Ultra-high resolution optical coherence tomography for monitoring tear meniscus volume in dry eye after topical cyclosporine treatment

Abstract

Purpose: This study was designed to determine the ability of ultra-high-resolution optical coherence tomography (UHR-OCT) to monitor tear meniscus volume after dry eye treatment with Restasis(®) (0.05% cyclosporine).

Methods: UHR-OCT was used to image the upper and lower tear menisci (height and volume) in 14 consecutive dry eye patients at baseline. The treatment group was initiated on daily Restasis and measurements were repeated at 1 and 2 months while on treatment. All measurements were performed immediately after a blink.

Results: The baseline tear meniscus volumes were 0.40 ± 0.19 μL (upper) and 0.43 ± 0.18 μL (lower). In the treatment group, tear meniscus heights showed significant increases of both upper (post-hoc test with Bonferroni correction: P = 0.003) and lower (P = 0.0003) tear menisci, after 1 month on Restasis. The tear meniscus volumes in the treatment group after 1 month of Restasis showed significant increases of both upper (P = 0.007) and lower (P = 0.007) tear menisci. At 2 months, the increase of the tear meniscus was still evident in all measured variables compared with baseline (P < 0.05).

Conclusion: UHR-OCT offers a promising tool for monitoring dry eye treatment. With this method, a measurable increase in tear meniscus volume was evident after 1 month of treatment with Restasis in dry eye patients.

Keywords: Restasis®; UHR-OCT; dry eye; tear dynamics; tear menisci.

Figure 1

Upper and lower tear menisci, imaged with ultra-high-resolution optical coherence tomography. Notes: A custom-built 3 μm resolution ultra-high-resolution optical coherence tomography was used to image both upper and lower tear menisci. The boundaries of the tear meniscus were clearly visualized. The bars represent a 500 μm scale. Abbreviation: CO, cornea.

Figure 2

Tear menisci before and after 2 months of Restasis^® treatment. Notes: The upper (UTM) and lower (LTM) tear menisci were imaged at baseline, 1, and 2 months from both eyes of a dry eye subject. The tear menisci appeared increased at 1 and 2 months, compared to baseline. Bars = 500 μm. Abbreviations: OD, oculus dexter; OS, oculus sinister.

Figure 3

Upper and lower tear menisci before and after Restasis^® treatment in dry eye patients. Notes: Upper (UTMH) and lower (LTMH) tear meniscus heights were significantly increased at 1 and 2 months compared with baseline (P < 0.05). Bars represent 95% confidence intervals.

Figure 4

Tear meniscus volumes before and after Restasis^® treatment in dry eye patients. Notes: Both upper and lower tear meniscus volumes (UTMV and LTMV) and total tear meniscus volume (TTMV) were significantly increased at 1 and 2 months, compared to baseline (P < 0.05). Bars represent 95% confidence intervals.