Diagnostic Cut-Off Values Based on Lipid Layer Pattern for Dry Eye Disease Subtypes Assessment

Area of Science:

• Ophthalmology
• Ocular Surface Disease
• Diagnostic Imaging

Background:

• Dry Eye Disease (DED) encompasses various subtypes, including Aqueous Deficient Dry Eye (ADDE), Evaporative Dry Eye (EDE), and Mixed Dry Eye (MDE).
• Accurate differentiation of DED subtypes is crucial for effective treatment strategies.
• The Lipid Layer Pattern (LLP) is a potential biomarker for DED assessment.

Purpose of the Study:

• To determine cut-off values for the Lipid Layer Pattern (LLP) to differentiate between subtypes of Dry Eye Disease (DED).
• To evaluate the diagnostic potential of LLP assessed via Guillon (LLP-G) and Colour (LLP-C) schemes in distinguishing DED subtypes.

Main Methods:

• 240 participants diagnosed with DED were categorized into ADDE, EDE, or MDE groups based on Tear Meniscus Height (TMH) and Meibomian Gland Loss Area (MGLA).
• Lipid Layer Pattern (LLP) was assessed using the Tearscope under both LLP-G and LLP-C schemes.
• Receiver Operating Characteristics (ROC) analysis was employed to determine diagnostic potential and cut-off values.

Main Results:

• LLP-G and LLP-C showed no significant diagnostic value in differentiating ADDE from EDE.
• LLP-G and LLP-C demonstrated diagnostic potential in distinguishing ADDE from MDE, with specific cut-off values and AUCs.
• LLP-G and LLP-C also showed significant potential in differentiating EDE from MDE, with identified cut-off values and AUCs.

Conclusions:

• The Lipid Layer Pattern (LLP), when assessed using the Tearscope, possesses diagnostic potential.
• LLP effectively distinguishes Mixed Dry Eye Disease (MDE) participants from those with Aqueous Deficient Dry Eye (ADDE) and Evaporative Dry Eye (EDE).
• These findings support the use of LLP assessment for subtype differentiation in DED management.