Optical Coherence Tomography for Measuring the Tear Film Meniscus: Correlation with Schirmer Test and Tear-Film Breakup Time

Altan-Yaycıoğlu, Rana; Sızmaz, Selçuk; Canan, Handan; Çoban-Karataş, Müge

doi:10.3109/02713683.2013.774422

Cited by 49 publications

(35 citation statements)

References 35 publications

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“…[215] Furthermore, they proceeded to test the role of OCT-derived TMH measurements in assessing response to punctal plug therapy for dry eye, which confirmed TMH as a quick and sensitive parameter in the diagnosis and therapeutic assessment of dry eye. [227] Other groups have confirmed the correlation of AS-OCT tear film biometry with Schirmer's test,[228] while retaining high reliability of central tear film measurements (intraclass correlation coefficient = 0.97), making AS-OCT a reliable, precise and accurate tool in tear film biometry. [229] However, it is worthwhile to note that tear film biometry may not be useful in the assessment of MGD-dependent EDE.…”

Section: Diagnostic Imaging In Dry Eye Diseasementioning

confidence: 98%

Image-guided evaluation and monitoring of treatment response in patients with dry eye disease

Qazi

Aggarwal

Hamrah

2014

Graefes Arch Clin Exp Ophthalmol

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Dry eye disease (DED) is one of the most common ocular disorders worldwide. The pathophysiological mechanisms involved in the development of DED are not well understood and thus treating DED has been a significant challenge for ophthalmologists. Most of the currently available diagnostic tests demonstrate low correlation to patient symptoms and have low reproducibility. Recently, sophisticated in vivo imaging modalities have become available for patient care, namely, in vivo confocal microscopy (IVCM) and optical coherence tomography (OCT). These emerging modalities are powerful and non-invasive, allowing real-time visualization of cellular and anatomical structures of the cornea and ocular surface. Here we discuss how, by providing both qualitative and quantitative assessment, these techniques can be used to demonstrate early subclinical disease, grade layer-by-layer severity, and allow monitoring of disease severity by cellular alterations. Imaging-guided stratification of patients may also be possible in conjunction with clinical examination methods. Visualization of subclinical changes and stratification of patients in vivo, allows objective image-guided evaluation of tailored treatment response based on cellular morphological alterations specific to each patient. This image-guided approach to DED may ultimately improve patient outcomes and allow studying the efficacy of novel therapies in clinical trials.

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Section: Diagnostic Imaging In Dry Eye Diseasementioning

confidence: 98%

Image-guided evaluation and monitoring of treatment response in patients with dry eye disease

Qazi

Aggarwal

Hamrah

2014

Graefes Arch Clin Exp Ophthalmol

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“…110 TMH has been shown to correlate with DED and the traditional measurements for DED. 97,110–120 Some studies suggest there is good repeatability and reproducibility of TMH measurements in DED and normals. 101,114,115,118,120–122 However, TMH taken with different machines may not be comparable.…”

Section: Point Of Care Biomarkersmentioning

confidence: 99%

“…120,122 They also have been shown to correlate with DED and traditional measurements for DED. 116,119,120 However, TMA and TMD measurements using OCT have not yet been incorporated in any multicenter clinical trial.…”

Section: Point Of Care Biomarkersmentioning

confidence: 99%

The Growing Need for Validated Biomarkers and Endpoints for Dry Eye Clinical Research

Roy

Wei

Kuklinski

et al. 2017

Invest. Ophthalmol. Vis. Sci.

