Tan Li Li, Sanjay Srinivasan, Morgan Philip B
School of Chemical and Life Sciences, Singapore Polytechnic, Singapore.
Ophthalmology and Visual Sciences, Khoo Teck Puat Hospital, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Cont Lens Anterior Eye. 2016 Dec;39(6):442-449. doi: 10.1016/j.clae.2016.08.004. Epub 2016 Aug 24.
To evaluate the efficacy of infrared (IR) ocular thermography in screening for dry eye disease (DED).
IR ocular thermography was performed on 62 dry eye and 63 age- and sex-matched control subjects. Marking of ocular surface and temperature acquisition was done using a novel 'diamond' demarcation method. 30 static- and 30 dynamic-metrics were studied and receiver operating characteristic curves were plotted. Efficacy of the temperature metrics in detecting DED were evaluated singly and in combination in terms of their area under the curve (AUC), Youden's index and discrimination power (DP).
Absolute temperature of the extreme nasal conjunctiva 5s and 10s after eye opening were best detectors for DED. With threshold value for the first metric set at 34.7°C, sensitivity and specificity was 87.1% (95% CI: 76.2-94.3%) and 50.8% (95% CI: 37.9-63.6%) respectively. With threshold value for the second metric set at 34.5°C, sensitivity and specificity was 77.6% (95% CI: 64.7-87.5%) and 61.9% (95% CI: 48.8-73.9%) respectively. The two metrics had moderate accuracy and limited performances with AUC of 72% (95% CI: 63-81%) and 73% (95% CI: 64-82%); Youden index of about 0.4 and DP of 1.07 and 1.05 respectively. None of the dynamic metrics was good detector for DED. Combining metrics was not able to increase the AUC.
This work suggests some utility for the application of IR ocular thermography for evaluation of dry eye patients.
评估红外（IR）眼热成像技术在筛查干眼疾病（DED）中的有效性。
对62例干眼患者及63例年龄和性别匹配的对照者进行IR眼热成像检查。采用一种新颖的“菱形”划分法进行眼表标记和温度采集。研究了30项静态指标和30项动态指标，并绘制了受试者工作特征曲线。根据曲线下面积（AUC）、约登指数和鉴别力（DP），对温度指标单独及联合检测DED的有效性进行评估。
睁眼后5秒和10秒时鼻侧结膜最远端的绝对温度是DED的最佳检测指标。第一个指标的阈值设定为34.7°C时，敏感性和特异性分别为87.1%（95%CI：76.2 - 94.3%）和50.8%（95%CI：37.9 - 63.6%）。第二个指标的阈值设定为34.5°C时，敏感性和特异性分别为77.6%（95%CI：64.7 - 87.5%）和61.9%（95%CI：48.8 - 73.9%）。这两个指标的准确性中等，性能有限，AUC分别为72%（95%CI：63 - 81%）和73%（95%CI：64 - 82%）；约登指数约为0.4，DP分别为1.07和1.05。没有一项动态指标是DED的良好检测指标。联合指标并不能提高AUC。
这项研究表明IR眼热成像技术在评估干眼患者方面具有一定的应用价值。
