ESCRS - PP03.11 - Determination Of The Non-Invasive Tear Break-Up Time Cut-Off Point For Diagnosis Of Dry Eye And Correlation With Other Dry Eye Tests

Determination Of The Non-Invasive Tear Break-Up Time Cut-Off Point For Diagnosis Of Dry Eye And Correlation With Other Dry Eye Tests

Published 2022 - 40th Congress of the ESCRS

Reference: PP03.11 | Type: Free paper | DOI: 10.82333/ytnr-s476

Authors: Elif Bagatur Vurgun* 1 , Ece Yalcındag Kactan 1 , Semra Akkaya Turhan 1 , Ayşe Ebru Toker 2

1Ophthalmology,Marmara University,Istanbul,Türkiye, 2Marmara University,Istanbul,Türkiye

Purpose

To determine the optimum non-invasive break-up time (NIBUT) cut-off point in patients with dry eye and to compare the average NIBUT with first NIBUT, fluorescein tear break-up time (TBUT), corneal fluorescein staining, Marx’s line, lid wiper epitheliopathy, Schirmer I test, and also meibography results. 

Setting

Marmara University Ophthalmology Department 

Methods

Both eyes of 83 subjects were included in this study. NIBUT measurement was performed with the Scheimplug-Placido disk system, and meibomian gland function was assessed with the Phoenix-Meibography Imaging module of topography (Sirius, CSO, Italy). Subjects completed the OSDI questionnaire and an ophthalmic examination, including Schirmer I test, TBUT, corneal fluorescein staining, Marx’s line, and lid wiper epitheliopathy. Dry eye was diagnosed based on the positive OSDI (>13) and at least one positive sign (TBUT and/or corneal fluorescein staining). Receiver operating characteristics were assessed to obtain the optimum cut-off threshold, sensitivity, and specificity of the NIBUT to determine dry eye. 

Results

The mean age of subjects was 47.2±15.5 years, and 65% of subjects were female. Forty-eight (57.8%) of subjects had dry eye. NIBUT was significantly shorter in dry eye patients (7.7s vs. 15.1s, p<0.001). According to the ROC curve analysis, the optimum cut-off point was 12.2s with an 89% sensitivity and 88% specificity, and the AUC was 0.92. The NIBUT significantly correlated with Schirmer I test and TBUT results (r=0.410, p<0.001 and r=0.881, p<0.001), and inversely correlated with corneal staining, Marx’s line grading, and lid wiper epitheliopathy staging (r=0.637, p<0.001; r=0.536, p<0.001 and r=0.574, p<0.01; respectively). Moreover, meibography grades were significantly and inversely correlated with NIBUT results (r=0.607, p<0.001).

Conclusions

The NIBUT is thought to be a strong predictor with high sensitivity and specificity, in addition to being a non-invasive and repeatable diagnostic test for the diagnosis of dry eye. It is also correlated with other ocular surface and meibomian gland function tests.