Klin Monbl Augenheilkd 2023; 240(03): 283-287
DOI: 10.1055/a-1778-4435
Experimentelle Studie

Evaluation of Tear Evaporation Rate in Subjects with a High Body Mass Index

Bewertung der Tränenverdunstungsrate bei Probanden mit einem hohen Body-Mass-Index
Ali Abusharha
Department of Optometry, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
,
Department of Optometry, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
,
Abdulhadi Alharbi
Department of Optometry, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
,
Department of Optometry, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
,
Mana A. Alanazi
Department of Optometry, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
,
Ali Alsaqar
Department of Optometry, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
,
Ali M. Masmali
Department of Optometry, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
,
Turki Almubrad
Department of Optometry, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
› Author Affiliations

Abstract

Aim This study evaluated the tear evaporation rate (TER) in subjects with a high body mass index (BMI) and tested the correlation between BMI and dry eye.

Methods Thirty male subjects aged 18 – 38 years (26.4 ± 4.0 years) with a high BMI (26.4 – 47.0 kg/m2) were enrolled in the study. In addition, a control group of 30 males aged 20 – 36 years (24.0 ± 3.6 years) with a normal BMI (< 25 kg/m2) participated in the study for comparison. Each subject completed the ocular surface disease index (OSDI), followed by the TER measurement using a handheld VapoMeter.

Results Significant differences (Wilcoxon test; p = 0.002 and 0.001) were found between the median scores of the OSDI (10.3 [3.7] vs. 5.9 [7.2]) and TER (35.5 [13.1] vs. 15.5 [12.8] g/m2 h) in the study and control groups, respectively. The OSDI indicated dry eye in 60.0% of subjects in the study group (n = 18). The TER measurements showed that 76.7% of subjects in the study group (n = 23) had dry eyes. A medium correlation (r = 0.569; p = 0.001) was found between the OSDI scores and TER measurements.

Conclusions The means of the tear evaporation rate and the ocular surface disease index scores are significantly higher in subjects with a high BMI compared with the control group. Therefore, a high BMI is considered a risk factor for dry eye. The measurement of the tear evaporation rate using a handheld VapoMeter is a simple and rapid method to detect dry eyes in combination with other tools.

Zusammenfassung

Ziel Diese Studie bewertete die Tränenverdunstungsrate (TER) bei Probanden mit einem hohen Body-Mass-Index (BMI) und testete die Korrelation zwischen BMI und trockenem Auge.

Methoden 30 männliche Probanden im Alter von 18 – 38 Jahren (26,4 ± 4,0 Jahre) mit einem hohen BMI (26,4 – 47,0 kg/m2) wurden in die Studie aufgenommen. Zusätzlich nahm zum Vergleich eine Kontrollgruppe von 30 Männern im Alter von 20 – 36 Jahren (24,0 ± 3,6 Jahre) mit einem normalen BMI (< 25 kg/m2) an der Studie teil. Jeder Proband vervollständigte den Ocular Surface Disease Index (OSDI), gefolgt von der TER-Messung mit einem tragbaren VapoMeter.

Ergebnisse Signifikante Unterschiede (Wilcoxon-Test; p = 0,002 und 0,001) wurden zwischen den Medianwerten des OSDI (10,3 [3,7] vs. 5,9 [7,2]) und TER (35,5 [13,1] vs. 15,5 [12,8] g/m2 h) in der Studien- bzw. Kontrollgruppe gefunden. Der OSDI zeigte bei 60,0% der Probanden in der Studiengruppe (n = 18) ein trockenes Auge an. Die TER-Messungen zeigten, dass 76,7% der Probanden in der Studiengruppe (n = 23) trockene Augen hatten. Zwischen den OSDI-Scores und den TER-Messungen wurde eine mittlere Korrelation (r = 0,569; p = 0,001) gefunden.

Schlussfolgerungen Die Mittelwerte der Tränenverdunstungsrate und der Ocular-Surface-Disease-Index-Scores sind bei Probanden mit hohem BMI im Vergleich zur Kontrollgruppe signifikant höher. Daher gilt ein hoher BMI als Risikofaktor für das trockene Auge. Die Messung der Tränenverdunstungsrate mit einem tragbaren VapoMeter ist eine einfache und schnelle Methode, um trockene Augen in Kombination mit anderen Instrumenten zu erkennen.



