title: Tear meniscus dimensions in tear dysfunction and their correlation with clinical parameters.
abstract: OBJECTIVE
  To evaluate relationships between tear meniscus dimensions and parameters of ocular surface disease in a variety of tear dysfunction conditions.
  
  
  METHODS
  Single-institution prospective observational study.
  
  
  METHODS
  This study from the Baylor College of Medicine included 128 eyes of 64 subjects. Cross-sectional lower tear meniscus height and tear meniscus area were measured using optical coherence tomography and were compared with tear break-up time (TBUT), corneal staining, conjunctival staining, and an irritation symptom questionnaire (Ocular Surface Disease Index). Study groups included meibomian gland disease (MGD), aqueous tear deficiency (ATD), Sjögren syndrome, non-Sjögren syndrome ATD, and control subjects. Statistical analyses were performed using the Pearson correlation and Student's t test.
  
  
  RESULTS
  When compared with mean tear meniscus height in controls (345 μm), mean tear meniscus height was lower in all tear dysfunction (234 μm; P = .0057), ATD (210 μm; P = .0016), and Sjögren syndrome groups (171 μm; P = .0054). For tear meniscus height ≤210 μm, relative risk ratio for developing corneal staining ≥10 was 4.65. Tear meniscus height correlated with corneal staining for all subjects (R = -0.32; P = .0008), MGD (R = +0.40; P = .059), and ATD (R = -0.36; P = .04). Tear meniscus area showed similar trends in MGD (R = +0.55; P = .006) and ATD (R = -0.40; P = .018). Tear meniscus height correlated with TBUT for all subjects (R = +0.39; P < .0001) and ATD (R = +0.37; P = .018).
  
  
  CONCLUSIONS
  In tear dysfunction conditions, lower tear volume correlates with worse corneal epithelial disease in ATD and Sjögren syndrome, conditions with lacrimal gland dysfunction. In contrast, higher tear volume is associated with corneal epithelial disease in MGD. These findings may improve the ability to identify patients at risk for corneal epithelial disease.
authors: Department of Ophthalmology, Cullen Eye Institute, Baylor College of Medicine, Houston, Texas.
authors: Cynthia I
authors: CI
authors: Tung
authors: Department of Ophthalmology, Cullen Eye Institute, Baylor College of Medicine, Houston, Texas.
authors: Andrew F
authors: AF
authors: Perin
authors: Department of Ophthalmology, Cullen Eye Institute, Baylor College of Medicine, Houston, Texas.
authors: Koray
authors: K
authors: Gumus
authors: Department of Ophthalmology, Cullen Eye Institute, Baylor College of Medicine, Houston, Texas. Electronic address: stevenp@bcm.edu.
authors: Stephen C
authors: SC
authors: Pflugfelder
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003228:Conjunctiva / Q000378:metabolism / Q000473:pathology; D003315:Cornea / Q000378:metabolism / Q000473:pathology; D015352:Dry Eye Syndromes / Q000175:diagnosis / Q000503:physiopathology*; D005141:Eyelid Diseases / Q000175:diagnosis / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007766:Lacrimal Apparatus Diseases / Q000175:diagnosis / Q000503:physiopathology*; D008297:Male; D008537:Meibomian Glands / Q000503:physiopathology*; D008875:Middle Aged; D011446:Prospective Studies; D018434:Sickness Impact Profile; D013194:Staining and Labeling / Q000379:methods; D011795:Surveys and Questionnaires; D013666:Tears / Q000737:chemistry*; D041623:Tomography, Optical Coherence; D055815:Young Adult