Review of the tear film measurements of a multifunctional instrument

Abstract

Purpose. The aim of this study was to test the measurements of the tear film stability and tear meniscus height of the Visio- nix 120+ (VX; Luneau Technology, Jerusalem, Israel). Material and Methods. In 24 volunteers (mean age = 37.42 ± 14.23 (standard deviation)), the tear film stability (V-NIBUT and V-NIBUT M) and the tear meniscus height (V-TMH) were determined with VX and the gold-standard, the “Tearscope” technique, of the right eyes (control; NIBUT and TMH). The symptoms were observed using the Ocular Disease Index-6 (OSDI-6). The methods were analysed with Cohen’s Kappa and intra-class correlation (ICC), the prediction probability with the Receiver-Operator-Characteristic-Curve (ROC). Results. The average OSDI-6 grade was 8.00 ± 5.75, the average tear film stability, measured with the VX, was 3.92 s ± 1.79 (V-NIBUT) and 7.36 s ± 1.67 (V-NIBUT M), the control was 10.57 s ± 6.84. The mean tear meniscus height, measured with the VX, was 0.31 mm ± 0.10, the control 0.31 mm ± 0.11. The Cohen’s Kappa analysis showed none to slight agree- ment between methods (V-NIBUT - NIBUT: Kappa -0.005, p = 0.708; V-NIBUT M – NIBUT: Kappa 0.035, p = 0.032; V-TMH - TMH: Kappa 0.06, p = 0.051). V-NIBUT to NIBUT gave an ICC of 0.167 (p = 0.332), V-NIBUT M to NIBUT gave 0.296 (p = 0,203) and V-TMH to TMH -0.192 (p = 0.661). While NIBUT was a significant discriminator of OSDI-6, this was not the case with V-NIBUT or V-NIBUT M (NIBUT: area under the ROC (AUC) = 0.832, p = 0.009; V-NIBUT: AUC = 0.547; p = 0.145; V-NIBUT M: AUC = 0.668, p = 0.127). Conclusion. The measurements of the VX differed signifi- cantly from the control measurements. Keywords tear film stability, NIBUT, tear meniscus height, OSDI-6, dry eye