Abstract

PurposeTo investigate the usability and the reproducibility of the tear meniscus values via swept-source optical coherence tomography (SS-OCT) and the conventional slit lamp microscope method with a graticule.MethodsThe right eye was examined in 90 healthy adult subjects who were grouped according to age (group 1: 20–39 years; group 2: 40–59 years; group 3: ≥60 years). The tear meniscus height (TMH) and tear meniscus area were measured using SS-OCT and TMH by the slit lamp microscope method. The reproducibility of each method was calculated using intraclass correlation coefficients (ICCs) in additionally enrolled 30 healthy young subjects. We also evaluated TMH at 3 mm from the corneal center in both temporal and nasal directions using SS-OCT.ResultsThe mean of the TMH values measured by SS-OCT was significantly higher than those measured by the slit lamp method (328 vs. 212 μm, P < 0.001, respectively). High reproducibility was observed for each method (ICC > 0.75 for both). No statistically significant differences were found in TMH among the age groups using both SS-OCT and slit lamp methods (P = 0.985, 0.380, respectively). TMH values at both sides of the corneal center were significantly smaller than those at the corneal center (P < 0.0001).ConclusionsTMH values obtained by the slit lamp method were lower than those obtained by SS-OCT. However, both methods yielded highly reproducible TMH measurements, suggesting that they are clinically useful. Tear meniscus values did not vary by age but by measurement points in our cohort.

Highlights

  • Aqueous tear deficiency dry eye is generally characterized by lower tear meniscus values [1], whereas disorders of the lacrimal duct are generally characterized by higher tear meniscus values [2]

  • The tear meniscus height (TMH) values obtained by swept-source OCT (SS-OCT) were significantly higher than those obtained by the slit lamp method

  • This is probably because SS-OCT imaging enables the observation of the tear film, which is produced by the surface tension effect and which cannot be detected by the slit lamp method

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Summary

Introduction

Aqueous tear deficiency dry eye is generally characterized by lower tear meniscus values [1], whereas disorders of the lacrimal duct are generally characterized by higher tear meniscus values [2]. Most ophthalmologists subjectively check the tear meniscus height (TMH) on the lower eyelid using a slit lamp microscope as the first step to evaluate TMH. The attachment of a graticule to the slit lamp eyepiece increases the objectivity of TMH measurements [3–5]. The clinical application of time domain anterior segment optical coherence tomography has dramatically increased the objectivity of tear meniscus measurements, including TMH and the tear meniscus area (TMA) [6–14]. The SS-1000 (Tomey Corp, Nagoya, Japan) swept-source OCT (SS-OCT) device, which was designed for imaging the anterior segment, uses a wavelength of 1310 nm and allows for cross-sectional analysis as well as 3-dimensional analysis of the anterior segment of the eyes— enabling the measurement of TMH and TMA as well as tear meniscus volume via the use of an invisible long-wavelength light source that does not cause photophobia [10, 13]. SS-1000 is capable of consecutive scanning of the tear fluid with a wide scanning range of 16 mm, including the center of the eyelid

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