Tear osmolarity as a biomarker for dry eye disease severity.

PURPOSE To study the association between tear osmolarity and dry eye severity grade, based on a modified Dry Eye Workshop (DEWS) scale, and between osmolarity and the signs and symptoms that determine dry eye disease severity. METHODS Nineteen patients with dry eye disease were asked to complete an evaluation of dry eye signs and symptoms composed of the Ocular Surface Disease Index (OSDI) questionnaire, corneal staining with fluorescein, conjunctival staining with lissamine green, tear-film breakup time (TFBUT), Schirmer's test with anesthesia, and tear sample collection. Tear samples were collected in 5-microL microcapillaries. Tear osmolarity was measured in the right eye with a tear osmometer. RESULTS Tear osmolarity correlated significantly with dry eye severity grade (modified DEWS). Schirmer's test and tear osmolarity correlated significantly at r=-0.52, with Schirmer's test result, with adjustment for age, contributing significantly to the independent estimate of tear osmolarity. CONCLUSIONS Tear osmolarity correlates with dry eye severity and therefore could provide a biomarker for disease severity.

[1]  J. P. Gilbard.  Tear film osmolarity and keratoconjunctivitis sicca. , 1985, The CLAO journal : official publication of the Contact Lens Association of Ophthalmologists, Inc.

[2]  Angus McFadyen,et al.  Dry eye diagnosis. , 2008, Investigative ophthalmology & visual science.

[3]  Christophe Baudouin,et al.  The definition and classification of dry eye disease: report of the Definition and Classification Subcommittee of the International Dry Eye WorkShop (2007). , 2007, The ocular surface.

[4]  J. Nelson,et al.  Tear film osmolality determination: an evaluation of potential errors in measurement. , 1986, Current eye research.

[5]  Lee Stern,et al.  Dysfunctional Tear Syndrome: A Delphi Approach to Treatment Recommendations , 2006, Cornea.

[6]  Gilbard Jp.  Tear film osmolarity and keratoconjunctivitis sicca. , 1985 .

[7]  R. Farris,et al.  Tear osmolarity--a new gold standard? , 1994, Advances in experimental medicine and biology.

[8]  P. Asbell,et al.  Evaluation of a New Tear Osmometer for Repeatability and Accuracy, Using 0.5-μL (500-Nanoliter) Samples , 2009, Cornea.

[9]  Debra A. Schaumberg,et al.  Dry Eye Disease: The Clinician's Guide to Diagnosis and Treatment , 2006 .

[10]  A. Tomlinson,et al.  Assessment of tear film dynamics: quantification approach. , 2005, The ocular surface.

[11]  Angus McFadyen,et al.  Tear film osmolarity: determination of a referent for dry eye diagnosis. , 2006, Investigative ophthalmology & visual science.

[12]  R. Farris,et al.  Osmolarity of tear microvolumes in keratoconjunctivitis sicca. , 1978, Archives of ophthalmology.

[13]  I. Mandel,et al.  Tear osmolarity variation in the dry eye. , 1986, Transactions of the American Ophthalmological Society.

[14]  A. Bron,et al.  Using osmolarity to diagnose dry eye: a compartmental hypothesis and review of our assumptions. , 2002, Advances in experimental medicine and biology.

[15]  R. Schiffman,et al.  Reliability and validity of the Ocular Surface Disease Index. , 2000, Archives of ophthalmology.

[16]  Y. Karakoç,et al.  Comparison of tear-film osmolarity in different types of contact lenses. , 2002, The CLAO Journal.