Reliability and clinical applicability of a novel tear film imaging tool

Abstract

Purpose The aim of our research was to investigate the reliability and clinical applicability of a modern tear film imaging tool by comparing the inter- and intragrader difference. The further goal was to compare the non-invasive tear break-up time (NIBUT) measured with the LacryDiag® device with traditional tear film break-up time (TBUT). Methods Comprehensive ophthalmological examination was performed, including LacryDiag® (Quantel Medical, France) (lower tear meniscus height measuring (LTMH), superior and inferior eyelid meibography (MeibS MeibI), interferometry (INT), NIBUT), slit lamp examination, and TBUT. Two independent, well-trained graders selected and analyzed the LTMH, MeibI, MeibS, and INT. The second grader reanalyzed the data 1 month later. Intra- and inter-examiner reliabilities were evaluated using intraclass correlation coefficients (ICC), while for categorical variable, Cohen’s kappa statistics were provided. The Bland-Altman plot was used for visualization of the agreement between measurements. Results Fifty healthy volunteers were examined. For LTMH both the inter- and intragrader variabilities were excellent. Between two graders, the ICC of MeibI was poor; however, between two graders, the ICC of MeibS was good, and the intragrader variability in MeibI and MeibS was excellent. For the INT, both intra- and intergrading were in fair and moderate agreement, although the intragrader agreement was higher. Comparing the NIBUT and TBUT, the agreement was slight. Conclusion Based on our results, examination of a patient during follow-up should be performed by the same examiner, because of the slight agreement. The LacryDiag® is a non-invasive, easy-to-use device, which can examine the tear film and save the recordings for easier follow-up.

Analysis of the ocular surface functional unit in episodic migraine

“…Though LacryDiag is validated and compared to other clinically used tear film analysing tools, it shows significant differences in meibography parameters between observers, likely influenced by the use of repeated testing and the non-dry eye cohort [ 48 ]. In our study one examiner (TN) carried out the analyses of LacryDiag data, in order to avoid the intergrader variability [ 30 ]. None of the other tear film parameters showed any alterations in migraine.…”

“…Several tear film parameters (lower tear meniscus height measuring [LTMH], superior eyelid meibography [Meib], interferometry [INT], non-invasive break-up time [NIBUT]) were defined using LacryDiag (Quantel Medical, France), a novel non-invasive tear film imaging tool as described elsewhere [ 30 ]. The analyses was performed by an experienced examiner (NT).…”

Prevalence of Dry Eye Disease in Laser-Assisted In Situ Keratomileusis Candidates

“…The videos were evaluated and matched to a set of standard videos provided by the manufacturer. 17,18 The lipid layer thickness (LLT) assessment criteria were focused on lipid layer color, reflection pattern, and dynamics. The scale ranged from A (thickest lipid layer) to G (thinnest lipid layer).…”

Dry eye disease and tear film assessment through a novel non-invasive ocular surface analyzer: The OSA protocol

“…These devices record the first alteration of the tear film (FNIBUT) as well as the average BUT for all points of measurement (MNIBUT). Keratograph 5M ( 45 – 48 ) performs the measurement automatically for 24 s, but using OSA ( 49 ), IDRA ( 12 , 50 , 51 ) and LacryDiag ( 13 , 52 ), the clinician manually activates and stops video recording. Keratograph 5M has shown good repeatability and reproducibility in patients with dry eye and healthy controls ( 43 ).…”