A Comprehensive Study on Tear Meniscus Height Inter-Eye Differences in Aqueous Deficient Dry Eye Diagnosis

Area of Science:

• Ophthalmology
• Ocular Surface Disease

Background:

• Dry eye disease (DED) is a prevalent chronic condition impacting ocular surface health.
• Accurate diagnostic methods are crucial for managing DED, particularly the aqueous deficient subtype (ADDE).

Purpose of the Study:

• To evaluate the diagnostic utility of the absolute inter-eye difference in tear meniscus height (|OD-OS| TMH) for detecting ADDE.
• To establish a reliable cut-off value for |OD-OS| TMH in identifying ADDE.

Main Methods:

• Ocular surface examinations and diagnostic assessments based on TFOS DEWS II guidelines were performed on 260 participants with DED symptoms.
• Participants were classified into ADDE and No ADDE groups based on TMH measurements.
• Statistical analysis determined the optimal |OD-OS| TMH cut-off value in a study group (n=200) and validated it in a cross-validation group (n=60).

Main Results:

• The |OD-OS| TMH demonstrated significant diagnostic capability, with an area under the curve of 0.719 (p < 0.001).
• A cut-off value of 0.033 mm for |OD-OS| TMH achieved 77.6% specificity and 59.1% sensitivity for ADDE detection.
• Cross-validation confirmed the association of this cut-off value with the TFOS DEWS II diagnostic criterion (Cramer's V = 0.354, p = 0.006).

Conclusions:

• The study supports the diagnostic potential of |OD-OS| TMH in identifying ADDE.
• The established cut-off value provides an objective clinical tool, enhancing diagnostic specificity for ADDE.