Contact Lens & Anterior Eye最新文献

{"title":"Longitudinal changes in choroidal structures among children with low to moderate myopia under orthokeratology treatment","authors":"Shengsong Xu ,&nbsp;Yanbin Wang ,&nbsp;Zhenbang Ruan ,&nbsp;Shuhang Wang,&nbsp;Runzhuo Yin,&nbsp;Xianghua Tang,&nbsp;Mingxin Lu,&nbsp;Weiyin Chen,&nbsp;Zhouyue Li,&nbsp;Xiao Yang","doi":"10.1016/j.clae.2024.102342","DOIUrl":"10.1016/j.clae.2024.102342","url":null,"abstract":"<div><h3>Purpose</h3><div>To explore the longitudinal changes in choroidal features in myopic children with low to moderate myopia under orthokeratology (<em>ortho</em>-k) treatment.</div></div><div><h3>Methods</h3><div>Children (n = 80) aged 8–12 years with spherical equivalent refraction of −1.00 to −6.00D were randomly assigned to the control (single vision spectacles) (n = 40) and <em>ortho</em>-k (n = 40) groups. OCT images were collected at the baseline, 1-, 6-, 12-, 18-, and 24-month visits. Choroidal structure parameters, including choroidal total area (TA), luminal area (LA), stromal area (SA), and choroidal vascularity index (CVI) were calculated. Axial length (AL) was measured as the primary indicator for myopic progression. The analysis followed the intention-to-treat criteria.</div></div><div><h3>Results</h3><div>Compared to the control, <em>ortho</em>-k significantly improved the choroidal structures in choroidal TA and LA at all follow-up points (all <em>P &lt;</em> 0.05). Choroidal LA was the primary contributor to TA changes (85.8 %[control], 91.4 %[<em>ortho</em>-k]), with the most significant improvement within the first 6 months. While, the changes in SA and CVI over time were not significantly different between the two groups (all <em>P &gt;</em> 0.05). Correlation matrices identified several noteworthy correlations between AL change and choroidal structure features. Further analysis showed a significant interaction effect between baseline choroidal LA and intervention type on subsequent AL change (<em>P</em> for interaction = 0.005), suggesting that <em>ortho</em>-k might be more effective in children with larger baseline choroidal LA.</div></div><div><h3>Conclusions</h3><div>This 2-year prospective study demonstrated that <em>ortho</em>-k can improve the choroidal structures, primarily manifested in choroidal LA, although this positive effect diminishes over time. Myopic children with larger baseline choroidal LA might benefit more from <em>ortho</em>-k.</div></div>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":"48 2","pages":"Article 102342"},"PeriodicalIF":4.1,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142796149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"International trends in prescribing multifocal and monovision soft contact lenses to correct presbyopia (2000–2023): An update","authors":"Philip B. Morgan ,&nbsp;Nathan Efron ,&nbsp;Craig A. Woods ,&nbsp;Deborah Jones ,&nbsp;Lyndon Jones ,&nbsp;Jason J. Nichols","doi":"10.1016/j.clae.2024.102348","DOIUrl":"10.1016/j.clae.2024.102348","url":null,"abstract":"<div><h3>Purpose</h3><div>Numerous multifocal soft contact lenses have been introduced into clinical practice over the past half century. The purpose of this work is to update earlier surveys by describing international trends in multifocal and monovision soft lens fitting for presbyopia between 2000–2023, inclusive.</div></div><div><h3>Method</h3><div>An annual contact lens prescribing survey was sent to eye care practitioners in up to 71 countries between 2000–2023. Data relating to 52,580 soft daily wear lens fits to presbyopes (those ≥45 years of age) undertaken in 20 countries returning reliable longitudinal data were analysed in respect of multifocal and monovision soft daily wear lens fits.</div></div><div><h3>Results</h3><div>Overall, multifocal and monovision soft daily wear lens prescribing to presbyopes has more than doubled over the course of this survey, from 26.4 % of standard soft daily wear lens fits in 2000 to 61.1 % in 2023 (p &lt; 0.0001). There were significant differences between countries in presbyopia soft daily wear lens prescribing (p &lt; 0.0001). Of all soft daily wear fits to males, 45.1 % were multifocal and monovision soft lenses, compared with 52.7 % for females (p &lt; 0.0001). When considered as the proportion of lenses fitted by age, multifocal soft lens fitting peaked between 50–65 years, followed by a precipitous drop until 85–90 years of age, and then an increase beyond 90 years of age. Analysis of 13,014 recent soft lens fits to presbyopes (2019–2023) revealed the following fitting proportions: multifocal lenses – 51 %; monovision – 10 %; and non-presbyopia fitting – 39 %.