Evaluation of dry eye subtypes and characteristics using conventional assessments and dynamic tear interferometry

Session Details

Session Title: Presented Poster Session: Imaging

Venue: Poster Village: Pod 3

First Author: : M.Kang SOUTH KOREA

Co Author(s): :    K. Seo   Y. Ji                    

Abstract Details

Purpose:

Although dry eye (DE) is associated with considerable morbidity and is among the most frequently encountered diseases in clinical ophthalmology, proper treatment remains challenging since the mechanisms underlying the severity of the disease remain unknown. We aimed to evaluate the subtypes and characteristics of DE using conventional tests and dynamic tear interferometry, and to investigate the determinants of disease severity in each DE subtype

Setting:

Department of Ophthalmology, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea

Methods:

Design: Cross-sectional, observational case series Setting: single center Participants: A total of 309 patients diagnosed with DE and 69 healthy controls Interventions/Exposures: All eyes were evaluated using conventional clinical tests including the Ocular Surface Disease Index (OSDI), Schirmer’s Test I (ST1), and Meibomian gland dysfunction (MGD) grade. The tear interferometric pattern and lipid layer thickness (LLT) were determined using DR-1α® and LipiView II®, respectively. Main Outcome Measures: DE subtypes differentiated based on ST1 scores, the presence of MGD, and dynamic tear interferometric patterns (pearl-, Jupiter-, and crystal-patterns); determinants of DE severity

Results:

Dynamic interferometric analysis revealed that 56.6% of patients with DE exhibited Jupiter-patterns, indicative of aqueous-deficiency, while 43.4% exhibited crystal-patterns, indicative of lipid-deficiency. These findings were in accordance with classification based on ST1 scores and MGD grade. Interestingly, of the 286 patients with EDE, 144 were categorized into the mixed-ADDE/EDE group, in which ST1 was identified as a strong negative determinant of OSDI. In contrast, 72.2% of patients with mixed-ADDE/EDE exhibited Jupiter-patterns (Jupiter-mixed), while 27.8% exhibited crystal-patterns (crystal-mixed). OSDI were significantly higher in the crystal-mixed group than in the Jupiter-mixed group, in which OSDI were independently associated with ST1 values only.

Conclusions:

Our findings indicate that majority of patients with EDE also exhibit aqueous tear deficiency, which can aggravate symptoms even in patients with lipid-deficient mixed-ADDE/EDE. Conventional assessments should be combined with interferometric tear pattern analysis to determine the most appropriate treatment for each patient with DE.

Financial Disclosure:

None