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Research article
Analysis on the First Tear Film Break-up Point in Sjögren's Syndrome and non-Sjögren's Syndrome Dry Eye Patients
Qihua Le
Fudan University Eye Ear Nose and Throat Hospital Department of Ophthalmology
Corresponding Author
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Background：Tear film instability plays an important role in the course of Sjögren's Syndrome dry eye (SSDE) even though it is generally classified as aqueous-deficient dry eye. The measurement of the first tear film break-up point (FTBUP) helps to evaluate the most unstable position of the tear film on ocular surface. We aim to investigate the first tear film break-up point (FTBUP) in Sjögren's Syndrome dry eye (SSDE) and non-Sjögren's Syndrome dry eye (NSSDE) patients, and explore its correlation with dry eye indices.
Methods: Twenty-two SSDE patients (44 eyes) and 22 NSSDE patients (44 eyes) were enrolled in the study. Oculus Keratograph K5M was used to measure the FTBUP, the first and average non-invasive keratographic breakup time (f-NIKBUT and av-NIKBUT), and meibomian gland dropout. Other tests of tear film were also performed including Ocular Surface Dryness Index (OSDI), Schirmer I test, fluorescein break-up time and corneal fluorescein staining.
One-way ANOVA with Bonferroni adjustment was used to compare dry eye indices. The locations of the FTBUP were compared between SSDE and NSSDE patients using chi-square test. The correlations between the FTBUP and ocular symptoms and signs were investigated using Pearson’s correlation coefficient test.
Results: The FTBUP occurred at the supranasal quadrant in 12/88 eyes, supratemporal quadrant in 8/88 eyes, inferonasal quadrant in 34/88 eyes, and inferotemporal quadrant in 34/88 eyes. The percentage of the FTBUPs occurring at the inferior cornea was significantly higher in the SSDE group than in the NSSDE group (86.3% vs 68.1%, P=.042). Moreover, FTBUP was more frequently observed in the temporal area in SSDE patients with positive corneal fluorescein staining, as opposed to the nasal area in SSDE patients with negative corneal staining(P=.032).
Conclusion: Tear film was more unstable in the inferior cornea than other areas of cornea in both SSDE and NSSDE patients. The location of the FTBUP in SSDE patients had a close relationship with cornea fluorescein staining.
Keywords
the First Tear Film Break-up Point, Sjögren's Syndrome dry eye, non-Sjögren's Syndrome Dry Eye
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This preprint is under consideration at BMC Ophthalmology. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Analysis on the First Tear Film Break-up Point in Sjögren's Syndrome and non-Sjögren's Syndrome Dry Eye Patients
Qihua Le
Fudan University Eye Ear Nose and Throat Hospital Department of Ophthalmology
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 29 Sep, 2020
No community comments so far
Editorial decision: Major revision
On 16 Jan, 2021
Review #1 received
Received 07 Jan, 2021
Reviewer #1 agreed
On 04 Jan, 2021
Reviewers invited
Invitations sent on 02 Jan, 2021
Editor assigned
On 21 Sep, 2020
First submitted
On 20 Sep, 2020
Submission checks complete
On 20 Sep, 2020
Editor invited
On 20 Sep, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Ophthalmology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background：Tear film instability plays an important role in the course of Sjögren's Syndrome dry eye (SSDE) even though it is generally classified as aqueous-deficient dry eye. The measurement of the first tear film break-up point (FTBUP) helps to evaluate the most unstable position of the tear film on ocular surface. We aim to investigate the first tear film break-up point (FTBUP) in Sjögren's Syndrome dry eye (SSDE) and non-Sjögren's Syndrome dry eye (NSSDE) patients, and explore its correlation with dry eye indices.
Methods: Twenty-two SSDE patients (44 eyes) and 22 NSSDE patients (44 eyes) were enrolled in the study. Oculus Keratograph K5M was used to measure the FTBUP, the first and average non-invasive keratographic breakup time (f-NIKBUT and av-NIKBUT), and meibomian gland dropout. Other tests of tear film were also performed including Ocular Surface Dryness Index (OSDI), Schirmer I test, fluorescein break-up time and corneal fluorescein staining.
One-way ANOVA with Bonferroni adjustment was used to compare dry eye indices. The locations of the FTBUP were compared between SSDE and NSSDE patients using chi-square test. The correlations between the FTBUP and ocular symptoms and signs were investigated using Pearson’s correlation coefficient test.
Results: The FTBUP occurred at the supranasal quadrant in 12/88 eyes, supratemporal quadrant in 8/88 eyes, inferonasal quadrant in 34/88 eyes, and inferotemporal quadrant in 34/88 eyes. The percentage of the FTBUPs occurring at the inferior cornea was significantly higher in the SSDE group than in the NSSDE group (86.3% vs 68.1%, P=.042). Moreover, FTBUP was more frequently observed in the temporal area in SSDE patients with positive corneal fluorescein staining, as opposed to the nasal area in SSDE patients with negative corneal staining(P=.032).
Conclusion: Tear film was more unstable in the inferior cornea than other areas of cornea in both SSDE and NSSDE patients. The location of the FTBUP in SSDE patients had a close relationship with cornea fluorescein staining.
Figure 1
Figure 2