Dry Eye Signs And Symptoms And Visual Field Reliability Metrics

To determine the role of signs and symptoms of dry eye disease (DED) on visual field (VF) standard reliability indexes and gaze tracking (GT) metrics.

Eye clinic, University Hospital of Rome Tor Vergata

Cross-sectional study to evaluate the role of DED signs and symptoms on VF reliability metrics in glaucoma patients. Tear break-up time (TBUT), corneal fluorescein staining (CFS) (National Eye Institute, NEI score) and the 5-item Dry Eye Questionnaire (DEQ-5) were determined. Common VF reliability indexes as fixation losses (FLs) and false positives (FPs) results were recorded. GT metrics were calculated as the percent of stimuli with gaze deviations of 1-2 degrees (M1), 3-5 degrees (M3), ³6 degrees (M6), tracking failure frequency (TFF) and blink frequency (BF). VF mean deviation (MD) was recorded. Spearman’s correlation coefficient and linear regression were used to test the impact of DED signs and symptoms on VF reliability metrics.

115 eyes were included in the analyses with mean DEQ-5 score of 8.2± 5.8, TBUT of 6.2±2.6 sec and CFS of 5±3.7. DED symptoms did not correlate with any of the VF reliability metrics (p>0.05), TBUT negatively correlated with FLs (-0.24; p=0.0128) and CFS positively correlated with FPs (0.28; p=0.0035). Multivariate linear regression evaluating the association of DED signs and symptoms together with age, sex and MD with the VF reliability indexes confirmed the negative association of FLs with TBUT (-0.78; p=0.014) and the positive association of FPs with CFS (0.18; p=0.030); additionally, M3 showed a negative association with TBUT (-0.96; p=0.042, respectively) while TFF were positively associated with CFS (2.0; p=0.022)

Dry eye symptoms severity did not influence the reliability of VF testing. In contrast, signs of DED significantly affected both standard reliability and GT metrics, with shorter TBUT being associated with increased rate of FLs and gaze deviations between 3-5 degrees and higher CFS scores determining increased FPs responses and greater TFF.