Shen Meixiao, Li Jianhua, Wang Jianhua, Ma Huixiang, Cai Chunyan, Tao Aizhu, Yuan Yimin, Lu Fan
School of Ophthalmology and Optometry, Wenzhou Medical College, Wenzhou, Zhejiang, China.
Invest Ophthalmol Vis Sci. 2009 Jun;50(6):2722-6. doi: 10.1167/iovs.08-2704. Epub 2009 Feb 14.
To measure the upper and lower tear menisci in patients with aqueous tear deficiency (ATD) dry eye by real-time optical coherence tomography (OCT) and to determine the most effective meniscus variables for the diagnosis of dry eye.
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.
The tear meniscus radius, height, and cross-sectional area were significantly smaller in patients with dry eye than in 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.
Upper tear meniscus variables in ATD patients were assessed by real-time OCT. The tear meniscus was smaller in ATD patients than in healthy subjects. LTMR and LTMH may have potential in the diagnosis of ATD.
通过实时光学相干断层扫描（OCT）测量泪液分泌不足（ATD）型干眼症患者的上下泪液半月皱襞，并确定诊断干眼症最有效的半月皱襞变量。
将48例预先筛选的ATD患者的眼睛与47例健康受试者的眼睛进行比较。眨眼后立即通过实时OCT同时对上下泪液半月皱襞进行成像。获取上下泪液半月皱襞的高度、半径和横截面积。
干眼症患者的泪液半月皱襞半径、高度和横截面积明显小于健康受试者（P < 0.01）。在正常受试者中，下泪液半月皱襞变量高于上泪液半月皱襞（P < 0.01）；然而，在ATD患者中，半月皱襞之间未发现显著差异。在两组中，上下泪液半月皱襞变量彼此高度相关。下泪液半月皱襞半径（LTMR）截断值为182微米和下泪液半月皱襞高度（LTMH）截断值为164微米时，干眼症诊断准确率良好。LTMR诊断敏感性和特异性分别为0.92和0.87。LTMH诊断敏感性和特异性分别为0.92和0.90。
通过实时OCT评估ATD患者的上泪液半月皱襞变量。ATD患者的泪液半月皱襞比健康受试者小。LTMR和LTMH在ATD诊断中可能具有潜力。