</div></div><div><h3>Conclusion</h3><div>There has been a substantial increase in soft contact lens correction of presbyopia using multifocal and monovision corrections throughout the 24 years of this survey. A significant number of soft contact lens-wearing presbyopes are not receiving a presbyopia contact lens correction.</div></div>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":"48 2","pages":"Article 102348"},"PeriodicalIF":4.1,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low-level light therapy and intense pulse light therapy in meibomian gland dysfunction. A systematic review and meta-analysis","authors":"Kai En Chan ,&nbsp;Beth Shin Rei Lau ,&nbsp;Blanche Xiao Hong Lim ,&nbsp;Ruochen Du ,&nbsp;Giuseppe Giannaccare ,&nbsp;Louis Tong ,&nbsp;Fiona Stapleton ,&nbsp;Chris Hong Long Lim","doi":"10.1016/j.clae.2024.102344","DOIUrl":"10.1016/j.clae.2024.102344","url":null,"abstract":"<div><h3>Background</h3><div>Meibomian gland dysfunction (MGD) is a leading cause of dry eye disease, affecting over a third of the global population. This disease is associated with ocular discomfort, reduced visual quality, and quality of life. Novel treatments like Intense Pulse Light (IPL) therapy and Low-Level Light Therapy (LLLT) have been reported to be useful in refractory MGD treatment. However, no systematic review has explored the utility of combining these two therapies.</div></div><div><h3>Methods</h3><div>Medline, Embase, and CENTRAL databases were searched for articles on LLLT + IPL therapy in MGD. A meta-analysis of single means was conducted to assess clinical endpoints.</div></div><div><h3>Results</h3><div>Analysis of 12 studies showed that LLLT + IPL therapy in MGD patients led to a significant decrease in Ocular Surface Disease Index score (MD: −22.8, 95 %CI: −29.1 to −16.5, I² = 97.5 %, p &lt; 0.001), and a significant increase in both Tear Break-up Time (MD: 2.2 s, 95 %CI: 0.9 s to 3.4 s, I² = 98.6 %, p &lt; 0.001) and Schirmer test (MD: 1.5 mm, 95 %CI: 0.6 mm to 2.5 mm, I² = 0.0 %, p = 0.001) at ≤ 3 months post treatment. These improvements were sustained in a sensitivity analysis at endpoints ≥ 6 months post treatment. While the percentage of loss of meibomian gland area (n = 4, MD: −3.8 %, 95 %CI: −7.2 % to −0.4 %, I² = 40.0 %, p = 0.031) was reported to be significantly reduced, this was not found to be sustained at endpoints ≥ 6 months post treatment (n = 2, MD: 5.9 %, 95 %CI: 1.8 % to 10.0 %, I² = 0.0 %, p = 0.005) in two studies.</div></div><div><h3>Conclusions</h3><div>This meta-analysis provides quantitative evidence supporting the clinical efficacy of LLLT + IPL therapy in MGD. Future research should evaluate its long-term safety and efficacy and compare it with alternative treatments.</div></div>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":"48 2","pages":"Article 102344"},"PeriodicalIF":4.1,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142786647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review of the potential treatment effects of topical epidermal growth factor for ocular surface disorders","authors":"Fatemeh Sanie-Jahromi ,&nbsp;Ali Arman ,&nbsp;Alireza Attar ,&nbsp;M.Hossein Nowroozzadeh","doi":"10.1016/j.clae.2024.102343","DOIUrl":"10.1016/j.clae.2024.102343","url":null,"abstract":"<div><h3>Purpose</h3><div>This systematic review, evaluated the role of epidermal growth factor (EGF) in corneal wound healing and the pathogenesis of ocular surface disorders (OSDs).</div></div><div><h3>Methods</h3><div>The clinical and experimental application of topical EGF therapy for OSDs was reviewed. This systematic research assessed articles published on PubMed/MEDLINE from 2000 to 2023 and summarized and discussed the findings of 38 experimental and 10 clinical studies. Reporting adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.