Procjena debljine lipidnoga sloja mjerenjem pucanja suznoga filma ručnim instrumentom [Non-invasive tear break-up time measurement using handheld lipid layer thickness assessment tool]

Vidas Pauk, Sania (2019) Procjena debljine lipidnoga sloja mjerenjem pucanja suznoga filma ručnim instrumentom [Non-invasive tear break-up time measurement using handheld lipid layer thickness assessment tool]. PhD thesis, Sveučilište u Zagrebu.

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Abstract

Aim: To determine feasibility and reliability of non-invasive tear break- up time (NIBUT) assessment using handheld tear lipid layer thickness assessment tool, and to compare it with standard tear break-up time (TBUT) test. ----- Methods: 108 patients were enrolled, 56 with and 52 without dry eye symptoms. Schein questionnaire was used order to determine the severity of dry eye symptoms. Ocular signs were assessed by NIBUT, TBUT, lipid layer thickness measurement, Lid-Parallel Conjunctival Folds, conjunctival hyperemia and corneal staining. ----- Results: Mean NIBUT and TBUT values were significantly shorter in dry eye symptoms group than in control group. NIBUT showed great correlation with TBUT as well as with other dry eye ocular signs and symptoms. Cutoff value to distinguish patients with symptoms of dry eye from control group was 12 seconds for NIBUT and 10 seconds for TBUT, with NIBUT having significantly higher sensitivity, specificity, area under the receiver operating characteristic curve, and repeatability. NIBUT was stronger connected and more consistent with dry eye than TBUT. Finally, it was better predictor and indicator of dry eye. ----- Conclusion: NIBUT measured by handheld instrument is simple, accessible, practical and, most of all, accurate and reliable method, superior than TBUT in dry eye diagnostics.

Abstract in Croatian

Cilj: Ispitati izvedivost i pouzdanost mjerenja neinvazivnog testa pucanja suznog filma (NIBUT) korištenjem ručnog instrumenta za procjenu debljine lipidnog sloja suza te ovu metodu usporediti sa standardnim invazivnim testom (TBUT). ----- Metode: U istraživanje je bilo uključeno 108 ispitanika, 56 sa simptomima bolesti suhoga oka i 52 bez tih simptoma. Za procjenu simptoma suhog oka koristio se standardni Scheinov upitnik, a za procjenu njegovih kliničkih znakova NIBUT, TBUT, debljina lipidnog sloja, hiperemija spojnice, nabori spojnice paralelni s rubom vjeđe te bojenje rožnice fluoresceinom. ----- Rezultati: Prosječne vrijednosti NIBUT-a i TBUT-a bile su značajno kraće u skupini ispitanika sa simptomima bolesti suhog oka nego u kontrolnoj skupini u svim trima mjerenjima. Vrijednosti NIBUT-a izvrsno su korelirale s vrijednostima TBUT-a te su dobro korelirale sa simptomima i ostalim kliničkim znakovima bolesti suhog oka. NIBUT je pri graničnoj vrijednosti od 12 sekunda imao bolju osjetljivost, specifičnost te veće područje ispod krivulje (AUC) od TBUT-a pri graničnoj vrijednosti od 10 sekunda. Njegove vrijednosti bile su povezanije i konzistentnije sa simptomima bolesti suhog oka nego vrijednosti TBUT-a. Imao je bolju ponovljivost te se pokazao kao bolji prediktor i indikator bolesti suhog oka od TBUT-a. ----- Zaključak: NIBUT mjeren korištenjem ručnog instrumenta za procjenu debljine lipidnog sloja suza je praktična, dostupna, jednostavna, a prije svega učinkovita, točna i pouzdana metoda u dijagnostici bolesti suhog oka koja bi mogla naći mjesto u svakodnevnome rutinskom radu oftalmologa te bi mogla biti bolja od standardnog TBUT-a u rutinskoj detekciji pacijenata sa suhim okom.

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