The Dry Eye Zone

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Abstract: OCT, LIPCOF and DE

Any more acronyms anyone?

Imaging lid-parallel conjunctival folds with OCT and comparing its grading with the slit lamp classification in dry eye patients and normal subjects.

Purpose:
to visualize and describe the morphological appearance of lid-parallel conjunctival folds (LIPCOF) using optical coherence tomography (OCT) and to relate it to dry eye signs and symptoms.

Methods:
LIPCOF grade, non-invasive tear film break-up time (NIBUT), lipid layer's interference pattern and dry eye symptoms were recorded in 17 normal and 33 dry eye cases. LIPCOF was evaluated with slit lamp and visualized with OCT. Three different algorithms for OCT was developed to grade LIPCOF using either tear meniscus height or the covering tear film on the folds evaluated by OCT.

Results:
The three OCT methods showed significant correlations with the slit lamp method (r=0.470--0.473, P<0.01). The OCT LIPCOF methods were independent of NIBUT. The Dry Eye Questionnaire (DEQ) scores correlated with the height of the folds, and the absence of tear film coverage of the folds (r=0.574, P<0.001, and r=-0.527, P<0.001, respectively). The OCT LIPCOF grades correlated with the DEQ scores (r=0.494, P<0.001 and r=0.310, P=0.029). The slit lamp grade did not correlate with the DEQ scores in the whole population, but in the normal group (r=0.458, P=0.024). The OCT LIPCOF grades showed inverse correlation with lipid pattern in the normal group (r=-0.422-0.481, P=0.05), however this association disappeared in the dry eye group.

Conclusions:
The OCT enabled a non-invasive high resolution method for imaging, evaluating and grading of the LIPCOF. These novel classifications correlated well with the slit lamp grade and the DEQ scores promising a new, more objective evaluation of dry eye.


Invest Ophthalmol Vis Sci. 2011 Jan 31. [Epub ahead of print]
Veres A, Tapaszto B, Kosina-Hagyó K, Somfai GM, Németh J.
Department of Ophthalmology, Semmelweis University, Budapest, Hungary.
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