Publication History

Received: 23 August 2021

Accepted: 17 February 2022

Article published online:
14 April 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
  • References

  • 1 Di Cesare M, Bentham J, Stevens GA. et al. Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 19.2 million participants. Lancet 2016; 387: 1377-1396
  • 2 Edwards CH, Aas E, Kinge JM. Body mass index and lifetime healthcare utilization. BMC Health Serv Res 2019; 19: 696
  • 3 Sun YQ, Burgess S, Staley JR. et al. Body mass index and all cause mortality in HUNT and UK Biobank studies: linear and non-linear mendelian randomization analyses. BMJ 2019; 364: 1042
  • 4 Bibbins-Domingo K, Coxson P, Pletcher MJ. et al. Adolescent overweight and future adult coronary heart disease. N Engl J Med 2007; 357: 2371-2379
  • 5 Kurth T, Gaziano JM, Berger K. et al. Body mass index and the risk of stroke in men. Arch Intern Med 2002; 162: 2557-2562
  • 6 Nissinen A, Kastarinen M, Tuomilehto J. Community control of hypertension – experiences from Finland. J Hum Hypertens 2004; 18: 553-556
  • 7 Tirosh A, Shai I, Afek A. et al. Adolescent BMI trajectory and risk of diabetes versus coronary disease. Surv Anesthesiol 2011; 55: 296-297
  • 8 Eriksson JG, Kajantie E, Lampl M. et al. Trajectories of body mass index amongst children who develop type 2 diabetes as adults. J Intern Med 2015; 278: 219-226
  • 9 Chua J, Chee ML, Chin CWL. et al. Inter-relationship between ageing, body mass index, diabetes, systemic blood pressure and intraocular pressure in Asians: 6-year longitudinal study. Br J Ophthalmol 2019; 103: 196-202
  • 10 Alasmari HD, Al-Shehri AD, Aljuaid TA. et al. Relationship between body mass index and obesity awareness in school students. J Clin Med Res 2017; 9: 520-524
  • 11 Bocquier A, Verger P, Basdevant A. et al. Overweight and obesity: knowledge, attitudes, and practices of general practitioners in France. Obes Res 2005; 13: 787-795
  • 12 Flegal KM, Shepherd JA, Looker AC. et al. Comparisons of percentage body fat, body mass index, waist circumference, and waist-stature ratio in adults. Am J Clin Nutr 2009; 89: 500-508
  • 13 Kitahara CM, Flint AJ, Berrington de Gonzalez AB. et al. Association between class III obesity (BMI of 40–59 kg/m2) and mortality: a pooled analysis of 20 prospective studies. PLoS Med 2014; 11: e1001673
  • 14 Eby JG, Colditz GA. Obesity/Overweight: Prevention and Weight Management. In: Kris H. ed. International Encyclopedia of Public Health. Oxford: Academic Press; 2008: 602-609
  • 15 [Anonymous] The definition and classification of dry eye disease: report of the Definition and Classification Subcommittee of the International Dry Eye WorkShop (2007). Ocul Surf 2007; 5: 75-92
  • 16 Pauk SV, Petriček I, Jukić T. et al. Noninvasive tear film break-up time assessment using handheld lipid layer examination instrument. Acta Clin Croat 2019; 58: 63-71
  • 17 Masmali A, Alqahtani TA, Alharbi A. et al. Comparative study of repeatability of phenol red thread test versus Schirmerʼs test in normal adults in Saudi Arabia. Eye Contact Lens 2014; 40: 127-131
  • 18 Goto E, Endo K, Suzuki A. et al. Tear evaporation dynamics in normal subjects and subjects with obstructive meibomian gland dysfunction. Invest Ophthalmol Vis Sci 2003; 44: 533-539
  • 19 Lemp MA. Report of the National Eye Institute/Industry workshop on Clinical Trials in Dry Eyes. CLAO J 1995; 21: 221-232
  • 20 Mathers WD, Binarao G, Petroll M. Ocular water evaporation and the dry eye: a new measuring device. Cornea 1993; 12: 335-340
  • 21 Tan JH, Ng EY, Acharya UR. Evaluation of tear evaporation from ocular surface by functional infrared thermography. Med Phys 2010; 37: 6022-6034
  • 22 Petznick A, Tan JH, Boo SK. et al. Repeatability of a new method for measuring tear evaporation rates. Optom Vis Sci 2013; 90: 366-371
  • 23 Morgan PB, Tullo AB, Efron N. Infrared thermography of the tear film in dry eye. Eye 1995; 9: 615-618
  • 24 Nichols J, Mitchell G, King-Smith P. Thinning rate of the precorneal and prelens tear films. Invest Ophthalmol Vis Sci 2005; 46: 2353-2361