</div></div><div><h3>Results</h3><div>The role of EGF and its receptor (EGFR) is indispensable in corneal wound healing after injury. The most important downstream molecular pathways are the MAPK/Erk and PI3K/Akt pathways, which lead to proliferation, migration, and differentiation of corneal epithelial cells. Other EGF-related pathways, such as Decorin and Erk signaling (decreasing Pax6), as well as upregulating VEGF, contribute to early and late remodeling after corneal healing. The effect of EGF on corneal wound healing is dose-dependent, and it interacts with other important pathways, such as TGF-β.</div></div><div><h3>Conclusions</h3><div>There are several studies on animals and humans that showed promise for topical EGF therapy in the form of drops, ointments, or loaded contact lenses for a variety of OSDs, such as dry eye disease, neurotrophic ulcers, and pterygium excision. The reported OSDs after using EGFR inhibitors for oncology patients, and their favorable response to topical EGF therapy, further support the significance of EGF in the pathogenesis and treatment of OSDs. However, current clinical evidence is scarce, and high-quality studies are warranted to confirm the therapeutic role of EGF topical treatment for a variety of OSDs and determine the most effective yet safe concentrations.</div></div>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":"48 2","pages":"Article 102343"},"PeriodicalIF":4.1,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In vitro killing effect of berberine and niclosamide on ocular Demodex folliculorum","authors":"Shujia Guo ,&nbsp;Yuqian Wang ,&nbsp;Jiani Li ,&nbsp;Yuwen Liu ,&nbsp;Yi Han ,&nbsp;Caihong Huang ,&nbsp;Huping Wu ,&nbsp;Jiaoyue Hu ,&nbsp;Zuguo Liu","doi":"10.1016/j.clae.2024.102336","DOIUrl":"10.1016/j.clae.2024.102336","url":null,"abstract":"<div><h3>Purpose</h3><div>To explore the <em>in vitro</em> killing effect of water-soluble berberine and lipid-soluble niclosamide against ocular <em>Demodex folliculorum</em>.</div></div><div><h3>Methods</h3><div><em>Demodex</em> with good vigor were collected from patients’ eyelashes. These mites were randomly distributed into different groups with 20 mites in each group. Saline, Double Distilled Water (DDW), Polysorbate 80 (TWEEN 80), Polyethylene glycol 300 (PEG 300) and Castor Oil were used to screen solvents and cosolvents. 20 % Tea Tree Oil (TTO) and Anhydrous Ethanol (EtOH) were used as positive controls. 0.2 % Berberine, 0.25 % Niclosamide and 0.5 % Niclosamide, were designated as experimental groups. Following treatment, the analysis of Kaplan-Meier survival curves and survival time of mites and safety of drugs were then performed.</div></div><div><h3>Results</h3><div>The survival of <em>Demodex in vitro</em> in Saline and DDW, was not significant different. Therefore, DDW, which was more conducive to the dissolution of berberine, was chosen as the solvent for berberine. 0.2 % Berberine significantly inhibited the survival distribution and survival time (P &lt; 0.001) of <em>Demodex in vitro</em> compared with the DDW group. Through the evaluation of several cosolvents, PEG300 had milder effects on <em>Demodex</em>. Hence, the proportion of PEG300 in the niclosamide solvent group was increased to reduce the irritability of the vehicle. Furthermore, niclosamide could significantly inhibit the survival of <em>Demodex</em> compared with the vehicle group, and the effect of 0.5 % Niclosamide was more obvious (P &lt; 0.001), and was better than 20 %TTO (P &lt; 0.001). In addition, after niclosamide administration, <em>Demodex</em> bodies exhibited gradual distortion along with increased transparency and the presence of blurred dark particles compared to those in the vehicle group. Moreover, both drugs showed good subjective tolerability and safety in a mouse model.</div></div><div><h3>Conclusion</h3><div>0.2 % berberine and 0.5 % niclosamide effectively inhibited <em>Demodex</em> survival <em>in vitro</em>, with 0.5 % niclosamide superior to 20 % TTO. These two drugs, with anti-Demodex, anti-bacterial, and anti-inflammatory properties, may offer alternative treatment for Demodex blepharitis.