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Observational Study
. 2014 Feb;157(2):301-310.e1.
doi: 10.1016/j.ajo.2013.09.024. Epub 2013 Sep 28.

Tear meniscus dimensions in tear dysfunction and their correlation with clinical parameters

Cynthia I Tung  1 , Andrew F Perin  1 , Koray Gumus  1 , Stephen C Pflugfelder  2
Affiliations
Observational Study

Tear meniscus dimensions in tear dysfunction and their correlation with clinical parameters

Cynthia I Tung et al. Am J Ophthalmol. 2014 Feb.

Abstract

Purpose: To evaluate relationships between tear meniscus dimensions and parameters of ocular surface disease in a variety of tear dysfunction conditions.

Design: Single-institution prospective observational study.

Methods: This study from the Baylor College of Medicine included 128 eyes of 64 subjects. Cross-sectional lower tear meniscus height and tear meniscus area were measured using optical coherence tomography and were compared with tear break-up time (TBUT), corneal staining, conjunctival staining, and an irritation symptom questionnaire (Ocular Surface Disease Index). Study groups included meibomian gland disease (MGD), aqueous tear deficiency (ATD), Sjögren syndrome, non-Sjögren syndrome ATD, and control subjects. Statistical analyses were performed using the Pearson correlation and Student's t test.

Results: When compared with mean tear meniscus height in controls (345 μm), mean tear meniscus height was lower in all tear dysfunction (234 μm; P = .0057), ATD (210 μm; P = .0016), and Sjögren syndrome groups (171 μm; P = .0054). For tear meniscus height ≤210 μm, relative risk ratio for developing corneal staining ≥10 was 4.65. Tear meniscus height correlated with corneal staining for all subjects (R = -0.32; P = .0008), MGD (R = +0.40; P = .059), and ATD (R = -0.36; P = .04). Tear meniscus area showed similar trends in MGD (R = +0.55; P = .006) and ATD (R = -0.40; P = .018). Tear meniscus height correlated with TBUT for all subjects (R = +0.39; P < .0001) and ATD (R = +0.37; P = .018).

Conclusions: In tear dysfunction conditions, lower tear volume correlates with worse corneal epithelial disease in ATD and Sjögren syndrome, conditions with lacrimal gland dysfunction. In contrast, higher tear volume is associated with corneal epithelial disease in MGD. These findings may improve the ability to identify patients at risk for corneal epithelial disease.

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Figures

Figure 1
Figure 1
Cross-sectional optical coherence tomography (OCT) images of lower tear meniscus. Measurements of tear meniscus height (TMH) and area (TMA) were performed using Optovue RTVue-100 software. Shown are (left) schematic diagram of tear meniscus cross-sectional image, (middle) sample image of normal tear meniscus (tear meniscus height = 290 μm; tear meniscus area = 0.024 μm2), and (right) sample image of aqueous tear deficient tear meniscus (tear menscius height = 148 μm; tear meniscus area = 0.004 μm2).
Figure 2
Figure 2
Mean values of tear meniscus height for each group. *Denotes significance compared to normal (p ≤ 0.05). **Denotes significance between groups indicated (p value ≤ 0.05). Groups include control (345 μm), all tear dysfunction (234 μm), meibomian gland disease (MGD) (302 μm), aqueous tear deficiency (ATD) (210 μm), Sjögren syndrome (171 μm), and non-Sjögren syndrome ATD (262 μm). Significant comparisons include all tear dysfunction vs. control (p = 0.0057); ATD vs. control (p = 0.0016); Sjögren syndrome ATD vs. control (p = 0.0054); and MGD vs. ATD (p = 0.0235); and Sjögren syndrome ATD vs. non-Sjögren syndrome ATD (p = 0.0358). Thick error bars indicate the 25% percentile and 75% percentile. Thin error bars indicate minimum and maximum values. Confidence intervals for each group are listed in the Results section.
Figure 3
Figure 3
Correlation graphs: Tear meniscus height vs. corneal staining. (left) All subjects (R = −0.32; p = 0.0008), (right) meibomian gland disease (MGD) (R = +0.40; p = 0.059) and aqueous tear deficient dry eye (ATD) (R = −0.36; p = 0.04).
Figure 4
Figure 4
Correlation graphs: Tear meniscus area vs. corneal staining. (left) All subjects (R = −0.25; p = 0.011), (right) meibomian gland disease (MGD) (R = +0.553; p = 0.006) and aqueous tear deficient dry eye (ATD) (R = −0.40; p = 0.018).
Figure 5
Figure 5
Correlation graphs: Tear meniscus height vs. tear break-up time (sec). All subjects (R = +0.391; p
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References

    1. Stern ME, Beuerman RW, Fox RI, Gao J, Mircheff AK, Pflugfelder SC. The pathology of dry eye: The interaction between ocular surface and lacrimal glands. Cornea. 1998;17(6):584–589. - PubMed
    1. Stern ME, Schaumburg CS, Pflugfelder SC. Dry eye as a mucosal autoimmune disease. Int Rev Immunol. 2013;32(1):19–41. - PMC - PubMed
    1. Yokoi N, Takehisa Y, Kinoshita S. Correlation of tear lipid layer interference patterns with the diagnosis and severity of dry eye. Am J Ophthalmol. 1996;122(6):818–24. - PubMed
    1. Goto E, Tseng SC. Differentiation of lipid tear deficiency dry eye by kinetic analysis of tear interference images. Arch Ophthalmol. 2003;121(2):173–80. - PubMed
    1. Bron AJ, Tiffany JM. The contribution of meibomian disease to dry eye. Ocul Surf. 2004;2(2):149–65. - PubMed

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