Turkiye Klinikleri Journal of Ophthalmology

.: ORIGINAL RESEARCH
Non-invasive Assessment of Dry Eye Patients: Correlation of Tear Osmolarity, Tear Meniscus Height and Non-invasive Tear Break-up Time with Other Tests
Kuru Göz Hastalarında Noninvaziv Değerlendirme: Gözyaşı Ozmolaritesi, Gözyaşı Menisküs Yüksekliği ve Noninvaziv Gözyaşı Kırılma Zamanının Diğer Testlerle İlişkisi
Azersara Vural KARAKILIÇa, Arzu TAŞKIRAN ÇÖMEZa
aDepartment of Ophthalmology, Çanakkale Onsekiz Mart University Faculty of Medicine, Çanakkale, TURKEY
Turkiye Klinikleri J Ophthalmol.2021;30(1):8-16
doi: 10.5336/ophthal.2020-75878
Article Language: EN
Full Text
ABSTRACT
 Objective: To determine the correlation of non-invasive tests with conventional tear function tests in dry eye patients. Material and Methods: One hundred and twenty-two eyes of 61 patients over 18 years old who applied to Çanakkale Onsekiz Mart University School of Medicine, Department of Ophthalmology with dry eye were included in the study. After general ophthalmological examination including best corrected visual acuity, biomicroscopic examination, non-invasive methods like Ocular Surface Disease Index (OSDI) scoring, tear osmolarity, non-invasive tear break-up time (NI-TBUT) measurement with Scheimpflug topography, meibomography, and measurement of the lower lid meniscus height (TMH) with optical coherence tomography were performed. After non-invasive tests, conventional tear function tests like Schirmer test, TBUT, cornea and conjunctiva staining were applied respectively. Results: A positive correlation was found between NI-TBUT and conventional TBUT (p<0.01 Spearman's rho: 0.473). TBUT was found to be positively correlated with Schirmer test and negatively correlated with corneoconjunctival staining (p<0.01 Spearman's rho: 0.393, rho:-0.418). Schirmer test results were correlated positively with TMH and negatively correlated with OSDI scoring and corneoconjunctival staining (p<0.05 Spearman's rho: 0.181; p<0.05 Spearman's rho:-0.214; p<0.01 Spearman's rho:- 0.394). Tear osmolarity test results and meibomography did not correlate with any test. Conclusion: The non-invasive and objective measurement of NI-TBUT may be a better diagnostic modality than TBUT for dry eye patients. Tear osmolarity and meibomography were not significant for diagnosis of early stage dry eye patients.

Keywords: Kuru göz sendromu; ozmolar konsantrasyon; Schirmer testi; gözyaşı menisküs yüksekliği; gözyaşı ozmolaritesi; gözyaşı kırılma zamanı; meibomografi
ÖZET
 Amaç: Kuru göz hastalarında, noninvaziv testlerin, konvansiyonel gözyaşı fonksiyon testleri ile korelasyonunu araştırmak. Gereç ve Yöntemler: Çanakkale Onsekiz Mart Üniversitesi Tıp Fakültesi Göz Hastalıkları Anabilim Dalına başvuran ve kuru gözü olan 18 yaşından büyük 61 hastanın 122 gözü çalışmaya alındı. Hastalara en iyi düzeltilmiş görme keskinliği ölçümü, biyomikroskobik ve oftalmoskopik muayeneyi içeren genel oftalmolojik muayene sonrasında sırasıyla noninvaziv yöntemler olan, 'Ocular Surface Disease Index (OSDI)' anketi, gözyaşı ozmolaritesi ölçümü, Scheimpflug topografi ile noninvaziv gözyaşı kırılma zamanı (Nİ-GKZ), meibomografi ve optik koherens tomografi ile alt kapak gözyaşı menisküs yüksekliği (GMY) ölçüldü. Noninvaziv yöntemler sonrasında sırasıyla geleneksel gözyaşı fonksiyon testleri olan Schirmer testi, GKZ, kornea ve konjonktivanın boyanması yapıldı. Bulgular: Nİ-GKZ ile GKZ arasında pozitif korelasyon saptandı (p<0,01 Spearman'ın rho: 0,473). GKZ'nin Schirmer testi ile pozitif, korneal boyanma ile negatif korelasyonu olduğu saptandı (p<0,01 Spearman'ın rho: 0,393; rho: -0,418). Schirmer testi, GMY ile pozitif, OSDI skoru ve korneokonjonktival boyanma ile negatif korele idi (p<0,05 Spearman'ın rho: 0,181; p<0,05 Spearman'ın rho: -0,214; p<0,01 Spearman'ın rho: -0,394). Gözyaşı ozmolaritesi ve meibomografi testlerinin hiçbir testle korelasyon göstermediği tespit edildi. Sonuç: Nİ-GKZ, noninvaziv ve objektif bir ölçüm olması sebebiyle, kuru göz hastalarında GKZ'den daha iyi bir tanısal yöntem olabilir. Gözyaşı ozmolaritesi ölçümü ve meibomografi sonuçları özellikle erken evre kuru gözhastalarının tanısında anlamlı bulunmamıştır.

Anahtar Kelimeler: Dry eye syndrome; osmolar concentration; Schirmer test; tear meniscus height; tear osmolarity; tear break-up time; meibomography
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