Agreement of noninvasive tear break-up time measurement between Tomey RT-7000 Auto Refractor-Keratometer and Oculus Keratograph 5M.
Agreement of noninvasive tear break-up time measurement between Tomey RT-7000 Auto Refractor-Keratometer and Oculus Keratograph 5M.
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DOI：
10.2147/opth.s110180
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发表时间：
2016
期刊：
影响因子：
--
通讯作者：
Tong L
中科院分区：
文献类型：
--
作者：
Lee R;Yeo S;Aung HT;Tong L
在不同的临床环境下，干眼的评估很难标准化。越来越多的人认识到泪液稳定性对于干眼症患者的定义和评估的重要性。最近，两种可用于客观测量非侵入性泪液破裂时间(NIBUT)的商用仪器问世，作为泪液稳定性的指标：Tomey RT-7000自动屈光度角膜测定仪和Oculus 5M角膜测定仪。我们的目标是使用这些模式来评估NIBUT测量的一致性。这项前瞻性横断面研究是在三级转诊眼科中心进行的，涉及126名连续的干眼症患者。使用RT-7000和K5M技术对参与者的右眼进行NIBUT评估，评估的顺序是随机的。在评估前2周，采用标准化患者干眼症评估问卷(SPEED)评估干眼症症状。受试者年龄为56.0±14.3岁，女性占69.84%。两种方式的测量值都是非正态分布(右偏)。RT-7000和K5M读数的中位数分别为4.2秒(0.1-10.0秒)和6.4秒(0.1-24.9秒)。RT-7000和K5M读数相关性较差(ρ=0.061，P=0.495)。组内相关系数为0.187(95%可信区间−为0.097~0.406)。布兰德-阿尔特曼的曲线图显示，这些机器的读数之间没有系统性差异。机器之间的一致性在不同的速度类别中没有区别。虽然NIBUT在评估泪液稳定性方面比基于染料的方法有理论和实践上的好处，但这两种方法之间的一致性很差。因此，评估NIBUT的研究和试验应避免在评估NIBUT时交替使用这些模式。需要更多的研究来提高关于如何确定NIBUT的共识。
It is difficult to standardize assessment of dry eye in different clinical settings. Increasingly, tear stability is recognized to be important for the definition and assessment of patients with dry eye. Recently, two commercially available instruments have been made available for objectively measuring noninvasive tear break-up time (NIBUT), as an indicator of tear stability: the Tomey RT-7000 Auto Refractor-Keratometer and Oculus Keratograph (K)5M. We aim to assess the agreement of NIBUT measurements using these modalities. This prospective cross-sectional study was carried out in a tertiary referral eye center and involved 126 consecutive dry eye patients. NIBUT assessment was performed on the right eyes of participants with both the RT-7000 and the K5M techniques, with the order of assessment randomized. The Standardized Patient Evaluation of Eye Dryness (SPEED) questionnaires were administered to assess dry eye symptoms in the 2 weeks before assessment. The age of the participants was 56.0±14.3 years (69.84% females). Measurements for both modalities were non-normally distributed (right-skewed). The median RT-7000 and K5M readings were 4.2 (range 0.1–10.0) and 6.4 (0.1–24.9) seconds, respectively. RT-7000 and K5M readings were poorly correlated (ρ=0.061, P=0.495). Intraclass correlation coefficient between the modalities was 0.187 (95% confidence interval −0.097 to 0.406). The Bland–Altman plot showed no systematic differences between the readings with these machines. The agreement between machines was not different in different SPEED categories. While there are theoretical and practical benefits of NIBUT for assessment of tear stability over dye-based methods, the agreement between the two modalities was poor. Hence, studies and trials assessing NIBUT should avoid using these modalities interchangeably for NIBUT assessment. More research is needed to improve consensus on how to determine NIBUT.