafo corneal y la t�cnica con fluoresce�na, y su correlaci�n con el cuestionario OSDI

“…Las medianas del TRLf reportadas por otros estudios [18][19][20] fueron inferiores a la encontrada en este estudio, que oscilaron entre 4.3 y 12.6 s. El estudio realizado por Wang y Craig 12 en Nueva Zelanda reportó incluso tiempos menores de 5 s en sujetos sanos. Se han reportado una alta variabilidad y poca reproducibilidad de la técnica, lo que puede explicar estos hallazgos 6 .…”

Evaluation of tear osmolarity measured by I-Pen osmolarity system in patients with dry eye

“…The normal healthy control group without dry eye was defined as having an OSDI symptom score ≤ 12, fluorescein tear-break up time ≥ 8 s, and Schirmer test ≥ 10 mm/5 min 16 – 18 . Subjects with symptomatic DED were defined as having an OSDI score ≥ 13 with fluorescein TBUT < 8 s or Schirmer test < 10 mm/5 min 17 . Only the data from either right or left eye of a subject which met the criteria was used.…”