Abstract
Purpose To evaluate the intraobserver repeatability and interobserver reproducibility of Strip Meniscometry Tube (SMTube) and determine the correlations among the SMTube measurements and other ocular examinations in dry eye disease (DED) patients. Methods The study recruited 73 eyes of 49 DED patients. Every subject was subjected to the following five measurements sequentially: the Ocular Surface Disease Index (OSDI) questionnaire, Tear Meniscus Height (TMH) assessment, SMTube measurements, tear film breakup time (BUT) examination, and Schirmer I test (SIT). The repeatability and reproducibility of the measurements were assessed by the intraclass correlation coefficient (ICC) and the Bland–Altman analysis, and the correlations were evaluated by the Spearman rank-order correlation. Results The repeatability and reproducibility of the SMTube measurements were good in DED patients. The ICCs between the repeatability and reproducibility of the SMTube measurements were 0.789 and 0.741, respectively, and the Bland–Altman 95% limits of the repeatability and the reproducibility were −1.726 to 1.658 and −0.967 to 1.474, respectively (all P < 0.01). The SMTube measurements had correlations with TMH, BUT, and SIT. The Spearman rank correlation coefficients between SMTube and TMH; SMTube and Schirmer I test; and SMTube and BUT were 0.632, 0.617, and 0.653, respectively (all P < 0.01). Conclusions The measurements of the SMTube may provide a novel, swift, noninvasive, and convenient approach to screen and diagnose DED with acceptable repeatability and reproducibility and specific correlations with TMH, BUT, and SIT.
Highlights
Dry eye disease (DED), a type of multifactorial disease accompanied by various ocular symptoms, is mainly caused by the instability of the tear film and the imbalance of the microenvironment of the ocular surface, which could accompany the inflammation and damage of the ocular surface and neurosensory disorders, which is according to the consensus of DED in China (2020)
Previous studies have mainly focused on the correlations among Strip Meniscometry Tube (SMTube) assessment and other ocular examinations, while the repeatability and reproducibility of SMTube have hardly been studied [5, 7, 9,10,11]. erefore, this study explored the intraobserver repeatability and interobserver reproducibility of the SMTube assessment as a reliable and guaranteed clinical tool, besides assessing the correlations among the SMTube and the Schirmer I test, breakup time (BUT), and Tear Meniscus Height (TMH)
In 2020, the consensus of DED in China refined DED as “a multifactorial chronic disease of the ocular surface characterized by a loss of homeostasis of the tear film or imbalance of the ocular surface microenvironment caused by abnormal quality, quantity, and dynamics of tears, which can be accompanied by ocular surface inflammation and damage and neurosensory abnormalities, resulting in a variety of ocular discomfort symptoms and/or visual dysfunction.”
Summary
Dry eye disease (DED), a type of multifactorial disease accompanied by various ocular symptoms, is mainly caused by the instability of the tear film and the imbalance of the microenvironment of the ocular surface, which could accompany the inflammation and damage of the ocular surface and neurosensory disorders, which is according to the consensus of DED in China (2020). DED has been considered a common disease, the “gold standard” signs or symptoms still do not exist [3]. The Schirmer I test and the tear film breakup time (BUT) assessment has been used widely to diagnose DED, while the Ocular Surface Disease Index (OSDI) questionnaire in the Chinese version has been used to evaluate patients’ subjective symptoms [3]. As traditional approaches are invasive and quite time consuming, it is imperative to find a concise and noninvasive testing method for the busy outpatient service
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