Abstract
Aim
To determine the diagnostic accuracy of non-invasive tear film break-up time (NIBUT)
measured by the handheld lipid layer examination instrument.
Methods
108 patients were enrolled in this cross-sectional study and divided into two groups:
patients with dry eye (n = 57) categorized by the presence of dry eye symptoms obtained
by Schein Questionnaire and minimally-one objective dry eye sign (tear film break-up
time <10 s or corneal, conjunctival and lid margin fluorescein staining), and healthy
subjects (n = 51).
Results
Dry eye subjects had significantly shorter NIBUT than healthy subjects (6 s vs 20 s,
p < 0.001). Logistic regression analysis showed that shorter NIBUT values were excellent
indicators of dry eye disease (p < 0.001), with consistency and no significant difference
between measurements, even after standardizing the results for age and sex. NIBUT
cut-off point to distinguish dry eye from healthy subjects was 12 s (sensitivity 90.2 %,
specificity 88.5 %, PPV 92.5 %, NPV 85.2 %, LR +7.82, LR− 0.11, DOR 70.92, DE 89.6 %).
Good, but lower accuracy was observed at cut-off value of 10 s (sensitivity 87.8 %,
specificity 88.5 %, PPV 92.3 %, NPV 82.1 %, LR+ 7.61, LR− 0.14, DOR 55.2, DE 88.1 %).
The area under the ROC curve (AUC) of 0.944 classified NIBUT as a diagnostic test
with very high accuracy.
Conclusion
This study showed a high diagnostic accuracy of NIBUT measured by the handheld lipid
layer examination instrument. This simple, reliable, objective and available instrument
might regularly take place in routine, standard dry eye diagnostic and can be used
by almost every eye specialist.
Keywords
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Article info
Publication history
Published online: October 27, 2022
Accepted:
October 19,
2022
Received in revised form:
October 1,
2022
Received:
June 17,
2022
Identification
Copyright
© 2022 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.
