NEW YORK (Reuters Health) – Optical coherence tomography (OCT) corneal epithelial mapping can help doctors better screen for and stage dry-eye disease (DED), new research suggests.
“Including OCT corneal epithelial mapping in a new diagnostic tool for DED could allow optimisation of the screening and staging of the disease in current practice as well as for clinical research purposes,” Dr. Alexandre Denoyer of Centre Hospitalier Universitaire (CHU) de Reims, in France, and colleagues write in the British Journal of Ophthalmology.
The researchers conducted complete ocular surface evaluations of 118 eyes in 59 patients with DED and of 110 eyes in 55 controls, finding significant epithelial thinning among DED patients in all locations (that is, superior, central and inferior zones).
The best marker for diagnosing DED using OCT was superior intermediate epithelial thickness (binormal estimated area under the receiver operating characteristic curve, 0.87; best cutoff thickness, 50 um). The best marker for grading DED severity was the difference between the inferior and superior peripheral zones (analysis of variance, P=0.009).
Multivariate analyses identified other significant variables that helped improve OCT sensitivity to 86.4% and specificity to 91.7%.
“Studies with larger patient groups are needed to validate this model,” the authors write, “but it is likely that OCT corneal epithelial mapping will expand the quality of dry eye examinations.”
Dr. Aaron Zimmerman, an associate professor of clinical optometry and the chair of continuing education at The Ohio State University College of Optometry in Columbus, said, “In the case of dry eye, there are likely cell turnover irregularities due to both mechanical and inflammatory factors, which may result in reduced epithelial thickness. If the cells are stressed for some reason, the tissue will likely be mildly to moderately atypical.”
“With the high sensitivity and specificity listed in the article, this novel technique can possibly screen for dry eye much more reliably – and in a less invasive manner – than the battery of tests currently being used to diagnose dry eye,” Dr. Zimmerman, who was not involved in the study, told Reuters Health by email. “Detecting any new sign of a disease, particularly for a disease that is relatively common, is important.”
“The findings did not correlate well with the symptom survey, but that is common for many tests for dry eye,” he noted.
“This particular OCT technology is not yet widely distributed, thus this diagnostic technique will not be immediately incorporated into many practices,” Dr. Zimmerman added. “The paper’s multivariate nomogram may also prove to be quite valuable for the diagnosis of dry eye in the future, but only in offices that have access to this specific OCT technology.”
Dr. Denoyer did not respond to requests for comment.
SOURCE: https://bit.ly/3g2TRBp The British Journal of Ophthalmology, online May 24, 2021.
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