title: The diagnostic significance of Fourier-domain optical coherence tomography in Sjögren syndrome, aqueous tear deficiency and lipid tear deficiency patients.
abstract: OBJECTIVE
  To determine the role of Fourier-domain optical coherence tomography (FD-OCT) in tear meniscus imaging and evaluate its diagnostic significance in Sjögren syndrome (SS), non-Sjögren's aqueous tear deficiency (ATD) and lipid tear deficiency (LTD) patients.
  
  
  METHODS
  Two hundred and thirty-six dry eye patients and 174 healthy controls were enrolled in this study. All subjects were grouped as follows: group A (ATD), group B (LTD), group C (SS) and group D (normal controls). All subjects underwent dry eye questionnaire, FD-OCT scanning, tear film break-up time (BUT), corneal fluorescence staining and Schirmer I test (SIT). Tear meniscus height (TMH), tear meniscus depth (TMD) and tear meniscus cross-sectional area (TMA) were measured using FD-OCT (RTVue-100). The area under the receiver operating characteristic curve and the cut-off point were determined using a logistic regression model.
  
  
  RESULTS
  Mean TMH, TMD, TMA, BUT and SIT of dry eye patients were significantly lower than those of the controls (p < 0.05). Tear meniscus values were significantly decreased in patients with SS compared with ATD and LTD patients. Tear meniscus values were significantly correlated with clinical examination results in all groups. Accuracy of dry eye diagnosis by FD-OCT is highest in patients with SS and lowest in LTD patients. The clinical diagnostic critical points were quite different between groups.
  
  
  CONCLUSIONS
  Fourier-domain optical coherence tomography could provide precise measurement of the tear meniscus with favourable repeatability. Diagnostic significance is more conspicuous in patients with SS. Tear meniscus measurement by FD-OCT is expected to become a valuable technique in ATD dry eye screening and diagnosis.
authors.affiliation: Department of Ophthalmology, Eye Ear Nose and Throat Hospital of Fudan University, Shanghai, China.
authors.forename: Xiaodi
authors.initials: X
authors.lastname: Qiu
authors.forename: Lan
authors.initials: L
authors.lastname: Gong
authors.forename: Yi
authors.initials: Y
authors.lastname: Lu
authors.forename: Huan
authors.initials: H
authors.lastname: Jin
authors.forename: Mark
authors.initials: M
authors.lastname: Robitaille
mesh_terms: D000328:Adult; D001834:Body Water / Q000737:chemistry*; D005260:Female; D015590:Fluorophotometry; D005583:Fourier Analysis; D006801:Humans; D008055:Lipids / Q000737:chemistry*; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D015203:Reproducibility of Results; D012859:Sjogren's Syndrome / Q000175:diagnosis* / Q000378:metabolism; D011795:Surveys and Questionnaires; D013666:Tears / Q000737:chemistry* / Q000378:metabolism; D041623:Tomography, Optical Coherence / Q000379:methods*
chemical_list: D008055:Lipids