The Dry Eye Zone

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Abstract: Upper and lower tear menisci in the diagnosis of dry eye.

Another direction in developing improved dry eye diagnostics.

Invest Ophthalmol Vis Sci. 2009 Feb 14. [Epub ahead of print]
Upper and lower tear menisci in the diagnosis of dry eye.
Shen M, Li J, Wang J, Ma H, Cai C, Tao A, Yuan Y, Lu F.
Wenzhou Medical College, School of Ophthalmology and Optometry, Wenzhou, Zhejiang, China.

Purpose: To measure the upper and lower tear menisci in aqueous tear deficiency (ATD) dry eye patients using real-time optical coherence tomography (OCT), and to determine the most effective meniscus variables for the diagnosis of dry eye.

Methods: Eyes of 48 pre-screened ATD patients were compared with those of 47 healthy subjects. Upper and lower tear menisci were imaged simultaneously by real-time OCT immediately after blinking. The height, radius, and cross-sectional area of upper and lower tear menisci were obtained.

Results: The tear meniscus radius, height, and cross-sectional areas were significantly smaller in dry eye patients than healthy subjects (P < 0.01). The lower tear meniscus variables were higher than the upper menisci (P < 0.01) in normal subjects; however, no significant differences between menisci were found in ATD patients. In both groups, the upper and lower tear meniscus variables were strongly correlated with each other. Good dry eye diagnostic accuracies were obtained with cutoff values for an "abnormal" lower tear meniscus radius (LTMR) of 182 microm and a lower tear meniscus height (LTMH) of 164 microm. The LTMR diagnostic sensitivity and specificity were 0.92 and 0.87 respectively. The LTMH diagnostic sensitivity and specificity were 0.92 and 0.90.

Conclusion: Upper tear meniscus variables in ATD patients were assessed for the first time using real-time OCT. The tear meniscus was smaller in patients with ATD compared with healthy subjects. LTMR and LTMH may have potential in the diagnosis of ATD.
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