Cornea - ARVO

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ARVO 2013 Annual Meeting Abstracts by Scientific Section/Group - Corneacontact lens wearers and non-wearers.Methods: This observational study recruited 101 non-contact lens(NCL) and experienced soft contact lens (CL) wearers betweenJanuary and September 2010. The CL group included “stainers” and“non-stainers”. Stainers had a history of inferior corneal dehydrationstaining (DHS) at a minimum of 50% of their previous visits to theClinical Research Center (CRC) and non-stainers presented withDHS at a maximum of 20% of their previous visits to the CRC, overa minimum of three visits. A dry eye questionnaire was administeredand ocular parameter measurements including non-invasive tearbreakup time (NITBUT), invasive tear breakup time (ITBUT), tearosmolarity, and corneal staining score were collected at a singlemorning visit. Room temperature and humidity were measured at thecommencement of each visit. The TearLab Osmolarity System(TearLab Corporation, San Diego, CA, USA) was used to measuretear osmolarity. NITBUT was analyzed on the natural log scale tobetter approximate normality.Results: Ninety nine subjects (69 females, 30 males; 64 non-Asians,35 Asians; 59 NCL, 40 CL) with a median age of 22 years (range 18-67 years) completed the study. Multivariate linear mixed effectsmodeling showed that tear hyperosmolarity was significantlyassociated with shorter NITBUT (p=0.002) but not with cornealstaining history or dryness symptoms. Additionally, shorter NITBUTwas significantly associated with positive corneal staining history(p
ARVO 2013 Annual Meeting Abstracts by Scientific Section/Group - CorneaMedical College, Wenzhou, China; 3 Ophthalmology, Hangzhou FirstPeople’s Hospital, Hangzhou, China.Purpose: Dry eye syndrome is a chronic inflammation of the ocularsurface due to lack of sufficient lubrication and moisture. As a result,an individual suffering from the dry eye syndrome will experienceuncomfortable symptoms of dryness, itchiness, and a burningsensation in the eyes. The goal of this study was to develop asensitive biomarker to quantitatively evaluate the severity in dry eyesby imaging limbal capillary perfusion and calculating the velocity ofblood flow.Methods: A retinal function imager (RFI, Optical Imaging Ltd,Rehovot, Israel) was used to capture reflectance changes as afunction of time under stroboscopic illumination. The system wasfurther adapted from its original use of retinal imaging to beingutilized in anterior surface imaging. Hemoglobin in red blood cellswas used as an intrinsic motion-contrast agent in the generation ofdetailed noninvasive capillary-perfusion maps (nCPMs) and thecalculation of the velocity of blood flow. Nine healthy subjects (3males and 6 females, age 29.8 ± 10.4 years) and nine previouslydiagnosed dry eye patients (4 males and 5 females, age 51.0 ± 17.5years) were recruited. The temporal conjunctivas of the patient’s righteyes were imaged with the RFI device. The velocity of blood flow inarteries and veins was measured at selected vessel segments in thetemporal conjunctivas.Results: The nCPMs showed capillaries in exquisite detail on thelimbal region and the limbal region appeared as a random distributionof branching, overlapping, and crossing vessels (Fig. 1A). Thevelocity of blood flow (Fig. 1B) in conjunctival arteries was 0.71 ±0.09 (mean ± SD, mm/s) and 0.80 ± 0.11 mm/s, for normal and dryeye patients, respectively (p < 0.05). The blood flow velocities inconjunctival veins were 0.69 ± 0.08 mm/s and 0.81 ± 0.16 mm/s, fornormal and dry eye patients, respectively (p < 0.05). There were nosignificant differences in blood flow velocities between arteries andveins in each group (P > 0.05).Conclusions: This pilot study demonstrated for the first time thatblood flow velocity of the conjunctiva may be altered in dry eyepatients, which might be a possible biomarker for evaluating dry eyeseverity and treatment efficacy. This potential biomarker may alsoprovide a window into dry eye causes and pave the way for morespecific tracking methods of dry eye endpoints in humans for thepurpose of new drug