J Korean Ophthalmol Soc.  2015 Nov;56(11):1684-1691. 10.3341/jkos.2015.56.11.1684.

Tear Meniscus Evaluation Using Optical Coherence Tomography in Meibomein Gland Dysfunction Patients

• Jeon SJ
• Baek JW
• Doh SH
• Chung SK

• KMID: 2214175
• DOI: http://doi.org/10.3341/jkos.2015.56.11.1684

Abstract

PURPOSE
This study compared tear meniscus parameters between normal control, aqueous tear deficient dry eye, and meibomein gland dysfunction groups using Fourier-domain optical coherence tomography (FD-OCT).
METHODS
This study included 33 normal eyes, 79 aqueous tear-deficient dry eyes (ATD), and 48 meibomein gland dysfunction dry eyes (MGD). Following routine examination including Schirmer test, tear break-up time, corneal staining, and tear meniscus parameters such as tear meniscus height (TMH), tear meniscus depth (TMD), and tear meniscus area (TMA) were obtained using FD-OCT. The differences among groups were assessed.
RESULTS
The averages of TMH, TMD, and TMA were 295.58 +/- 58.36 microm, 166.67 +/- 30.43 microm, and 0.0360 +/- 0.01100 mm2 in normal eyes, respectively, 226.43 +/- 42.18 microm, 147.44 +/- 38.38 microm, and 0.0209 +/- 0.01015 mm2 in ATD, respectively, 272.81 +/- 64.21 microm, 159.37 +/- 44.05 microm, and 0.0295 +/- 0.01271 mm2 in MGD, respectively. Tear meniscus parameters were significantly lower in ATD. Tear meniscus parameters in MGD were higher than ATD and lower than normal eyes, but the TMA was the only statistically significant value.
CONCLUSIONS
Although tear meniscus parameters in MGD were higher than ATD, they could not be distinguished from normal eyes. Tear meniscus evaluation using FD-OCT could be a useful measurement system in classification and treatment choice for dry eye patients.

Keyword

Dry eye syndrome; Meibomian gland dysfunction; Optical coherence tomography; Tear meniscus

MeSH Terms

Classification
Dry Eye Syndromes
Humans
Tears*
Tomography, Optical Coherence*

Figure

• 

  Figure 1. Measurement of optical coherence tomography (OCT) parameters of tear meniscus. (A) Tear meniscus heights (TMH) in-dicates vertical linear length between upper end of tear meniscus reaching the cornea and lower end of the tear meniscus reaching the lower conjunctiva. Tear meniscus depth (TMD) indicates horizontal linear length between the outer limit of the tear meniscus and apex. (B) Tear meniscus area (TMA) indicates the entire selection of tear meniscus shown in OCT image (arrow). Measurements of TMH, TMA, and TMD were performed using RTVue-100 software.

• 

  Figure 2. Mean values of TMH, TMD, and TMA for each group. When compared to the control group, statistically sig-nificant differences existed in all tear meniscus parameters in the ATD group ( p = 0.000, p = 0.047, p = 0.000), but in the MGD group, only TMA was significantly low ( p = 0.030). In the MGD group, the mean TMH, TMD, and TMA was higher than the ATD group, and only TMH and TMA are statistically significant ( p = 0.000, p = 0.000). TMH = tear meniscus heights; TMD = tear meniscus depth; TMA = tear meniscus area; ATD = aqueous tear deficiency; MGD = meibomian gland dysfunction; Dx = diagnosis. * Denotes statistically sig-nificance compared between groups indicated.

• 

  Figure 3. Spearman correlation between tear meniscus parame-ters and TBUT in meibomian gland dysfunction patients. Correlation graphs between TBUT and (A) TMH, (B) TMD, and (C) TMA. TBUT = tear break-up time; TMH = tear meniscus heights; TMD = tear meniscus depth; TMA = tear meniscus area.

• 

  Figure 4. The ROC curves of TMH, TMD, and TMA in meibo-mian gland dysfunction group. Area under the ROC of TMH, TMD, and TMA is 0.396, 0.384, 0.357, respectively. ROC = receiver operator characteristic; TMH = tear meniscus heights; TMD = tear meniscus depth; TMA = tear meniscus area.

Reference

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