TY - JOUR
T1 - Characteristics and Utility of Fluorescein Breakup Patterns among Dry Eyes in Clinic-Based Settings
AU - Shigeyasu, Chika
AU - Yamada, Masakazu
AU - Yokoi, Norihiko
AU - Kawashima, Motoko
AU - Suwaki, Kazuhisa
AU - Uchino, Miki
AU - Hiratsuka, Yoshimune
AU - Tsubota, Kazuo
N1 - Funding Information:
This work was supported by the Japan Dry Eye Society, Tokyo, Japan, and Santen Pharmaceutical Co., Ltd., Osaka, Japan. Study group investigators and clinical sites: Yoshitsugu Tagawa (Kitaichijo Tagawa Eye Clinic, Sapporo, Hokkaido, Japan), Seika Den (Akasaka Tokyu Shimazaki Eye Clinic, Tokyo, Japan), Miki Iwasaki (Ryogoku Eye Clinic, Tokyo, Japan), Hiroshi Saito (Saito Eye Clinic, Saitama, Japan), Reiko Ishida (Ishida Clinic, Shizuoka, Japan), Aoi Komuro (Shijo-karasuma Komuro Eye Clinic, Kyoto, Japan), Naoki Iwasaki (Iwasaki Eye Clinic, Osaka, Japan), Harue Matsumoto (Matsumoto Eye Clinic, Tokushima, Japan), Tomoko Goto (Hanamizuki Eye Clinic, Ehime, Japan), Atsuko Kiyosawa (Kiyosawa Eye Clinic, Fukuoka, Japan).
Funding Information:
Conflicts of Interest: M.Y. is a consultant for Otsuka Pharmaceutical Co., Ltd. and Johnson & Johnson Vision Care Co. N.Y. is a consultant for Kissei Co., Ltd., and Rohto Co., Ltd. K.S. is an employee of Santen Pharmaceutical Co., Ltd. K.T. is a consultant, speaker’s bureau member, and grant recipient of Santen Pharmaceutical Co., Ltd., as well as a speaker’s bureau member and grant recipient of Otsuka Pharmaceutical Co., Ltd. Outside the submitted work, K.T. reports his position as CEO of Tsubota Laboratory, Inc., Tokyo, Japan, a company focusing on treatment, prevention, and medical devices for dry eye. The authors report no other conflicts of interest in this work.
Funding Information:
Funding: This work was supported by the Japan Dry Eye Society, Tokyo, Japan, and Santen Pharmaceutical Co., Ltd., Osaka, Japan.
Publisher Copyright:
© 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
PY - 2020/9
Y1 - 2020/9
N2 - (1) Background: To evaluate the characteristics of fluorescein breakup patterns (FBUPs) among patients with dry eye disease (DED) and efficacy of FBUPs as a diagnostic test for DED subgroups. (2) Methods: The study enrolled 449 patients with DED. FBUPs were categorized as follows: area break (AB), line break (LB), spot break (SB), dimple break (DB), and random break (RB). Schirmer value, fluorescein breakup time (FBUT), keratoconjunctival score, DED subgroups and subjective symptoms were examined. (3) Results: LB patients presented with short FBUT and high keratoconjunctival score. AB patients presented with short FBUT, high cornea and keratoconjunctival scores. SB patients were young with short FBUT. DB patients exhibited low keratoconjunctival score. RB patients were young, with long FBUT and low keratoconjunctival scores. Among DED subgroups, LB and AB constituted 74.7% of aqueous-deficiency dry eye (ADDE). SB and DB constituted 42.4% of short FBUT dry eye (short FBUT-DE). Post-test probabilities and positive likelihood ratios for ADDE were 58.7% and 1.63, respectively; those for short FBUT-DE were 46.3% and 2.02, respectively. Patients with SB and AB exhibited significantly severe subjective symptoms than other FBUPs. (4) Conclusions: FBUPs are associated with both objective findings and symptoms of DED and may be a clinical tool for identification of DED subgroups.
AB - (1) Background: To evaluate the characteristics of fluorescein breakup patterns (FBUPs) among patients with dry eye disease (DED) and efficacy of FBUPs as a diagnostic test for DED subgroups. (2) Methods: The study enrolled 449 patients with DED. FBUPs were categorized as follows: area break (AB), line break (LB), spot break (SB), dimple break (DB), and random break (RB). Schirmer value, fluorescein breakup time (FBUT), keratoconjunctival score, DED subgroups and subjective symptoms were examined. (3) Results: LB patients presented with short FBUT and high keratoconjunctival score. AB patients presented with short FBUT, high cornea and keratoconjunctival scores. SB patients were young with short FBUT. DB patients exhibited low keratoconjunctival score. RB patients were young, with long FBUT and low keratoconjunctival scores. Among DED subgroups, LB and AB constituted 74.7% of aqueous-deficiency dry eye (ADDE). SB and DB constituted 42.4% of short FBUT dry eye (short FBUT-DE). Post-test probabilities and positive likelihood ratios for ADDE were 58.7% and 1.63, respectively; those for short FBUT-DE were 46.3% and 2.02, respectively. Patients with SB and AB exhibited significantly severe subjective symptoms than other FBUPs. (4) Conclusions: FBUPs are associated with both objective findings and symptoms of DED and may be a clinical tool for identification of DED subgroups.
KW - Clinical study
KW - Dry eye
KW - Fluorescein breakup pattern
KW - Tear film breakup time
UR - http://www.scopus.com/inward/record.url?scp=85092396313&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85092396313&partnerID=8YFLogxK
U2 - 10.3390/diagnostics10090711
DO - 10.3390/diagnostics10090711
M3 - Article
AN - SCOPUS:85092396313
SN - 2075-4418
VL - 10
JO - Diagnostics
JF - Diagnostics
IS - 9
M1 - 711
ER -