Abstract
BackgroundIn clinical practice, fluctuating vision or decreased quality of vision is a common complaint in DED patients. Our study was designed to investigate the change in dynamic optical quality in dry eye patients after the use of artificial tears.MethodsFifty-nine patients with dry eye disease (DED) and 31 control subjects were included in this prospective case-control study. There was no significant difference in age and sex between these two groups (P = 0.342, P = 0.847, respectively). Clinical evaluation of the ocular surface included Ocular Surface Disease Index (OSDI), tear film break-up time (TBUT), lipid layer thickness (LLT), and Schirmer I test. DED patients were divided into two groups, mild (31 patients) and severe (28 patients). The optical quality of the tear film was measured with the Optical Quality Analysis System (OQAS) using the mean objective scatter index (mean OSI), standard deviation of objective scatter index (SD-OSI) and modulation transfer function cut-off (MTF cut-off). After baseline examinations, one drop of artificial tears (ATs, carboxymethylcellulose ophthalmic solution, 0.5%) was instilled in both eyes, and optical quality parameters were measured again at 5 and 30 min following application of ATs.ResultsAt baseline, the mean OSI was higher in the DED group (0.95 ± 0.54) than in controls (0.54 ± 0.23, P < 0.001). The SD-OSI was also significantly increased in DED patients (0.44 ± 0.71) compared to control subjects (0.12 ± 0.06, P = 0.003). Five minutes after AT instillation, mean OSI and SD-OSI decreased significantly in severe DED patients (P = 0.044; P = 0.018), remained unchanged in mild DED patients, and increased in the control group (P = 0.019; P < 0.001). Thirty minutes after AT instillation, no significant difference in optical quality parameters was observed among the three groups.ConclusionThe effect of ATs on optical quality in patients with DED may differ according to the severity of the disease. Measurement of optical quality might be a promising tool to evaluate the effects of various ATs and possibly individualize treatment in DED patients.
Highlights
In clinical practice, fluctuating vision or decreased quality of vision is a common complaint in Dry eye disease (DED) patients
No statistical difference in lipid layer thickness (LLT) was observed between the two DED groups (P = 0.223) (Table 1)
To previous studies, our study showed that optical quality parameters (MTF cut-off, mean objective scatter index (OSI) and Standard deviation of objective scatter index (SD-OSI)) were changed in DED patients and these changes are correlated to DED severity
Summary
In clinical practice, fluctuating vision or decreased quality of vision is a common complaint in DED patients. Our study was designed to investigate the change in dynamic optical quality in dry eye patients after the use of artificial tears. Dry eye disease (DED) is a multifactorial disease of the ocular surface, characterized by an unstable tear film associated with symptoms of ocular surface irritation and visual impairment [1]. A previous study by our group demonstrated that OSI fluctuations were significantly increased in eyes with DED, and the degree of fluctuations was correlated with the severity of the DED [4]. Habay et al showed similar results, with both the mean value and standard deviation of the OSI significantly decreased in severe dry eye patients [9]
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