Correlation between ocular surface disease index and tear meniscus height in dry eye disease at a Johannesburg tertiary eye hospital
Date
2021
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Abstract
Background: Dry eye disease is a common, and potentially vision-threatening problem. The Ocular Surface Disease Index is a well-established method of subjectively assessing dry eye disease. Objective means of diagnosing dry eye disease suffer from poor reproducibility, low sensitivity and specificity, are invasive, time consuming and often require specialized equipment. It is hypothesized that optical coherence tomography of the tear meniscus may address these problems. Aim: The primary aim of this study was to describe the correlation between the Ocular Surface Disease Index © and tear meniscus height in dry eye disease measured by optical coherence tomography. The secondary aim was to determine a useful diagnostic cut-off value for tear meniscus height in the diagnosis of dry eye disease. Setting: The study was conducted at St John Eye Hospital, Soweto, South Africa. Methods: This was a prospective, cross-sectional study of adults at a tertiary level eye clinic. Participants were included if they were older than 18 and excluded if they were contact lens wearers, had an established diagnosis of dry eye disease, or were known to have (or be taking any treatment for) any ophthalmological or medical condition that has the potential to influence dry eye disease. A control and investigative group was determined using the Dry Eye Ocular surface disease index. The inferior tear meniscus height of both groups was imaged using optical coherence tomography. Results: A total of 36 right eyes of 36 patients was included in this study. Patient ages ranged from 20 – 64 years, with a median age of 43 years. Overall there were more females (n = 27) than males (n = 9). There was a moderate negative correlation between the normal/dry eye group and tear meniscus height (rb = - 0.452, p = 0.032). Optimizing sensitivity and specificity yielded a diagnostic cut-off tear meniscus height of 296um. Conclusion: Tear meniscus height tends to decrease between Ocular Surface Disease Index classifications of ‘normal’ and ‘dry eye disease’. However, tear meniscus height performed poorly as an objective measure of dry eye disease in our study population limiting recommendations to adopt it as a diagnostic test. Keywords: Dry eye disease, Ocular Surface Disease Index , Optical Coherence Tomography, tear meniscus height.
Description
A research report submitted in partial fulfilment of the requirement for the degree of Master of Medicine in Ophthalmology to the Faculty of Health Sciences, University of the Witwatersrand, 2021
Keywords
Dry eye disease, Ocular Surface Disease, Optical Coherence Tomography, Tear meniscus height