Effect of topical glaucoma medication on tear lipid layer thickness in patients with unilateral glaucoma

Purpose: To compare the lipid layer thickness (LLT) using the LipiView® ocular surface interferometer (TearScience® Inc, Morrisville, NC) between the eye treated with glaucoma medication and untreated normal eye in the unilateral glaucoma patients, and evaluate the effect of topical glaucoma medication on the LLT parameters in glaucoma eyes. Methods: The participants in this cross-sectional comparative study were unilateral glaucoma patients treated with topical glaucoma medications for more than 12 months. Three LLT parameters (average, minimum, and maximum) obtained by the LipiView® were compared between the glaucomatous eye and normal eye. The factors associated with LLT parameters in the eyes treated with glaucoma medication were investigated with multiple regression analysis. Results: Thirty patients with unilateral normal tension glaucoma were enrolled in the present study. Lipid layer average, minimum, and maximum were 64.83 ± 16.50, 51.63 ± 16.73, and 82.53 ± 20.62 in glaucomatous eyes, 77.26 ± 17.81, 62.83 ± 20.99, and 86.13 ± 15.42 in normal eyes. Lipid layer average and minimum were significantly thinner than those in normal eyes (P < 0.001, P < 0.001, respectively). Longer duration of glaucoma eye drops and a greater number of glaucoma medications were associated with the lower LLT average (? = ?0.456, P < 0.001, ? = ?8.517, P = 0.003, respectively), and increasing glaucoma medications have a significant correlation with lower LLT minimum in glaucoma eyes (? = ?8.814, P = 0.026). Conclusion: The present study highlights that patients with long-term glaucoma medications need to be assessed for LLT parameters objectively evaluate their ocular surface health.

Correlation Analysis of Tear Film Lipid Layer Thickness and Ocular Surface Disease Index

PURPOSE: To analyze the relationship between ocular surface disease index and tear film lipid layer thickness (LLT) using a LipiView II® (LipiView® Ocular Surface Interferometer, TearScience®, Morrisville, NC, USA) interferometer. METHODS: Forty-nine patients diagnosed with dry eye syndrome were recruited for this prospective study. Patients completed ocular surface disease index questionnaires. We performed slit lamp examination, Schirmer test, corneal and conjunctival fluorescein staining, measured tear film break-up time, and graded meibomian gland dysfunction. Tear LLT, blinking time, and dynamic meibomian imaging were analyzed using a LipiView II® ocular interferometer. To control for missing data, we analyzed four sets of imputated data via the multiple imputation method and performed Pearson correlation analysis. Patients were assigned to one of two LLT categories (LLT < 60 or LLT ≥ 60) and Chi-square test was performed. RESULTS: Among ocular surface disease parameters, tear film break-up time (tBUT) had a statistically significant correlation with average and maximum LLT (average LLT; p = 0.008, 0.035, 0.006, 0.049, maximum LLT; p = 0.006, 0.042, 0.020, 0.049, Pearson correlation analysis with multiple imputation) but there was no significant correlation with minimum LLT (minimum LLT; p = 0.048, 0.090, 0.079, 0.039). Of the patients with a relatively thick average LLT or maximum LLT (LLT ≥ 60 nm), 80% and 88% had a tBUT < 10, respectively. Conversely, 39% and 47% of patients with relatively thin average LLT (LLT < 60 nm) had a tBUT < 10 (average LLT; p = 0.013, maximum LLT; p = 0.039). CONCLUSIONS: Average LLT and maximum LLT were significantly correlated with tBUT. Patients with a relatively thin average or maximum LLT tended to have a shorter tBUT. Based on these results, measuring tear film LLT using a LipiView II® interferometer may be useful in the diagnosis and follow-up of patients with evaporative dry eye.

Evaluation of Changes in Tear Film Lipid Layer Thickness Using Ocular Surface Interferometer after Artificial Tear Application

PURPOSE: The changes in tear film lipid layer thickness (LLT) after artificial tears application using LipiView®II interferometer were assessed. METHODS: We performed a prospective study of patients with dry eye disease. All subjects underwent measurement of tear film break-up time, Schirmer test, ocular surface staining, meibomian gland evaluation, and subjective score assessment using the Ocular Surface Disease Index. All subjects were randomly assigned to 1 of 3 groups using table of random numbers (group 1, sodium hyaluronate [HA] 0.1% eye drops without preservatives; group 2, HA 0.3% eye drops without preservatives and group 3, HA 0.1% with benzalkonium chloride 0.003%). LLT was measured before, immediately after and 1 hr, 3 hrs, and 6 hrs after artificial tears application. Additionally, the patients were divided into 2 subgroups depending on the presence of meibomian gland dysfunction (MGD) and further evaluated. RESULTS: Significant change in LLT was observed at 3 hrs after artificial tears instillation. LLT in groups 1 and 2 showed significant changes over time (p < 0.01 and p < 0.01, respectively). However, LLT in group 3 showed no change. LLT was unchanged in patients without MGD. Conversely, in MGD patients, a significant difference in LLT between groups 1 and 2 was observed immediately after and 1 hr and 3 hrs after instillation of artificial tears (p = 0.04, p < 0.01 and p = 0.02, respectively) but not at 6 hrs. However, no significant difference in LLT between groups 1 and 3 was observed in MGD patients. CONCLUSIONS: LLT after instillation of artificial tears measured using LipiView®II interferometer was affected by artificial tear concentration and presence of preservatives. Additionally, the presence of MGD can impact the pattern of LLT changes induced by artificial tear instillation. Therefore, LLT measurements using LipiView®II interferometer require at least a 6-hrs interval after use of eye drops, especially for patients with MGD or using artificial tears with preservatives.