</div></div>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":"48 2","pages":"Article 102336"},"PeriodicalIF":4.1,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of text messages designed to change contact lens compliance: A randomised controlled trial","authors":"Adam Samuels ,&nbsp;Lisa Keay ,&nbsp;Kate Faasse ,&nbsp;Nicole Carnt","doi":"10.1016/j.clae.2024.102341","DOIUrl":"10.1016/j.clae.2024.102341","url":null,"abstract":"<div><h3>Purpose</h3><div>Contact lens behaviours such as poor hand and lens hygiene are common and are associated with increased risk of microbial keratitis. Evidence for health promotion strategies to address this gap is required. The trial examined the effectiveness of a customised text-messaging intervention on compliance, discontinuation rate and wearer satisfaction in contact lens wearers.</div></div><div><h3>Methods</h3><div>The parallel group, double masked, randomised clinical trial was pre-registered with the Australian and New Zealand Clinical Trials Registry (ACTRN12621001719820). Contact lens wearers were recruited using social media and optometry partners in clinical practice. Participants (n = 76) received the intervention and usual care. The control group (n = 75) received usual care. Intervention text messages (range 56–76) were customised, provided education, reminders, and motivation and were delivered over six months. Outcomes were validated self-report online surveys for compliance (0–100), satisfaction (0–100) and discontinuation (Y/N), at 3 months and 6 months. Secondary outcomes were intervention feasibility and acceptability.</div></div><div><h3>Results</h3><div>Participants mean age was 38 years, 105/151 (70 %) female and 83 % completed the trial (intervention 60/76, control 65/75). The intervention group demonstrated better compliance than control with an adjusted between-group-difference at 3 months of 5.2, 95 % confidence interval (CI), 1.6–8.7, <em>P</em> = 0.004 and at 6 months 3.9, 95 % CI 0.2–7.6, <em>P</em> = 0.04. This difference in compliance is clinically significant, equivalent to a single change in a behaviour such as starting to handwash or ceasing overnight wear. There was no adjusted between-group-difference in satisfaction at 3 months (0.8, 95 % CI -4.3–6.0, <em>P</em> = 0.75) or at 6 months (-0.4, 95 % CI -5.7–4.9, <em>P</em> = 0.89). Few participants (7/151, 4.6 %) discontinued contact lens wear (3 intervention, 4 control). The messages were delivered successfully (98 %), at A$11 per participant. Participants reported <em>appropriate</em> message content (75 %), language (80 %) and delivery timing (97 %).</div></div><div><h3>Conclusion</h3><div>This customised text message intervention was a feasible and acceptable method for improving contact lens compliance.</div></div>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":"48 2","pages":"Article 102341"},"PeriodicalIF":4.1,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perspectives of dry eye patients in the United Kingdom on risk factors and desired treatment outcomes","authors":"Jeremy Chung Bo Chiang ,&nbsp;James S. Wolffsohn","doi":"10.1016/j.clae.2024.102340","DOIUrl":"10.1016/j.clae.2024.102340","url":null,"abstract":"<div><h3>Purpose</h3><div>Successful management of dry eye disease depends upon an effective two-way communication between eyecare practitioners and affected patients. However, there has been limited investigation into the perspectives of patients with dry eye disease in the United Kingdom regarding their risk factors and desired treatment outcomes.</div></div><div><h3>Methods</h3><div>An online, self-administered, anonymous survey was distributed to patients based in the United Kingdom who have had a diagnosis of dry eye disease between November 2023 to March 2024. The survey consisted of four main sections including demographics, the 5-item Dry Eye Questionnaire (DEQ-5), and Likert scales rating the likelihood of various risk factors contributing to their dry eyes and the desired treatment outcomes in various components of signs and symptoms.</div></div><div><h3>Results</h3><div>The survey was completed by 152 respondents (mean age 51.7 ± 16.7 years, 103 females). Respondents rated environmental conditions the highest in terms of likelihood of contributing to their dry eye disease [median (interquartile range): 7.5 (5–10)], followed by digital device use [7 (4–9)] and poor sleep quality [4 (1–7)]. In terms of desired treatment outcomes, symptom frequency and severity as well as tear stability were ranked the highest in importance [10 (8–10)].