Garhöfer Gerhard, Dos Santos Valentin Aranha, Stegmann Hannes, Schmidl Doreen, Adzhemian Narine, Werkmeister René M, Schmetterer Leopold
Department of Clinical Pharmacology, Medical University of Vienna, 1090 Vienna, Austria.
Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, 1090 Vienna, Austria.
J Clin Med. 2020 Nov 23;9(11):3791. doi: 10.3390/jcm9113791.
To determine the association between tear film thickness (TFT) as measured with ultra-high resolution optical coherence tomography (UHR-OCT) and signs and symptoms of dry eye disease (DED).
A total of 450 eyes from 225 patients with DED from six different randomized clinical trials were included in this pooled analysis. In all subjects, TFT was measured with a custom-built UHR-OCT system. Symptoms of DED were quantified using a standardized Ocular Surface Disease Index (OSD)I questionnaire and clinical signs including tear film break up time (TFBUT) and Schirmer I test were assessed. Associations of the average TFT with OSDI, TFBUT, and Schirmer I test were calculated using a linear regression analysis.
The average TFT of the included sample (mean age, 45.0 ± 13.3 years; 65% female) was 4.2 ± 0.5 µm and the OSDI 36.2 ± 10.4. A significant negative correlation was found between TFT and OSDI (r = -0.36 to -0.31; < 0.001). Tear break up time and Schirmer I test were not correlated with OSDI. Significant albeit weak correlations were found between TFT and TFBUT (r = 0.17 to 0.25; < 0.01) as well as Schirmer I (r = 0.36 to 0.37; < 0.001). Subgroup analysis revealed that the correlation was stronger in the subjects with abnormal Schirmer I (<15 mm; r = 0.50 to 0.54; < 0.001).
The present study demonstrates an objective measurement of TFT using a novel OCT approach for DED that correlates with symptoms and signs of DED. Our data are consistent with the idea that TFT represents the aqueous-deficient component of DED.
确定通过超高分辨率光学相干断层扫描（UHR-OCT）测量的泪膜厚度（TFT）与干眼病（DED）的体征和症状之间的关联。
本汇总分析纳入了来自六项不同随机临床试验的225例DED患者的450只眼。在所有受试者中，使用定制的UHR-OCT系统测量TFT。使用标准化的眼表疾病指数（OSDI）问卷对DED症状进行量化，并评估包括泪膜破裂时间（TFBUT）和Schirmer I试验在内的临床体征。使用线性回归分析计算平均TFT与OSDI、TFBUT和Schirmer I试验之间的关联。
纳入样本的平均TFT（平均年龄45.0±13.3岁；65%为女性）为4.2±0.5µm，OSDI为36.2±10.4。发现TFT与OSDI之间存在显著负相关（r=-0.36至-0.31；P<0.001）。泪膜破裂时间和Schirmer I试验与OSDI无关。发现TFT与TFBUT之间存在显著但较弱的相关性（r=0.17至0.25；P<0.01）以及与Schirmer I之间存在显著但较弱的相关性（r=0.36至0.37；P<0.001）。亚组分析显示，在Schirmer I异常（<15mm）的受试者中相关性更强（r=0.50至0.54；P<0.001）。
本研究证明了使用一种新型OCT方法对DED的TFT进行客观测量，该测量与DED的症状和体征相关。我们的数据与TFT代表DED中水分缺乏成分的观点一致。
