Jun Myeong Yun; Hye Bin Yim; Hyun Seung Kim; Kyung Sun Na

doi:10.3341/jkos.2017.58.6.640

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Yun, Yim, Kim, and Na: Clinical Significance of Tear Film Osmolarity for Non-Sjögren Dry Eye Diagnosis

Original Article

Journal of the Korean Ophthalmological Society 2017; 58(6): 640-645.

Published online: 16 June 2017

DOI: https://doi.org/10.3341/jkos.2017.58.6.640

Clinical Significance of Tear Film Osmolarity for Non-Sjögren Dry Eye Diagnosis

Jun Myeong Yun, MD¹, Hye Bin Yim, MD, PhD¹, Hyun Seung Kim, MD, PhD², Kyung Sun Na, MD, PhD²

¹Department of Ophthalmology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea.

²Department of Ophthalmology and Visual Science, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Address reprint requests to Kyung Sun Na, MD, PhD. Department of Ophthalmology, The Catholic University of Korea Yeouido St. Mary's Hospital, #10, 63-ro, Yeongdeungpo-gu, Seoul 07345, Korea. Tel: 82-2-3779-1520, Fax: 82-2-761-6869, drna@catholic.ac.kr

Received 9 February 2017 Revised 27 March 2017 Accepted 19 May 2017

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate the diagnostic value of tear film osmolarity for non-Sjogren dry eye syndrome through measuring the correlation between tear osmolarity and several conventional dry eye parameters.

Methods

In this observational cross-sectional study, 274 patients (274 eyes) with non-Sjogren dry eye syndrome were examined using tear film osmolarity and the following conventional dry eye parameters: Schirmer's test, tear film break-up time, ocular surface disease index (OSDI), and corneal staining score. The correlations between tear film osmolarity and each conventional dry eye parameter were assessed using Spearman's correlation coefficients.

Results

The mean tear film osmolarity of the study population was 296.34 ± 21.08 mOsm/L. The tear film osmolarity was significantly negatively correlated with the Schirmer's test value (r = -0.431, p < 0.001) and tear break-up time (r = -0.131, p = 0.031), while it was significantly positively correlated with the OSDI scores (r = 0.191, p = 0.001) and corneal staining scores (r = 0.150, p = 0.013).

Conclusions

Tear film instability was significantly correlated with other conventional dry eye parameters. However, additional studies are required to determine its feasibility as a stand-alone diagnostic tool.

Keywords: Non-sjogren dry eye, Schirmer's test, Tear film osmolarity

Figures and Tables

Figure 1

Association between tear osmolarity and the Schirmer's test, tear break-up time, Ocular Surface Disease Index (OSDI) score and Corneal staining score. The tear osmolarity was significantly negatively correlated with the Schirmer's test value (A), and tear break-up time (B). The tear osmolarity was significantly positively correlated with OSDI scores (C), and the corneal staining scores (D). Data were analyzed using Spearman correlation.

Table 1

Clinical characteristics of study population

Values are presented as mean ± SD (range) or n (%) unless otherwise indicated.

TBUT = tear film break-up time; OSDI = Ocular Surface Disease Index (values were not calculated by using OSDI formula).

Table 2

Comparison of clinical measurements between different severity groups

Values are presented as mean ± SD unless otherwise indicated.

DEWS = International Dry Eye Workshop; OSDI = Ocular Surface Disease Index (values were not calculated by using OSDI formula); TBUT = tear film break-up time.

^*Mann-Whitney test.

Table 3

International Dry eye Workshop (DEWS) Classification of dry eye disease severity^*

OSDI = Ocular Surface Disease Index (values were not calculated by using OSDI formula); TBUT = tear film break-up time.

^*Developed by Suzuki et al.14

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