Abstract
Purpose. To determine the intraexaminer repeatability and interexaminer reproducibility of tear meniscus height (TMH) and noninvasive Keratograph tear breakup time (NIKBUT) measurements obtained with the Keratograph 5M (K5M) in a sample of healthy and dry eye populations. Methods. Forty-two patients with dry eye disease (DED group) and 42 healthy subjects (healthy group) were recruited in this prospective study. In all subjects, each eye received 3 consecutive measurements using the K5M for the TMH and NIKBUTs (NIKBUT-first and NIKBUT-average). And then a different examiner repeated the measurements. The repeatability and reproducibility of measurements were assessed by the coefficient of variation (CV) and intraclass correlation coefficient (ICC). Results. The repeatability and reproducibility of TMH and NIKBUTs were good in both DED and healthy groups (CV% ≤ 26.1% and ICC ≥ 0.75 for all measurements). Patients with DED showed better intraexaminer repeatability for NIKBUTs, but worse for TMH than healthy subjects. Average TMH, NIKBUT-first, and NIKBUT-average were significantly lower in DED group than in healthy group (all P values < 0.05). Conclusions. Measurements of TMH and NIKBUTs obtained with the K5M may provide a simple, noninvasive screening test for dry eye with acceptable repeatability and reproducibility. The NIKBUTs were more reliable, but TMH was less reliable in patients with DED.
Highlights
Dry eye disease (DED) is a chronic, multifactorial disease of the tears and ocular surface, which is caused by either decreased tear production or increased tear film evaporation [1]
The Ocular Surface Disease Index (OSDI) and Oxford scale values were significantly less, while fluorescein tear breakup time (FBUT), Schirmer test, and corneal sensation values were significantly more for the DED group than for the healthy group
FBUT is the most widely performed examination to aid in assessing the tear film stability
Summary
Dry eye disease (DED) is a chronic, multifactorial disease of the tears and ocular surface, which is caused by either decreased tear production or increased tear film evaporation [1]. Common objective clinical measures assessing the tear film and diagnosing DED are known as the fluorescein tear breakup time (FBUT) and Schirmer test [5, 6]. Recent advanced Placido topograph, the Keratograph 5M (K5M; Oculus Optikgerate GmbH, Wetzlar, Germany), has additional imaging modalities designed to noninvasively measure TMH and noninvasive Keratograph tear breakup time (NIKBUT) [13,14,15]. It has been used in the evaluation of tear film and diagnosis of DED [12]. The intraexaminer repeatability and interexaminer reproducibility of the measurements for TMH and NIKBUTs were evaluated, and their results in the DED patients and the healthy population were compared
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