Evaluation of Dry Eye With Videokeratographer Using a Newly Developed Indicator

center dot PURPOSE: To analyze the effectiveness of a newly de-veloped indicator that quantitatively assesses disturbance in Meyer-ring (MR) images obtained via videokeratogra-pher and assess its usefulness for the clinical evaluation of dry eye (DE). center dot DESIGN: Cross-sectional study. center dot METHODS: This study involved 79 eyes of 79 DE pa-tients (10 males and 69 females; mean age: 62.7 years). After MR images were obtained via videokeratographer, the degree of blur was quantified at multiple points on the ring, with the total value across the cornea being defined as the disturbance value (DV). Correlations between to-tal DV (TDV; the sum of DV for 5 seconds after eye opening) and 12 DE symptoms, Dry Eye-Related Qual-ity of Life Score (DEQS), tear meniscus radius (mm), tear film (TF) lipid-layer spread grade (SG; grades 1-5, 1 = best), TF noninvasive breakup time (NIBUT, seconds), fluorescein breakup time (FBUT, seconds), corneal epithelial damage score (CEDS; maximum: 15 points), conjunctival epithelial damage score (CjEDS; maximum: 6 points), and Schirmer 1 test value (mm) were analyzed via univariate and multivariate analyses. center dot RESULTS: No significant correlations were found be-tween TDV and each DE symptom or DEQS, yet sig-nificant correlations were found between TDV and SG, NIBUT, FBUT, CEDS, and CjEDS ( r = 0.56, -0.45, -0.45, 0.72, and 0.62, respectively, all P < .01). TDV was found to be described as 2334 + (412.1 x CEDS) - (302.0 x FBUT) ( R 2 = 0.593, P < .0001). center dot CONCLUSIONS: Our newly developed indicator, DV, re-flecting TF dynamics and stability and corneoconjuncti-val epithelial damage, may be useful for quantitatively as-sessing DE ocular-surface abnormalities. (Am J Oph-thalmol 2023;252: 135-146. (c) 2023 Elsevier Inc. All rights reserved.)