</div></div><div><h3>Conclusions</h3><div>This survey demonstrated the perceptions of dry eye patients in the United Kingdom regarding lifestyle or modifiable risk factors contributing to their dry eye disease, as well as the most important treatment outcomes of these patients. These aspects should be considered by clinicians in the management of dry eye disease, as well as researchers particularly when designing studies which investigate treatment effects of current and novel dry eye interventions.</div></div>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":"48 2","pages":"Article 102340"},"PeriodicalIF":4.1,"publicationDate":"2024-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"LipiFlow for the treatment of dry eye disease: A Cochrane systematic review summary","authors":"Tsz Wing Yim ,&nbsp;Andrew D. Pucker ,&nbsp;Erin Rueff ,&nbsp;William Ngo ,&nbsp;Anna A. Tichenor ,&nbsp;John E. Conto","doi":"10.1016/j.clae.2024.102335","DOIUrl":"10.1016/j.clae.2024.102335","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the effectiveness and the safety of LipiFlow for treating signs and symptoms of dry eye disease (DED) in adults.</div></div><div><h3>Methods</h3><div>The following databases were searched for randomized trials: CENTRAL, MEDLINE Ovid, <span><span>Embase.com</span><svg><path></path></svg></span>, PubMed, LILACS, <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span>, and WHO ICTRP on 24 October 2022. The included studies were conducted in adults (≥18 years) with DED or meibomian gland dysfunction (MGD) as defined by the investigators. Standard Cochrane methodology was applied.</div></div><div><h3>Results</h3><div>This study included 13 trials that randomized a total of 1,155 participants (66 % female; age range = 19 to 86 years). Five trials compared LipiFlow with basic warm compresses. Analyzing symptom scores in these trials yielded conflicting evidence of a difference in symptoms between LipiFlow and basic warm compresses after 4 weeks. There was no evidence of a difference in meibomian gland expression, meibum quality, or tear breakup time when comparing LipiFlow with basic warm compresses. Another 5 trials compared LipiFlow with thermostatic devices. Analysis of symptom scores in these trials at 4 weeks showed that thermostatic devices had reduced Ocular Surface Disease Index (OSDI) scores by a mean difference of 4.59 as compared with LipiFlow. The remaining 3 included trials could not be grouped for comparisons. The overall evidence was of low or very low certainty, with most trials being assessed as having a high risk of bias. No trial reported any intervention-related, vision-threating adverse events.</div></div><div><h3>Conclusions</h3><div>LipiFlow performs similarly to other DED treatments. Further research with adequate masking and a standardized testing methodology is still needed.</div></div>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":"48 2","pages":"Article 102335"},"PeriodicalIF":4.1,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142677635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic performance of qualitative and quantitative methods of meibomian gland dropout evaluation in dry eye disease: An investigator-masked, randomised crossover study","authors":"Michael T.M. Wang ,&nbsp;Barry Power ,&nbsp;Ally L. Xue ,&nbsp;Ji Soo Kim ,&nbsp;Jennifer P. Craig","doi":"10.1016/j.clae.2024.102324","DOIUrl":"10.1016/j.clae.2024.102324","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the discriminative abilities and optimal cut-off values of qualitative meiboscale grading and percentage meibomian gland dropout measurements from each of two instruments (Keratograph 5M and LipiView II) in detecting dry eye disease, as defined by the TFOS DEWS II criteria.</div></div><div><h3>Methods</h3><div>A total of 227 community residents (143 females, 84 males; mean ± SD age, 36 ± 15 years) were recruited in a prospective, investigator-masked, randomised, crossover study. Dry eye symptomology, tear film parameters, and ocular surface characteristics were evaluated in a single clinical session. Qualitative meiboscale grading and quantitative percentage gland dropout assessment using Image J software were evaluated by independent masked assessors, in a randomised order.