title: Lid-parallel conjunctival folds (LIPCOF) and dry eye: a multicentre study.
abstract: OBJECTIVE
  The study was designed to test the clinical application of the grading of lid-parallel conjunctival folds (LIPCOF) as a diagnostic test for dry eye.
  
  
  METHODS
  At 12 centres in 11 countries, 272 eyes of 272 dry eye patients (75 men, 197 women) were examined. Their mean age was 52.7±16.2 years. The LIPCOF were graded according to the method of Höh et al. The tear film break-up time (BUT) was measured, and fluorescein staining and the Schirmer 1 test were performed. The subjective symptoms were evaluated by 16 questions.
  
  
  RESULTS
  The LIPCOF score demonstrated significant positive correlations with age, dry eye disease severity and fluorescein staining (r>0.2, p<0.001), and negative correlations with BUT and results of the Schirmer 1 test (r<-0.2, p<0.001). The LIPCOF score exhibited a significant correlation with the overall subjective symptoms (r=0.250, p<0.001). The sensitivity and specificity of LIPCOF grading for discriminating between normal and dry eyes were best with the cut-off between LIPCOF degrees 1 and 2.
  
  
  CONCLUSIONS
  The displayed medium sensitivity and specificity, and good positive predictive value of the LIPCOF test support the use of LIPCOF grading as a simple, quick and non-invasive dry eye screening tool.
authors.affiliation: Department of Ophthalmology, Semmelweis University, Budapest, Hungary. nemeth.janos@med.semmelweis-univ.hu
authors.forename: János
authors.initials: J
authors.lastname: Németh
authors.forename: Eszter
authors.initials: E
authors.lastname: Fodor
authors.forename: Zsolt
authors.initials: Z
authors.lastname: Lang
authors.forename: Krisztina
authors.initials: K
authors.lastname: Kosina-Hagyó
authors.forename: András
authors.initials: A
authors.lastname: Berta
authors.forename: Tímea
authors.initials: T
authors.lastname: Komár
authors.forename: Igor
authors.initials: I
authors.lastname: Petricek
authors.forename: Mohamed
authors.initials: M
authors.lastname: Higazy
authors.forename: Marek
authors.initials: M
authors.lastname: Prost
authors.forename: Christina
authors.initials: C
authors.lastname: Grupcheva
authors.forename: Ozlem Evren
authors.initials: OE
authors.lastname: Kemer
authors.forename: Petra
authors.initials: P
authors.lastname: Schollmayer
authors.forename: Ameed
authors.initials: A
authors.lastname: Samaha
authors.forename: Katarina
authors.initials: K
authors.lastname: Hlavackova
mesh_terms: D003228:Conjunctiva / Q000473:pathology*; D003937:Diagnosis, Differential; D015352:Dry Eye Syndromes / Q000175:diagnosis* / Q000378:metabolism; D005260:Female; D019793:Fluorescein; D005456:Fluorescent Dyes; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D013666:Tears / Q000737:chemistry
chemical_list: D005456:Fluorescent Dyes; D019793:Fluorescein