Tashbayev Behzod, Badian Reza A, Chen Xiangjun, Vitelli Valeria, Lagali Neil, Dartt Darlene, Hove Lene Hystad, Jensen Janicke Liaaen, Utheim Tor Paaske
Department of Oral Surgery and Oral Medicine, University of Oslo, Oslo, Norway
Norwegian Dry Eye Clinic, Oslo, Norway.
BMJ Open. 2025 Apr 10;15(4):e090305. doi: 10.1136/bmjopen-2024-090305.
Measurement of tear film stability is central in dry eye disease (DED) diagnosis. In this study, we aimed to compare the performance of two methods of tear film stability measurement: non-invasive tear break-up time (NIBUT) and fluorescein tear film break-up time (FTBUT).
Cross-sectional study.
The study involved 132 subjects of 65-year-old inhabitants of the Oslo region who were not seeking ophthalmic care.
The participants underwent a battery of DED tests, including NIBUT measured on Oculus Keratograph 5M and a traditional method using fluorescein drops (FTBUT). Oculus Keratograph 5M measures two types of NIBUT:; appearance time of the first dry spot (NIBUT) and average NIBUT.
74 participants (56%) were female and 58 were male (44%). Subjects presented with varying degrees of DED signs and symptoms. Mean values of NIBUT and FTBUT from all the participants were significantly different (6.2±4.9 s vs 8.6±6.2 s, p<0.0001). There was also a significant difference between NIBUT and NIBUT values (6.2±4.9 s vs 8.3±5.5 s, p<0.0001). In contrast, no difference was observed between FTBUT and NIBUT values (8.6±6.2 s vs 8.3±5.5 s, p=0.655). The receiver operating characteristic curve analysis was performed to compare NIBUT and FTBUT in regards to other clinical tests (Ocular Surface Disease Index, ocular surface staining, blink interval, eye redness, corneal sensitivity, lid debris, Schirmer I test, tear osmolarity, meibum quality, meibum expressibility, lid hyperemia, tear meniscus height,. irregular lid margin, conjunctival hyperaemia, margin telangiectasia, lipid layer and meibomian gland drop-out). While FTBUT demonstrated results with area under the curve>0.6, neither NIBUT nor NIBUT showed significant results.
NIBUT was shorter than FTBUT. Low correlation between NIBUT and FTBUT indicates that these diagnostic tests are not interchangeable. Other DED tests had correlation, though low, while NIBUT did not demonstrate correlation.
泪膜稳定性测量是干眼疾病（DED）诊断的核心。在本研究中，我们旨在比较两种泪膜稳定性测量方法的性能：非侵入性泪膜破裂时间（NIBUT）和荧光素泪膜破裂时间（FTBUT）。
横断面研究。
该研究纳入了132名奥斯陆地区65岁的居民，他们未寻求眼科护理。
参与者接受了一系列DED测试，包括在Oculus Keratograph 5M上测量的NIBUT以及使用荧光素滴眼液的传统方法（FTBUT）。Oculus Keratograph 5M测量两种类型的NIBUT：第一个干燥点出现时间（NIBUT）和平均NIBUT。
74名参与者（56%）为女性，58名参与者（44%）为男性。受试者呈现出不同程度的DED体征和症状。所有参与者的NIBUT和FTBUT平均值有显著差异（6.2±4.9秒对8.6±6.2秒，p<0.0001）。NIBUT和NIBUT值之间也有显著差异（6.2±4.9秒对8.3±5.5秒，p<0.0001）。相比之下，FTBUT和NIBUT值之间未观察到差异（8.6±6.2秒对8.3±5.5秒，p=0.655）。进行了受试者工作特征曲线分析，以比较NIBUT和FTBUT与其他临床测试（眼表疾病指数、眼表染色、眨眼间隔、眼红、角膜敏感性、睑缘碎屑、Schirmer I试验、泪液渗透压、睑板腺质量、睑板腺可挤压性、睑充血、泪液弯月面高度、不规则睑缘、结膜充血、睑缘毛细血管扩张、脂质层和睑板腺缺失）的情况。虽然FTBUT的曲线下面积结果>0.6，但NIBUT和NIBUT均未显示出显著结果。
NIBUT比FTBUT短。NIBUT和FTBUT之间的低相关性表明这些诊断测试不可互换。其他DED测试虽相关性较低，但NIBUT未显示出相关性。
