title: Correlation between optical coherence tomography-derived assessments of lower tear meniscus parameters and clinical features of dry eye disease.
abstract: OBJECTIVE
  To measure the correlation between subjective symptom score, conventional clinical tests, and Fourier-domain optical coherence tomography (FD-OCT) of lower tear meniscus parameters in patients with dry eye disease.
  
  
  METHODS
  Eighteen patients with dry eye disease requiring medical therapy and/or punctal occlusion were recruited for this prospective, nonrandomized, observational case series. Severity of symptoms of dry eye disease was assessed using the Indiana University Dry Eye Questionnaire 2002. Clinical assessments were completed using slit-lamp biomicroscopy, rose bengal dye staining, fluorescein tear breakup time (TBUT), and a 5-minute Schirmer test with topical anesthesia. The lower tear meniscus was imaged using an FD-OCT system with 5-μm axial resolution and measured manually by a masked grader using computer calipers. Correlation was assessed using Spearman correlation coefficient (ρ).
  
  
  RESULTS
  The mean (±SD) scaled symptom score was 58 ± 21, with a range of 0 to 100. Vital staining test averaged 1.7 ± 3.4, TBUT averaged 4.4 ± 1.8 seconds, and Schirmer tests averaged 10.2 ± 8.1 mm. As determined by optical coherence tomography, the meniscus height was 228 ± 153 μm, depth was 127 ± 79 μm, and cross-sectional area was 0.018 ± 0.021 mm. Optical coherence tomography meniscus area was negatively correlated with the symptom questionnaire score (P < 0.01) and positively correlated with Schirmer test results (P < 0.01). There was no significant correlation between symptom score and rose bengal staining, TBUT, or Schirmer test results (P > 0.01).
  
  
  CONCLUSIONS
  Lower tear meniscus measurement with FD-OCT is an objective noninvasive test that correlates well with symptoms of dry eye disease and the Schirmer test.
authors.affiliation: Doheny Eye Institute, and Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
authors.forename: Pho
authors.initials: P
authors.lastname: Nguyen
authors.forename: David
authors.initials: D
authors.lastname: Huang
authors.forename: Yan
authors.initials: Y
authors.lastname: Li
authors.forename: Srinivas R
authors.initials: SR
authors.lastname: Sadda
authors.forename: Sylvia
authors.initials: S
authors.lastname: Ramos
authors.forename: Rajeev R
authors.initials: RR
authors.lastname: Pappuru
authors.forename: Samuel C
authors.initials: SC
authors.lastname: Yiu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003315:Cornea / Q000473:pathology; D015352:Dry Eye Syndromes / Q000175:diagnosis* / Q000378:metabolism / Q000628:therapy; D005143:Eyelids / Q000473:pathology; D005260:Female; D019793:Fluorescein; D005456:Fluorescent Dyes; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012395:Rose Bengal; D011795:Surveys and Questionnaires; D013666:Tears / Q000378:metabolism*; D041623:Tomography, Optical Coherence; D055815:Young Adult
chemical_list: D005456:Fluorescent Dyes; D012395:Rose Bengal; D019793:Fluorescein