Clinical Accuracy of an Advanced Corneal Topographer with Tear-Film Analysis in Functional and Structural Evaluation of Dry Eye Disease

ABSTRACT

Purpose: Dry eye disease (DED) is a common condition that significantly lowers the quality of life. As the disease grows more prevalent, multiple commercial instruments have been developed to measure the ocular surface of dry eyes, but no single device has yet been successful in comprehensive measurements. The current study aimed to investigate the clinical accuracy and utility of the Antares topographer in the diagnosis of DED.

Methods: Thirty-three consecutive patients underwent analyses of their non-invasive first tear-film break-up time (NIF-BUT), tear meniscus height (TMH) and meibography with the Antares topographer. The meibography with the LipiView scan was conducted. Slit-lamp examinations were done for assessments of meibomian glands (MG) and fluorescein tear-film break-up time (FBUT). Schirmer 1 test was done. The Ocular Surface Disease Index (OSDI) scores were graded.

Results: Thirty-three eyes of 33 patients (mean age 61.5 ± 10.6 years, range 37.5–76.4 years, 27.3% males) completed the study. According to the Antares measurements, the NIF-BUT of the patient population was 5.0 ± 3.4 seconds on average (1.1–15.0 seconds), and the TMH was 0.2 ± 0.1 mm at center (0.1–0.5 mm). The average OSDI score was 22.4 ± 16.6 points (0.0–79.5 points). When correlations were calculated, significant correlations were found between the NIF-BUT from the Antares topographer and FBUT (r = 0.538, P = .001), and between MG dropout from the Antares topographer and that from the LipiView interferometer (r = 0.446, P=.009). Antares NIF BUT and FBUT were in agreement with one another (95% limits of agreement (LOA) −5.04 ± 6.37, P=.198) as were the infrared images from the Antares topographer and those from the LipiView interferometer (95% LOA −0.25 ± 0.35, P=.073).

Conclusion: The Antares topographer is useful in the diagnosis of DED. Among its outputs, the NIF-BUT and MG dropout most closely correlated with currently accepted modes of diagnosis. However, concurrent clinical examinations are recommended for clinical follow-up.

Keywords:

• Antares topographer
• dry eye
• meibomian gland dysfunction
• tear break-up time

Acknowledgments

We thank Lumenis (Australia) for providing the Antares corneal topographer.

Additional information

Funding

The study was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology [NRF-2019R1F1A1062468].