  • 25 Rohit A, Ehrmann K, Naduvilath T. et al. Validating a new device for measuring tear evaporation rates. Ophthalmic Physiol Opt 2014; 34: 53-62
  • 26 Alanazi SA, Abusharha A, Fagehi R. et al. Assessment of the tear evaporation rate in chronic smokers using Delfin VapoMeter. Int J Ophthalmol Vis Sci 2019; 4: 37-41
  • 27 Abusharaha A, Alturki AA, Alanazi SA. et al. Assessment of tear-evaporation rate in thyroid gland patients. Clin Ophthalmol 2019; 13: 131-135
  • 28 Word Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA 2013; 310: 2191-2194
  • 29 Schiffman RM, Christianson MD, Jacobsen G. et al. Reliability and validity of the Ocular Surface Disease Index. Arch Ophthalmol 2000; 118: 615-621
  • 30 Cohen J. Statistical Power Analysis for the Behavioral Sciences. Hillsdale, NJ: Lawrence Erlbaum Associates; 1988
  • 31 Craig JP, Nelson JD, Azar DT. et al. TFOS DEWS II report executive summary. Ocul Surf 2017; 15: 802-812
  • 32 Shimazaki J, Sakata M, Tsubota K. Ocular surface changes and discomfort in patients with meibomian gland dysfunction. Arch Ophthalmol 1995; 113: 1266-1270
  • 33 Tsubota K, Yamada M. Tear evaporation from the ocular surface. Invest Ophthalmol Vis Sci 1992; 33: 2942-2950
  • 34 Tomlinson A, Doane MG, McFadyen A. Inputs and outputs of the lacrimal system: review of production and evaporative loss. Ocul Surf 2009; 7: 186-198
  • 35 Alanazi SA. Assessment of tear film in subject with high body mass index. Clin Optom (Auckl) 2019; 11: 77-84
  • 36 Alanazi SA, Alomran AA, Abusharha A. et al. An assessment of the ocular tear film in patients with thyroid disorders. Clin Ophthalmol 2019; 13: 1019-1026
  • 37 Masmali AM, Al-Shehri A, Alanazi SA. et al. Assessment of Tear Film Quality among Smokers Using Tear Ferning Patterns. J Ophthalmol 2016; 2016: 8154315
  • 38 Ho KC, Jalbert I, Watt K. et al. A possible association between dry eye symptoms and body fat: a prospective, cross-sectional preliminary study. Eye Contact Lens 2017; 43: 245-252
  • 39 Miljanovic B, Trivedi KA, Dana MR. et al. Relation between dietary n-3 and n-6 fatty acids and clinically diagnosed dry eye syndrome in women. Am J Clin Nutr 2005; 82: 887-893
  • 40 Ziemanski JF, Wolters LR, Jones-Jordan L. et al. Relation between dietary essential fatty acid intake and dry eye disease and meibomian gland dysfunction in postmenopausal women. Am J Ophthalmol 2018; 189: 29-40
  • 41 Alanazi SA, Alfaifi AS, Abusharha A. et al. Effect of short-term oral vitamin D3 supplementation on tear film in dry eye subjects. Int J Ophthalmol Vis Sci 2019; 4: 51-57
  • 42 Dao AH, Spindle JD, Harp BA. et al. Association of dyslipidemia in moderate to severe meibomian gland dysfunction. Am J Ophthalmol 2010; 150: 371-375.e1
  • 43 Alanazi SA. Assessment of ocular tear film stability in subjects with high total cholesterol levels. Med J Cairo Univ 2019; 87: 2721-2728
  • 44 Yokoi N, Mossa F, Tiffany JM. et al. Assessment of meibomian gland function in dry eye using meibometry. Arch Ophthalmol 1999; 117: 723-729
  • 45 Shimazaki J, Goto E, Ono M. et al. Meibomian gland dysfunction in patients with Sjögren syndrome. Ophthalmology 1998; 105: 1485-1488
  • 46 Mathers WD. Ocular evaporation in meibomian gland dysfunction and dry eye. Ophthalmology 1993; 100: 347-351
  • 47 Korb DR, Greiner JV. Increase in tear film lipid layer thickness following treatment of meibomian gland dysfunction. Adv Exp Med Biol 1994; 350: 293-298
  • 48 McCulley JP, Aronowicz JD, Uchiyama E. et al. Correlations in a change in aqueous tear evaporation with a change in relative humidity and the impact. Am J Ophthalmol 2006; 141: 758-760
  • 49 Uchiyama E, Aronowicz JD, Butovich IA. et al. Increased evaporative rates in laboratory testing conditions simulating airplane cabin relative humidity: an important factor for dry eye syndrome. Eye Contact Lens 2007; 33: 174-176
  • 50 Borchman D, Foulks GN, Yappert MC. et al. Factors affecting evaporation rates of tear film components measured in vitro . Eye Contact Lens 2009; 35: 32-37
  • 51 Abusharha AA, Yami AA, Alsreea K. et al. Repeatability and reproducibility of tear film evaporation rate measurement using a new closed-chamber evaporimeter. Open Ophthalmol J 2021; 15: 117-121