The Effects of Warm Compression on Eyelid Temperature and Lipid Layer Thickness of Tear Film

PURPOSE: Warm compression using a commercial heat pad was used to evaluate the effects of temperature on the eyelids and tear film lipid layer thickness. METHODS: Targeting 13 patients (26 eyes) with non-specific eye disease such as dry eye syndrome or Meibomian gland dysfunction, we measured the average thickness of the tear film lipid layer in both eyes with the LipiView 2® System (Tearscience®, Morrisville, NY, USA). We performed warm compression on the right eye only in order to evaluate the effectiveness of massage and measured the temperature of the right eye lid immediately, 3 minutes, and 5 minutes after compression in order to compare with the untreated left eye. After warm compression for 5 minutes, we measured tear film lipid layer thickness of both eyes and analyzed the effectiveness of warm compression. RESULTS: The average tear film lipid layer thickness was 55.1 ± 21.0 nm in the right eyes and 53.9 ± 13.9 nm in the left eyes (p = 0.474). Before performing the warm compression, the temperature of the right eye lid was 53.9 ± 13.9 nm, and that of the left was 35.9 ± 0.2℃. The eye lid temperature of the right eye immediately, 3 minutes, and 5 minutes after warm compression was 40.3 ± 1.3℃, 40.3 ± 1.3℃, and 40.3 ± 1.9℃, respectively, and these temperatures were relatively constant during the massage. Tear film lipid layer thickness after warm compression in the right eye was 83.5 ± 18.8 nm, which was increased compared to the original temperature (p = 0.001) and showed significant difference compared with the 65.5 ± 27.1 nm in the left eye (p = 0.005). CONCLUSIONS: Warm compression increased the tear film lipid layer thickness and showed a relatively constant increased temperature of 40.3℃ over 5 minutes. This technique will be helpful for maintaining tear film lipid layer thickness in patients with Meibomian gland dysfunction.

The Effects of Warm Compression on Eyelid Temperature and Lipid Layer Thickness of Tear Film

PURPOSE: Warm compression using a commercial heat pad was used to evaluate the effects of temperature on the eyelids and tear film lipid layer thickness. METHODS: Targeting 13 patients (26 eyes) with non-specific eye disease such as dry eye syndrome or Meibomian gland dysfunction, we measured the average thickness of the tear film lipid layer in both eyes with the LipiView 2® System (Tearscience®, Morrisville, NY, USA). We performed warm compression on the right eye only in order to evaluate the effectiveness of massage and measured the temperature of the right eye lid immediately, 3 minutes, and 5 minutes after compression in order to compare with the untreated left eye. After warm compression for 5 minutes, we measured tear film lipid layer thickness of both eyes and analyzed the effectiveness of warm compression. RESULTS: The average tear film lipid layer thickness was 55.1 ± 21.0 nm in the right eyes and 53.9 ± 13.9 nm in the left eyes (p = 0.474). Before performing the warm compression, the temperature of the right eye lid was 53.9 ± 13.9 nm, and that of the left was 35.9 ± 0.2℃. The eye lid temperature of the right eye immediately, 3 minutes, and 5 minutes after warm compression was 40.3 ± 1.3℃, 40.3 ± 1.3℃, and 40.3 ± 1.9℃, respectively, and these temperatures were relatively constant during the massage. Tear film lipid layer thickness after warm compression in the right eye was 83.5 ± 18.8 nm, which was increased compared to the original temperature (p = 0.001) and showed significant difference compared with the 65.5 ± 27.1 nm in the left eye (p = 0.005). CONCLUSIONS: Warm compression increased the tear film lipid layer thickness and showed a relatively constant increased temperature of 40.3℃ over 5 minutes. This technique will be helpful for maintaining tear film lipid layer thickness in patients with Meibomian gland dysfunction.

Optical Quality and Tear Film Analysis after Various Lubricating Eye - Drops.

Purpose: To compare the optical quality and tear film analysis of normal and dry eye individuals after instilling various lubricating eye drops. Materials and Methods: A total of 50 eyes of 25 normal individuals and 20 eyes of 10 dry eye patients were studied using LipiView Interferometer (TearScienceInc, Morrisville, North Carolina, USA) Optical Quality Analysis System (OQAS) and HD Analyzer (Visiometrics, Terrassa, Spain). These patients were subjected to randomized use of drop A (polyethylene glycol 400 NF 0.4%, propylene glycol 0.3%), drop B (sodium carboxymethyl cellulose (CMC) and glycerin 0.9%), and drop C (sodium CMC-5 mg). The optical quality and tear film were analyzed at the end of 10 min, 40 min and 1 week. Results: The average interferometric units measured were 82.36, 74.28 and 71.4 with drops A, B and C, respectively. The average objective scatter index was 0.42 before using any drops and 0.48, 0.38 and 0.42 after drops A, B and C, respectively. The average modulation transfer function was 43.7 before drops and 39, 45.6 and 46 after usage of drops A, B, and C, respectively. Conclusion: The lipiview analysis suggested that drop A had a beneficial effect on the lipid layer of the tear film. Metrics on OQAS revealed that drops B and C showed improvement in MTF and OSI in normal as well as dry eye patients.