| Purpose We aimed at finding the optimal concentration and dose of fluorescein for assessing the fluorescein tear film break-up time(FBUT),in order to design a device which could quantificationally drip fluorescein into eyes.FBUT measured by the optimal concentration and dose of fluorescein was compared with noninvasive tear film break-up time(NIBUT)measured by Keratograph and other surface ocular parameters.Methods 1.A total of 10 master's candidates from Grade 2015 to Grade 2017 of Fujian Medical University were recruited as subjects.Sex,age and ocular surface disease index(OSDI)of these subjects were recorded.Each subject received FBUT test on the right eye on the first day,third day,fifth day,and seventh day.Each subject on the same day received FBUT test with five different concentration and dose of fluorescein at 30-minute intervals(Group A : 0.25% 1ul FL;Group B: 0.5% 1ul FL;Group C: 1% FL FL;Group D: 0.5% 0.5ul FL;Group E: 0.5 % 2ul FL).The distribution of fluorescein on the ocular surface under a diffused cobalt blue light slit lamp was shot in real time by a digital camera.The image quality was evaluated by 2 master graduate students and 1 professor of ophthalmology.Images were scored 4 points,3 points,2 points and 1 point from the best to the worst,respectively.The score of each group was compared.The stability of FBUT was evaluated by the coeficient of variation(CV)of five FBUT subsequently measured,and the reliability of FBUT was evaluated by comparing the CV of FBUTs on the 1st,3rd,5th and 7th days.2.A total of 27 patients(54 eyes)who attended the ophthalmology of the Second Affiliated Hospital of Fujian Medical University were recruited as the subjects.All the subjects received the FBUT test based on the optimal concentration and dose of fluorescein hereinbefore.The following information was recorded,including the first noninvasive tear film break-up time(NIBUT-f),the average noninvasive tear film break-up time(NIBUT-ave),tear meniscus height(TMH),Schirmers?test,loss of meibomian glands,and OSDI.Then the relationship between FBUT and OSDI,NIBUT-f,NIBUT-ave,TMH,Schirmers?test,loss of meibomian glands were analysed.Results 1.Image score of Group B(0.5% 1ul FL)was higher than the rest four groups,and the difference was statistically significant(P<0.05).Therefore,image quality of 0.5% 1ul group is the best.The average value of FBUT measured 5 times consecutively in the 1% 1ul FL group(4.73±1.607s)is shorter than that in 0.5% 1ul group(10.09±4.512s)as well as in 0.5% 2ul group(10.78±3.997s),and the difference was statistically significant(P<0.05).The CV of FBUT in the 0.5% 1ul group measured 5 times consecutively(0.053±0.020)is less than that in the 1% 1ul group(0.308±0.122)as well as in 0.5% 2ul group(0.175±0.148),and the difference was statistically significant(P<0.05).The CV of FBUT in the 0.5% 2ul group measured 5 times consecutively was less than that in the 1% 1ul group,and the difference was statistically significant(P<0.05).The CV of FBUT measured repeatedly(the1st,3rd,5th,7th day)of 0.5% 1ul group was less than 1%(0.051±0.025)1ul group(0.103±0.055),the difference was statistically significant(P<0.05).Neither the difference between 0.5% 1ul group and 0.5% 2ul group nor the difference between 1% 1ul group and 0.5% 2ul group was statistically significant.2.FBUT was significantly correlated with NIBUT-f(r= 0.619,P=0.000,P<0.01).FBUT was significantly correlated with NIBUT-ave(r=0.556,P=0.000,P<0.01).Schirmer I test was significantly correlated with FBUT(r=0.673,P=0.000,P<0.01).FBUT was not significantly correlated with OSDI(r=-0.056,P=0.687,P>0.05).FBUT was not significantly correlated with TMH(r=0.220,P=0.111,P>0.05).FBUT was not significantly correlated with the loss of meibomian gland(r=-0.080,P=0.565,P>0.05).Conclusions In FBUT test,0.5% 1ul fluorescein sodium is the most stable and reliable.Hence,we designed a device which can drip 0.5% 1ul fluorescein into eyes.FBUT is a positively correlated with Schirmer I test,NIBUT-f,and NIBUT-ave,but not significantly correlated with OSDI,TMH,or loss of meibomian gland. |
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