</div></div><div><h3>Results</h3><div>Overall, 92 (41 %) participants fulfilled the TFOS DEWS II criteria for dry eye disease. The diagnostic performances for percentage meibomian gland dropout measurements (C-statistic range, 0.629 to 0.647) were significantly greater than qualitative meiboscale grading (C-statistic range, 0.547 to 0.560) for both instruments. The Youden-optimal diagnostic cut-off percentage gland dropout was &gt; 20 % and optimal threshold meiboscale grade was &gt; 1 for both superior and inferior eyelid measurements from the two instruments. Inter-instrument weighted Cohen’s kappa coefficients for meiboscale grading were 0.734 and 0.682, respectively, and Bland-Altman biases (95 % limits of agreement) for percentage gland dropout were −1.8 % (−28.1 % to 24.4 %) and −1.5 % (−29.3 % to 26.2 %), respectively.</div></div><div><h3>Conclusions</h3><div>Despite exhibiting comparable discriminative abilities, meibography parameters obtained from the Keratograph and LipiView were not directly interchangeable. Overall, percentage gland dropout measurements demonstrated superior diagnostic performance, which would support their use in clinical trials and epidemiology studies, where practicable.</div></div>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":"48 2","pages":"Article 102324"},"PeriodicalIF":4.1,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intrasession repeatability and interobserver reproducibility of ICP Tearscope measurements of tear meniscus height and non-invasive breakup time","authors":"Ana Rosa Barrio ,&nbsp;Mariano González-Pérez ,&nbsp;Pedro Arriola-Villalobos ,&nbsp;Beatriz Antona","doi":"10.1016/j.clae.2024.102333","DOIUrl":"10.1016/j.clae.2024.102333","url":null,"abstract":"<div><h3>Purpose</h3><div>To examine intrasession repeatability and interobserver reproducibility of tear meniscus height (TMH) and non-invasive tear breakup time (NIBUT) measurements provided by ICP Tearscope, and their agreement with Keratograph 5 M measurements in persons with and without dry eye.</div></div><div><h3>Methods</h3><div>Participants were 48 individuals with dry eye disease (DED) and 44 healthy controls. To determine intrasession repeatability, two consecutive TMH and NIBUT measurements were carried out by a single experienced examiner using ICP Tearscope. For interobserver reproducibility, a second masked investigator measured TMH and NIBUT on the first image and video captured by the examiner. Keratograph 5 M measurements of both variables were carried out by the same examiner. Repeatability and reproducibility were evaluated through within-subject standard deviation (Sw), coefficient of variation (CoV), intraclass correlation coefficient (ICC) and Bland-Altman plots (bias and limits of agreement (LoA)).</div></div><div><h3>Results</h3><div>The TMH measurement with ICP Tearscope showed both, a moderate intrasession repeatability (Sw = 0.045, CoV &lt; 19.82 %, ICC &gt; 0.684) and interobserver reproducibility (Sw = 0.032, CoV &lt; 14.09 %, ICC &gt; 0.926).</div><div>The NIBUT measurement showed worse intrasession repeatability in the DED group (CoV = 27.53 %) than in the Control group (CoV = 13.31 %). Even though similar Sw, LoA and ICC values were observed in both groups (Sw = 2.55 s and 2.34 s; LoA = −6.60 to 5.18 s and −4.82 to 6.51 s, Control and DED respectively, ICCs &gt; 0.95). Interobserver reproducibility indicated a moderate amount of variability with CoV ≤ 15.01 % recorded in both groups.</div><div>Agreement between the two devices was poor. Limits of agreement were not clinically acceptable for TMH (LoA = −0.19 to 0.14 mm and −0.16 to 0.13 mm, Control and DED, respectively) and for NIBUT (LoA = −12.74 to 14.08 s and −12.19 to 12.87 s, Control and DED, respectively).</div></div><div><h3>Conclusions</h3><div>ICP Tearscope provides TMH and NIBUT measurements that show weak repeatability and moderate interobserver reproducibility. This device is not interchangeable with the Keratograph 5 M.</div></div>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":"48 2","pages":"Article 102333"},"PeriodicalIF":4.1,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}