title: Non-invasive assessment of tear film stability with a novel corneal topographer in Indian subjects.
abstract: The aim of the study is to investigate the applicability of a newly developed corneal topographer in assessing tear film stability in Indian subjects. A prospective comparative study of 25 Indian subjects with dry eyes attending a tertiary eye care clinic in South India and 25 normal control subjects was conducted. The diagnosis of dry eye was made based on ocular surface disease index questionnaire. Non-invasive tear film break-up time (NI-TBUT) was measured using a new method based on a corneal topographer equipped with modified scan software. The correlations between the NI-TBUT and the traditional fluorescein tear film break-up time (F-TBUT), Schirmer I test values were determined. A total of 50 patients (100 eyes) were included. The values of NI-TBUT were significantly lower than the values of F-TBUT in both the cases (NI-TBUT 5.78 ± 0.8 s and F-TBUT 7.56 ± 0.5 s; p < 0.02) and controls (NI-TBUT 11.66 ± 1 s and F-TBUT 12.92 ± 1.2 s; p < 0.01). NI-TBUT values were significantly lower than the corresponding F-TBUT values in the varying grades of dry eyes. The mean NI-TBUT values in mild dry eyes was 6.42 ± 0.2 s, moderate dry eyes was 4.70 ± 0.3 s and in severe dry eyes was 2.32 ± 1.2 s. There was a significant difference in the NI-TBUT values for cases and controls (p < 0.001). There was a good correlation seen between the NI-TBUT values and the F-TBUT values, Schirmer I values and the ODSI scores. NI-TBUT was found to have a sensitivity of 86.1 % and a specificity of 81.1 % when the cut-off value was kept at 6.2 s. We investigated the performance of a non-invasive technique for measuring tear film stability to aid in the diagnosis of dry eye disease. It is a useful non-invasive objective method for the detection of dry eye, and its varying grades and may be useful in monitoring the efficacy of therapies for dry eye.
authors.affiliation: Sankara Eye Centre, Sivanadapuram, Sathy Road, Coimbatore, India. drvipulbhandari@gmail.com.
authors.forename: Vipul
authors.identifier: http://orcid.org/0000-0001-8548-9244
authors.initials: V
authors.lastname: Bhandari
authors.affiliation: Sankara Eye Centre, Sivanadapuram, Sathy Road, Coimbatore, India.
authors.forename: Jagdeesh K
authors.initials: JK
authors.lastname: Reddy
authors.affiliation: Sankara Eye Centre, Sivanadapuram, Sathy Road, Coimbatore, India.
authors.forename: Kirti
authors.initials: K
authors.lastname: Relekar
authors.affiliation: Sankara Eye Centre, Sivanadapuram, Sathy Road, Coimbatore, India.
authors.forename: Ameya
authors.initials: A
authors.lastname: Ingawale
authors.affiliation: Sankara Eye Centre, Sivanadapuram, Sathy Road, Coimbatore, India.
authors.forename: Neeraj
authors.initials: N
authors.lastname: Shah
mesh_terms: D000328:Adult; D000368:Aged; D044466:Asian People; D016022:Case-Control Studies; D019781:Corneal Topography / Q000295:instrumentation*; D015352:Dry Eye Syndromes / Q000175:diagnosis* / Q000378:metabolism; D005260:Female; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012372:ROC Curve; D012680:Sensitivity and Specificity; D013666:Tears / Q000000981:diagnostic imaging*
keywords: Corneal topographer; Indian; Non-invasive; TBUT