Ocular surface analysis and automatic non-invasive assessment of tear film breakup location, extension and progression in patients with glaucoma
Keywords: 
Keratograph 5 M
Tear film breakup
Dry area growth rate
BUT
NITBUT
Issue Date: 
2020
Publisher: 
Springer Nature
Project: 
info:eu-repo/grantAgreement/MINECO/Proyectos de investigación en salud (AE Salud 2014)/PI14%2F00811/ES/Análisis de la superficie ocular en pacientes con glaucoma crónico y su relación con las alteraciones de las glándulas de Meibomio y la producción mucínica
ISSN: 
1471-2415
Note: 
This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Citation: 
Guarnieri, A. (Adriano); Carnero, E. (Elena); Bleau, A.M. (Anne-Marie); et al. "Ocular surface analysis and automatic non-invasive assessment of tear film breakup location, extension and progression in patients with glaucoma". BMC. 20 (1), 2020, 12
Abstract
Background: Tear film stability is the key event in ocular surface diseases. The purpose of this study is to evaluate spatial and temporal progression of the tear film breakup using an automatic non-invasive device. Methods: Non-invasive tear breakup time (NITBUT) parameters, such as First NITBUT (F-NITBUT) and Average NITBUT (A-NITBUT), were evaluated in 132 glaucoma and 87 control eyes with the Keratograph 5 M device. Further analysis of this data was used to determine size, location and progression of tear film breakup with automatically identified breakup areas (BUA). The progression from First BUA (F-BUA) to total BUA (T-BUA) was expressed as Dry Area Growth Rate (DAGR). Differences between both groups were analysed using Student t-test for parametric data and Mann-Whitney U test for non-parametric data. Pearson’s correlation coefficient was used to assess the relationship between parametric variables and Spearman in the case of non-parametric variables. Results: F-NITBUT was 11.43 ± 7.83 s in the control group and 8.17 ± 5.73 in the glaucoma group (P = 0.010). A-NITBUT was 14.04 ± 7.21 and 11.82 ± 6.09 s in control and glaucoma groups, respectively (P = 0.028). F-BUA was higher in the glaucoma group than in the control group (2.73 and 2.28; P = 0.022) and was more frequently located at the centre of the cornea in the glaucoma group (P = 0.039). T-BUA was also higher in the glaucoma group than in the control group (13.24 and 9.76%; P = 0.012) and the DAGR was steeper in the glaucoma group than in the control group (34.38° and 27.15°; P = 0.009). Conclusions: Shorter NITBUT values and bigger, more central tear film breakup locations were observed in the glaucoma group than in the control group. The DAGR indicates that tear film rupture is bigger and increases faster in glaucomatous eyes than in normal eyes.

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