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PurposeBiomarkers with minimally invasive and reproducible objective metrics provide the key to future paradigm shifts in understanding of the underlying causes of dry eye disease (DED) and approaches to treatment of DED. We review biomarkers and their validity in providing objective metrics for DED clinical research and patient care.MethodsThe English-language literature in PubMed primarily over the last decade was surveyed for studies related to identification of biomarkers of DED: (1) inflammation, (2) point-of-care, (3) ocular imaging, and (4) genetics. Relevant studies in each group were individually evaluated for (1) methodological and analytical details, (2) data and concordance with other similar studies, and (3) potential to serve as validated biomarkers with objective metrics.ResultsSignificant work has been done to identify biomarkers for DED clinical trials and for patient care. Interstudy variation among studies dealing with the same biomarker type was high. This could be attributed to biologic variations and/or differences in processing, and data analysis. Correlation with other signs and symptoms of DED was not always clear or present.ConclusionsMany of the biomarkers reviewed show the potential to serve as validated and objective metrics for clinical research and patient care in DED. Interstudy variation for a given biomarker emphasizes the need for detailed reporting of study methodology, including information on subject characteristics, quality control, processing, and analysis methods to optimize development of nonsubjective metrics. Biomarker development offers a rich opportunity to significantly move forward clinical research and patient care in DED.OverviewDED is an unmet medical need — a chronic pain syndrome associated with variable vision that affects quality of life, is common with advancing age, interferes with the comfortable use of contact lenses, and can diminish results of eye surgeries, such as cataract extraction, LASIK, and glaucoma procedures. It is a worldwide medical challenge with a prevalence rate ranging from 8% to 50%. Many clinicians and researchers across the globe are searching for better answers to understand the mechanisms related to the development and chronicity of DED. Though there have been many clinical trials for DED, few new treatments have emerged over the last decade. Biomarkers may provide the needed breakthrough to propel our understanding of DED to the next level and the potential to realize our goal of truly personalized medicine based on scientific evidence. Clinical trials and research on DED have suffered from the lack of validated biomarkers and less than objective and reproducible endpoints. Current work on biomarkers has provided the groundwork to move forward. This review highlights primarily ocular biomarkers that have been investigated for use in DED, discusses the methodologic outcomes in providing objective metrics for clinical research, and suggests recommendations for further work.

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“…The results showed that dry eye patients with punctal plugs have higher tear meniscus heights. Studies have shown that OCT is a reproducible, objective, and noninvasive instrument for measuring the tear lake 61,62. Of interesting potential value is the ability to measure tear film thickness using OCT. One study found highly reproducible measurements using ultrahigh resolution OCT.…”

Section: Emerging Technologies For Diagnosismentioning

confidence: 99%

Diagnosis of dry eye disease and emerging technologies

Zeev¹,

Miller²,

Latkany³

2014

OPTH

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Dry eye is one of the most commonly encountered problems in ophthalmology. Signs can include punctate epithelial erosions, hyperemia, low tear lakes, rapid tear break-up time, and meibomian gland disease. Current methods of diagnosis include a slit-lamp examination with and without different stains, including fluorescein, rose bengal, and lissamine green. Other methods are the Schirmer test, tear function index, tear break-up time, and functional visual acuity. Emerging technologies include meniscometry, optical coherence tomography, tear film stability analysis, interferometry, tear osmolarity, the tear film normalization test, ocular surface thermography, and tear biomarkers. Patient-specific considerations involve relevant history of autoimmune disease, refractive surgery or use of oral medications, and allergies or rosacea. Other patient considerations include clinical examination for lid margin disease and presence of lagophthalmos or blink abnormalities. Given a complex presentation and a variety of signs and symptoms, it would be beneficial if there was an inexpensive, readily available, and reproducible diagnostic test for dry eye.

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Optical Coherence Tomography for Measuring the Tear Film Meniscus: Correlation with Schirmer Test and Tear-Film Breakup Time

Abstract: OCT values were significantly lower in patients with Schirmer values of <5 mm. Tear meniscus measurements obtained by OCT are reliable for establishing a diagnosis of dry eye.

Cited by 49 publications

References 35 publications

Image-guided evaluation and monitoring of treatment response in patients with dry eye disease

Image-guided evaluation and monitoring of treatment response in patients with dry eye disease

The Growing Need for Validated Biomarkers and Endpoints for Dry Eye Clinical Research

Diagnosis of dry eye disease and emerging technologies

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