title: Tear Interferometric Patterns Reflect Clinical Tear Dynamics in Dry Eye Patients.
abstract: OBJECTIVE
  We investigated whether the tear interferometric pattern was able to identify differences in tear film kinetics among clinical subtypes of dry eye.
  
  
  METHODS
  A total of 138 eyes of 76 subjects (38 men and 38 women; mean age ± SD, 61.6 ± 16.2 years) with or without dry eye who visited Itoh Clinic from May to August 2015 were enrolled in a cross-sectional study. Clinical diagnosis of dry eye subtype was based on tear film parameters. The pattern of tear film kinetics determined by interferometry was classified as 0 (monotonous gray or multicolor interferometric fringe with a noninvasive breakup time [NIBUT] of ≥5 seconds), 1 (multicolor interferometric fringe with a NIBUT of <5 seconds), or 2 (grayish amorphous interferometric fringe with a NIBUT of <5 seconds), and reliability of classification was evaluated. Lipid layer thickness (LLT) for the tear film was also determined by interferometry.
  
  
  RESULTS
  Interrater κ values for evaluation of interferometric patterns ranged from 0.57 to 0.94 for both physicians and nonphysicians with reference to a dry eye expert, the latter of whom showed an intrarater reliability of 0.90. The distribution of eyes among interferometric patterns 0, 1, and 2 coincided well with the clinical subgroups of normal tear condition, non-Sjögren syndrome aqueous-deficient dry eye, and meibomian gland dysfunction, respectively. A multicolor interferometric fringe was essentially observed only at an LLT of >70 nm.
  
  
  CONCLUSIONS
  Tear interferometry was able to reliably distinguish clinical subtypes of dry eye by reflecting the balance between the lipid and aqueous layers of the tear film.
authors.affiliation: Itoh Clinic Saitama, Japan 2Lid and Meibomian Gland Working Group, Japan.
authors.forename: Reiko
authors.initials: R
authors.lastname: Arita
authors.affiliation: Lid and Meibomian Gland Working Group, Japan 3Department of Ophthalmology, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan.
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Morishige
authors.affiliation: Lid and Meibomian Gland Working Group, Japan 4Kowa Pharmaceutical Co. Ltd., Nagoya, Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Fujii
authors.affiliation: Lid and Meibomian Gland Working Group, Japan 5Omiya Hamada Eye Clinic, Saitama, Japan.
authors.forename: Shima
authors.initials: S
authors.lastname: Fukuoka
authors.affiliation: Kim's Eye Hospital, Konyang University College of Medicine, Seoul, South Korea.
authors.forename: Jae Lim
authors.initials: JL
authors.lastname: Chung
authors.affiliation: Department of Ophthalmology, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Kyoung Yul
authors.initials: KY
authors.lastname: Seo
authors.affiliation: Itoh Clinic Saitama, Japan.
authors.forename: Kouzo
authors.initials: K
authors.lastname: Itoh
mesh_terms: D003430:Cross-Sectional Studies; D015352:Dry Eye Syndromes / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007368:Interferometry; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010808:Physical Examination / Q000379:methods; D011446:Prospective Studies; D013666:Tears / Q000502:physiology*