There are several ways to diagnose dry eye disease (DED), from simple slit lamp assessment to advanced diagnostic measures and patient questionnaires, but they can be time consuming and don’t necessarily evaluate the severity of the disease. 

In a recent study, researchers investigated a new model to optimize the objective diagnosis of DED by making use of OCT corneal epithelial mapping.

Fifty-nine dry eye patients (118 eyes) and 55 controls (110 eyes) were included, and corneal epithelial thickness was collected using OCT for seven zones. Superior intermediate epithelial thickness was the best marker for diagnosing DED using OCT. The difference between the inferior and superior peripheral zones was the best marker for grading the severity of DED. A multivariate approach identified other significant factors, such as gender, which the authors explained provided a better understanding of the relationship with corneal epithelial thickness.

“Interestingly enough, our multivariate analysis also identified two other accurate parameters: (1) the difference between superior and inferior epithelial thicknesses in the peripheral zone and (2) the daily use of antiglaucoma drugs (for at least three months, as defined in our inclusion criteria),” the authors explained in their study. “As a result, integrating OCT epithelial mapping and specific patient features in an integrated scoring scale proved to be highly effective in the diagnosis of DED, even without an ophthalmological examination of the patient. Such an innovative approach could help better screen DED via paramedical approach in order to detect the disease and then refer the patient to a specialist.”

“More precisely, we also defined a cut-off value for superior epithelial thickness under 50μm as a highly sensitive and specific marker to differentiate patients with dry eye from healthy people. These results seem to be consistent with previous publications, which found thinning in the upper area of the corneal epithelium.”

The authors concluded that this diagnostic tool could ultimately help optimize the screening and staging of DED and evaluate the severity and evolution of the disease.

Edorh NA, Maftouhi AE, Ajerada Z, et al. New model to better diagnose dry eye disease integrating OCT corneal epithelial mapping. Br J Ophthalmol. [Epub ahead of print].