Evaluation of objective visual quality in dry eye disease and corneal nerve changes
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ORIGINAL PAPER
Evaluation of objective visual quality in dry eye disease and corneal nerve changes Jiahui Ma . Shanshan Wei . Xiaodan Jiang . Yilin Chou . Yuexin Wang . Ran Hao . Jiarui Yang . Xuemin Li
Received: 19 November 2019 / Accepted: 20 June 2020 Ó The Author(s) 2020
Abstract Purpose To explore objective visual quality in dry eye diseases (DED) and the correlation between corneal nerves and objective visual quality. Methods Ninety-eight eyes of 49 patients with DED were included. Each patient was evaluated with the ocular surface disease index (OSDI), eyelid margin signs and meibomian gland assessments; corneal staining; tear film breakup time (TBUT); tear meniscus height (TMH); in vivo confocal microscopic (IVCM); objective visual quality including the objective scatter index (OSI), mean objective scattering index (mOSI), modulation transfer function (MTF) cutoff value and Strehl ratio. Results A significant correlation was found between the OSDI and mOSI (r = 0.422, p = 0.005), MTF cutoff value (r = - 0.355, p = 0.020), and Strehl ratio (r = - 0.446, p = 0.003). The OSI was significantly correlated with TBUTf (r = - 0.213, p = 0.042). The mOSI, MTF cutoff value, Strehl ratio were correlated with eyelid margin signs and meibomian assessments. Additionally, there was a statistically significant
Jiahui Ma, Shanshan Wei, Xiaodan Jiang: Co-first authors. J. Ma S. Wei X. Jiang Y. Chou Y. Wang R. Hao J. Yang X. Li (&) Department of Ophthalmology, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing 100191, China e-mail: [email protected]
correlation between corneal nerve length and the mOSI (r = - 0.239, p = 0.037), OSI (r = - 0.294, p = 0.028), MTF cutoff value(r = 0.282, p = 0.012), and Strehl ratio (r = 0.299, p = 0.008). Conclusions Our study explored that objective visual quality was correlated with clinical symptoms and signs in DED patients. Furthermore, for the first time, our study explored the relationship between corneal nerves and objective visual quality and discovered that longer and wider corneal nerves were associated with better objective visual quality, which suggested that nerve changes may be a factor that related to poor visual quality in DED patients. Keywords Dry eye diseases Objective visual quality OQAS II In vivo confocal microscope
Introduction DED is a multifactorial disease of the ocular surface characterized by a loss of homeostasis of the tear film, associated with ocular symptoms. Tear film instability, ocular surface inflammation and neurosensory abnormalities all can be etiological factors in DED [1]. This chronic ocular surface disease can cause decreased visual quality and various complications that may even lead to a reduction in quality of life [2]. Although visual acuity is often normal by standard
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scales, visual quality may be poor due to the impact of DED. In patients with severe DED, visual quality can be permanently damaged,
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