title: A new method for tear film stability analysis using videokeratography.
abstract: OBJECTIVE
  To report a new tear film stability analysis system using videokeratography.
  
  
  METHODS
  Observational case series.
  
  
  METHODS
  New videokeratography software for TMS-2N (topographic modeling system; TOMEY Corporation, Nagoya, Japan) was developed that can automatically capture consecutive corneal surface images every second for 10 seconds. Forty-eight adult volunteers (80 eyes) were recruited for this study, and all subjects were examined with the new system. Corneal topographs were analyzed for tear breakup time (TMS-BUT) and the ratio of breakup area to entire color-code area (TMS-BUA) was calculated. Routine methods for tear film breakup time evaluation using slit-lamp microscope and fluorescence staining (SLE-BUT) were performed for comparison purposes. Regressive correlations of TMS-BUT or TMS-BUA with SLE-BUT were analyzed. Based on SLE results, subjects were separated into two groups with normal and short BUT, respectively. TMS-BUT and TMS-BUA were compared with SLE-BUT data with regard to the sensitivity and specificity of evaluation of dry eye symptoms.
  
  
  RESULTS
  Topographic modeling system-tear breakup time (TMS-BUT) had a positive correlation with SLE-BUT (R = 0.7219, P <.0001), whereas TMS-BUA showed a negative correlation (R = 0.6317, P <.0001). Among 34 eyes with normal SLE-BUT, 11 eyes (32.35%) displayed abnormal TMS-BUT, 9 (81.82%) of which were associated with dry eye symptoms. The sensitivities of TMS-BUT and TMS-BUA were 97.5% and 95%, respectively, significantly higher than that of SLE-BUT (75%), with P =.008 and 0.01, respectively. Topographic modeling system-BUT and TMS-BUA displayed a similar rate of specificity in comparison with SLE-BUT.
  
  
  CONCLUSIONS
  This new videokeratography system is a noninvasive and objective method with increased sensitivity for tear film stability analysis.
authors.affiliation: Department of Ophthalmology, Ehime University School of Medicine, Japan.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Goto
authors.forename: Xiaodong
authors.initials: X
authors.lastname: Zheng
authors.forename: Stephen D
authors.initials: SD
authors.lastname: Klyce
authors.forename: Hisashi
authors.initials: H
authors.lastname: Kataoka
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Uno
authors.forename: Mike
authors.initials: M
authors.lastname: Karon
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Tatematsu
authors.forename: Takeo
authors.initials: T
authors.lastname: Bessyo
authors.forename: Kazuo
authors.initials: K
authors.lastname: Tsubota
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Ohashi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003315:Cornea / Q000737:chemistry / Q000502:physiology; D019781:Corneal Topography / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013666:Tears / Q000737:chemistry / Q000502:physiology*; D013997:Time Factors