Llorens-Quintana Clara, Szczesna-Iskander Dorota, Iskander D Robert
Department of Optics and Photonics, Wroclaw University of Science Technology, Wroclaw, Poland *
Department of Biomedical Engineering, Wroclaw University of Science Technology, Wroclaw, Poland.
Optom Vis Sci. 2019 Feb;96(2):103-110. doi: 10.1097/OPX.0000000000001336.
Noninvasive high-speed videokeratoscopy equipped with specific software has shown potential for assessing the homeostasis of tear film, providing clinicians with a fast and consistent tool for supporting dry eye diagnosis and management.
The purpose of this study was to evaluate the efficacy of a recently proposed method for characterizing tear film dynamics using noninvasive high-speed videokeratoscopy in assessing the loss of homeostasis of tear film.
Thirty subjects from a retrospective study, of which 11 were classified as dry eye and 19 as healthy, were included. High-speed videokeratoscopy measurements were performed using E300 videokeratoscope (Medmont Pty., Ltd., Melbourne, Australia). Raw data were analyzed using a recently proposed method to estimate the dynamics of the tear film based on a fractal dimension approach. This method provides three time-varying indicators related to the regularity of the reflected rings: tear film surface quality indicator, breaks feature indicator, and distortions feature indicator. From each indicator, five parameters were extracted and analyzed, including noninvasive breakup time, mean value of the indicator in the stability phase, mean value of the indicator in the whole interblink interval, mean value of the indicator in the leveling phase, and the general trend of the time series. Receiver operating characteristic curves were used to determine the sensitivity and specificity of each parameter in dry eye detection.
The best discrimination performance between dry eye and healthy subjects was achieved with the breaks feature indicator noninvasive breakup time parameter, with an area under the curve of 0.85. For a cutoff value of 10 seconds, the sensitivity was 100% and the specificity was 84%.
The analyzed method improves the assessment of tear film homeostasis in comparison with previous high-speed videokeratoscopy methods showing higher potential in assisting dry eye diagnosis.
配备特定软件的非侵入性高速角膜地形图仪已显示出评估泪膜稳态的潜力，为临床医生提供了一种快速且一致的工具，以支持干眼的诊断和管理。
本研究的目的是评估一种最近提出的使用非侵入性高速角膜地形图仪表征泪膜动力学的方法在评估泪膜稳态丧失方面的有效性。
纳入了一项回顾性研究中的30名受试者，其中11名被归类为干眼，19名被归类为健康受试者。使用E300角膜地形图仪（澳大利亚墨尔本的Medmont Pty., Ltd.）进行高速角膜地形图测量。使用一种最近提出的基于分形维方法估计泪膜动力学的方法对原始数据进行分析。该方法提供了三个与反射环规律性相关的随时间变化的指标：泪膜表面质量指标、破裂特征指标和变形特征指标。从每个指标中提取并分析了五个参数，包括非侵入性泪膜破裂时间、稳定期指标的平均值、整个眨眼间隔期指标的平均值、平衡期指标的平均值以及时间序列的总体趋势。使用受试者工作特征曲线来确定每个参数在干眼检测中的敏感性和特异性。
破裂特征指标的非侵入性泪膜破裂时间参数在干眼和健康受试者之间实现了最佳的区分性能，曲线下面积为0.85。对于截断值为10秒，敏感性为100%，特异性为84%。
与先前的高速角膜地形图方法相比，所分析的方法改进了泪膜稳态的评估，在辅助干眼诊断方面显示出更高的潜力。