approval.Center Grant P30 EY014801, Research to Prevent Blindness (RPB),Department of Defense (DOD- Grant#W81XWH-09-1-0675).Program Number: 4336 Poster Board Number: C0074Presentation Time: 8:30 AM - 10:15 AMReal World Analytical Performance of the TearLab OsmolaritySystem with an Enhanced Temperature SensorBenjamin D. Sullivan, Stephen G. Zmina, Matthew G. Zmina,Michael S. Berg. TearLab Corp, San Diego, CA.Purpose: Tear film instability is an inherent feature of dry eyedisease. The blink-to-blink variability that characterizes the disease,but disappears in normal subjects or treated patients, has causedmany to confuse expected eye-to-eye differences for analyticalvariation of the TearLab Osmolarity System. The purpose of thisstudy was to report real world performance of first generation andrecently updated TearLab Osmolarity System, in order to quantify therelative difference between analytical and biological variability.Methods: Prior to FDA CLIA waiver, 113 TearLab systems wereinstalled under the moderately complex program, which requiredeach doctor to be independently audited by state inspectors to ensurethat the systems matched manufacturer claims. Sites performed 20Normal and 20 High Control tests on one day, followed by tensequential days of tests at each level, with expected results of 297mOsm/L and 338 mOsm/L at each level. For the enhanced systems,240 High Control tests were performed on three units at temperaturesof 20°C, 23°C, 25°C and 30°C using three batches of test cards at onesite.Results: First generation controls averaged 295.4 ± 4.0 mOsm/L and338.6 ± 4.8 mOsm/L respectively for the 20/20 tests, with an averageCV from the sites of 1.4% and 1.6% at each level. Over ten days, thecontrols averaged 294.1 ± 4.8 mOsm/L and 336.6 ± 5.2 mOsm/Lrespectively, with an average CV of 1.6% and 1.6% at each level.Enhanced systems reported a mean osmolarity of 340.3 ± 3.5mOsm/L, with an average CV of 0.8% across each temperature onHigh Controls. Using these standard deviations, a Gaussian errormodel suggests that 1.6±0.4 tests are needed to produce ameasurement within 3 mOsm/L (< 1% error) of the true value,validating the requirement that both eyes should be tested as part of astandard TearLab osmolarity examination, and that more than twotests give little additional information.Conclusions: Preliminary results of the enhanced TearLab systemsuggest it meets or exceeds the precision of the first generationsystem. The analytical precision of the TearLab Osmolarity System isa minor component of the expected variability in dry eye disease, andeye-to-eye difference can be considered a clinical indicator of dry eyerather than the result of analytical imprecision.Commercial Relationships: Benjamin D. Sullivan, TearLab, Corp.(I), TearLab, Corp. (E), US7017394 (P); Stephen G. Zmina,TearLab, Corp. (I), TearLab, Corp. (E), US8020433 (P); Matthew G.Zmina, TearLab, Corp. (E), TearLab, Corp. (I); Michael S. Berg,TearLab Corporation (I), TearLab Corporation (E)Support: TearLab, Corp.Commercial Relationships: Jianhua Wang, NIH (F), RPB (F);Hong Jiang, NIH (F); Aizhu Tao, None; Delia DeBuc, NIH/NEI-EY020607 (F), NIH Center Core Grant P30EY014801 (F), NIHR01EY020607S (F), Department of Defense (DOD-Grant#W81XWH-09-1-0675) (F), US 61/139,082 (P); Yilei Shao,None; Jianguang Zhong, None; Sandra Pineda, NoneSupport: Supported by research grants in part from the NIHEY021012, EY021336, R01EY020607 and R01EY020607S, NIHProgram Number: 4337 Poster Board Number: C0075Presentation Time: 8:30 AM - 10:15 AMEvaluation of the Validity of the Diagnostic Criteria for Dry Eyein Japan Using Subjective Symptoms: Osaka StudyNorihiko Yokoi 1 , Miki Uchino 2 , Yuichi Uchino 2 , MURAT DOGRU 2 ,Motoko Kawashima 2 , Aoi Komuro 1 , Yukiko Sonomura 1 , HiroakiKato 1 , Kazuo Tsubota 2 , Shigeru Kinoshita 1 . 1 Ophthalmology, KyotoPrefectural University of Medicine, Kyoto, Japan; 2 Ophthalmology,Keio University School of Medicine, Tokyo, Japan.©2013, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permissionto reproduce any abstract, contact the ARVO Office at arvo@arvo.org.
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