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. 2017 Sep 8;12(9):e0184296.
doi: 10.1371/journal.pone.0184296. eCollection 2017.

Relation of accommodative microfluctuation with dry eye symptoms in short tear break-up time dry eye

Minako Kaido  1   2 , Motoko Kawashima  1 , Yuta Shigeno  1 , Yoshiaki Yamada  3 , Kazuo Tsubota  1
Affiliations

Relation of accommodative microfluctuation with dry eye symptoms in short tear break-up time dry eye

Minako Kaido et al. PLoS One. .

Abstract

Purpose: To investigate accommodative microfluctuations (AMFs) and visual function in short tear break-up time (BUT)-type dry eye (DE) and non-DE subjects.

Methods: This prospective comparative study included 48 volunteers with DE symptoms (mean age 34.8 ± 5.5 years, age range 25-42 years) and 73 without DE symptoms (mean age 30.6 ± 4.7 years, age range 25-42 years). The eyes were divided into two groups: (1) DE group with DE symptoms and BUT ≤ 5 s and (2) non-DE group without DE symptoms and BUT > 5 s. We excluded eyes with Schirmer score ≤ 5 mm and positive keratoconjunctival epithelial damage. Tear evaluation, AMF, and functional visual acuity (VA) examinations were performed. AMF parameters included total high-frequency component (HFC), HFC with low accommodation for the task of staring into the distance (HFC1), and HFC with high accommodation for deskwork (HFC2). Functional VA parameters included starting VA, functional VA, visual maintenance ratio, and blink frequency.

Results: A total of 33 and 34 eyes were categorized in the DE and non-DE groups, respectively. Mean blink frequency and HFC1 values were significantly higher in the DE group than they were in the non-DE group.

Conclusions: DEs with symptoms showed abnormal AMF and visual function, which may be associated with DE symptoms.

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Conflict of interest statement

Competing Interests: Kowa Co., Ltd. Japan provided a monetary grant for research unrelated to the current study to the Department of Ophthalmology of Keio University School of Medicine. Drs Kazuo Tsubota and Minako Kaido hold patent rights for the method and apparatus used for the measurement of functional visual acuity (US patent no: 7470026). The other authors have no affiliation with any corporation. Yoshiaki Yamada is an employee of Santen Pharmaceutical Co., Ltd., Japan, while Kazuo Tsubota is a consultant and has received research funds unrelated to this study from Santen Pharmaceutical Co., Ltd. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. Measurement system of dynamic auto-refractometer.
(A) Dynamic auto-refractometer (AA-2TM) device. (B) Measurement system: accommodative microfluctuations are measured while focusing on an out-of-focus image at each predetermined distance. (C) Normal pattern of frequency of kinetic reaction map: the graph appears in green and green-yellow-red bars with low and high accommodation, respectively, that represents low HFC1 and relatively low HFC2 values. (D) Accommodative excess pattern of frequency of kinetic reaction map: the graph appears in red bars with low and high accommodation that represents high HFC1and HFC2 values, respectively.
Fig 2
Fig 2. Frequency scores of dry eye symptoms for each group.
Fig 3
Fig 3. Functional visual acuity parameters for each group.
(A) Starting and functional visual acuity, (B) visual maintenance ratio, and (C) blink frequency of study subjects.
Fig 4
Fig 4. Power spectra for accommodative parameters of each group.
High-frequency component (HFC) 1, between 0.0–0.75 diopter with low accommodation for staring into the distance task; HFC2, between -1.0 and -3.0 diopters with high accommodation for desk work; and total HFC, between 0.75 and -3.0 diopters.
Fig 5
Fig 5. Mechanism of dry eye symptom stimulation.
See this image and copyright information in PMC

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