Feasibility Analysis Of Dry Eye Screening Based On Corneal And Forehead Temperature Measurements

Objective: To explore the feasibility of rapid screening of dry eye patients by measuring central corneal temperature and forehead temperature with infrared thermal imaging.Methods: This study was a cross-sectional study.The subjects who met the inclusion and exclusion criteria in the outpatient department of Shenyang heshi ophthalmology hospital from May to August 2022 were selected as subjects.The Tear Meniscus Height(TMH),Non-Invasive Tear break-up time(NITBUT)and eye redness analysis score of each subject were collected.The central corneal temperature and forehead temperature of both eyes were collected by infrared thermal imager(room temperature 20℃-23℃,humidity 60%-65%).The Ocular Surface Disease Index(OSDI)questionnaire was used to evaluate the subjective feelings of the patients.The thermal imaging images were processed by Dali infrared report analysis system(v2.05 Zhejiang Dali Technology Co.,LTD.)to obtain the temperature of the central cornea(central area of the pupil of both eyes)and the temperature of the central forehead(the intersection point of the front midline of the face and 5cm above the tip of the nose)of the subjects.The eye with short NITBUT in each subject’s eyes was included in the final analysis.Results: A total of 79 subjects and 79 eyes were included in this study.The Dry Eye(DE)group consisted of 36 subjects(36 eyes),including 13 males and 23 females,with an average age of 35.72±10.49 years.There were 43 subjects(43 eyes)in the control group(non-dry eye group),including 10 males and 33 females,with an average age of34.44±8.69 years.There was no significant difference in age and gender between the two groups(P >0.05).The dry eye group had a significantly higher OSDI score than the control group(34.14±16.63 vs.7.82±3.77,P <0.001).TMH was significantly lower in the dry eye group than in the control group(0.20±0.03 vs.0.23±0.08,P=0.033).There was no significant difference in eye redness score between the dry eye group and the control group(1.04±0.33 vs.1.01±0.28,P=0.623).The NITBUT of dry eye group was lower than that of control group(5.99±2.01 vs.10.42±3.40,P <0.001).The central corneal temperature was higher in the dry eye group than in the control group(35.86±0.99 vs.35.33±1.08,P=0.026).There was no significant difference in forehead temperature between the dry eye group and the control group(35.94±0.51 vs.35.77±0.54,P=0.171).ROC curve analysis showed that the area under the curve of central corneal temperature and forehead temperature in the dry eye group was 0.655 and 0.562,respectively.The best cut-off value of central corneal temperature for predicting dry eye group was >35.85℃,with a sensitivity of 58.3% and a specificity of 68%.The best cut-off value of forehead temperature for predicting dry eye group was >35.35℃,with a sensitivity of83% and a specificity of 32.6%.Correlation analysis showed that there was a moderate negative correlation between central corneal temperature and non-contact break-up time(r=-0.433,p<0.001).There was a weak negative correlation between forehead temperature and non-contact tear film break-up time(r=-0.263,p=0.019).Conclusion: The central corneal temperature of dry eye group was higher than that of control group.Measurement of central corneal temperature using thermal imaging may serve as a potential dry eye screening tool.In addition,central corneal temperature predicted dry eye better than forehead temperature.