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  • Title: Assessment of tear film stability in dry eye with a newly developed keratograph.
    Author: Hong J, Sun X, Wei A, Cui X, Li Y, Qian T, Wang W, Xu J.
    Journal: Cornea; 2013 May; 32(5):716-21. PubMed ID: 23132457.
    Abstract:
    PURPOSE: To investigate the applicability of a newly developed corneal topographer in assessing tear film stability. METHODS: This is a prospective, case-control study. Forty-four Chinese dry eye patients and 41 normal subjects were recruited. Noninvasive tear film break-up time (NI-BUT) was measured using a new method based on a corneal topographer equipped with modified scan software. The reliability of the measurements was determined. Then, the correlations between the NI-BUT and the traditional fluorescein tear film break-up time, Schirmer I test values, and inferior tear meniscus height measurements were determined. The receiver operating characteristic curve technique was used to evaluate the NI-BUT examination in the diagnosis of dry eye. RESULTS: In total, a significant difference between the NI-BUT and the fluorescein tear film break-up time was found (3.2 ± 2.3 seconds vs. 5.2 ± 3.4 seconds; P < 0.001). The coefficient of variation and intraclass correlation coefficient values of NI-BUT were 12.8% and 0.93, respectively, for NI-BUT for intraobserver repeatability and 15.4% and 0.88, respectively for interobserver repeatability. The NI-BUT showed a good correlation with other dry eye examinations (all P < 0.05). In addition, the NI-BUT was significantly shorter in dry eye patients (2.0 ± 0.2 seconds) than in normal subjects (4.3 ± 0.3 seconds; P < 0.001). When the cutoff value was set at <2.65 seconds, the sensitivity and specificity of the test were 84.1% and 75.6%, respectively. CONCLUSIONS: Measurements of NI-BUT obtained with the newly developed corneal topographer may provide a simple, noninvasive screening test for dry eyes with acceptable sensitivity, specificity, and repeatability.
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