Assessment of Tear Meniscus Dimensions Using Anterior Segment Optical Coherence Tomography in Vitamin D Deficiency in a Pediatric Population

Abstract

Background To investigate of the effect of vitamin D (Vit-D) deficiency on the tear film in children and compare it with that of healthy subjects.

Methods This prospective and cross-sectional study comprised 75 eyes of children who had Vit-D deficiency (Group 1) and 85 eyes of age- and gender-matched healthy children (Group 2). The tear-film break-up time (TF-BUT) and Schirmer test values, as well as the Ocular Surface Disease Index (OSDI) scores, were recorded for the participants in all groups. Measurement of the tear meniscus area (TMA) and tear meniscus height (TMH) was performed 2 times in the same day via the use of anterior segment-optical coherence tomography (AS-OCT).

Results The mean age of the participants in Group 1 was 12.42 ± 3.40 years, while in Group 2, it was 12.59 ± 2.32 years (p = 0.758). Group 1 comprised 43 females and 32 males, while Group 2 comprised 44 females and 41 males (p = 0.250). The mean TMH, TMA, and Schirmer test values were found to be significantly lower in children with Vit-D deficiency (Group 1) than in healthy children (Group 2), with p < 0.05 for all the values. It was concluded that there was no significant difference in the values for the mean TF-BUT and OSDI scores (p = 0.029 and p = 0.596, respectively).

Conclusion The children with Vit-D deficiency exhibited lower TMH, TMA, and Schirmer test values. The alterations that were observed in these parameters were more prominent in the participants who had lower Vit-D levels.

Zusammenfassung

Hintergrund Es sollte die Wirkung von Vitamin-D-Mangel (Vit-D) auf den Tränenfilm bei Kindern untersucht und mit der von gesunden Probanden verglichen werden.

Methoden Diese prospektive Querschnittsstudie umfasste 75 Augen von Kindern mit Vit-D-Mangel (Gruppe 1) und 85 Augen von alters- und geschlechtsangepassten gesunden Kindern (Gruppe 2). Die Aufreißzeit des Tränenfilms (TF-BUT) und Schirmer-Test-Werte sowie die Werte des Ocular Surface Disease Index (OSDI) wurden für die Teilnehmer in allen Gruppen aufgezeichnet. Die Messung der Tränenmeniskusfläche (TMA) und der Tränenmeniskushöhe (TMH) wurde 2-mal am selben Tag unter Verwendung einer optischen Kohärenztomografie des vorderen Segments (AS-OCT) durchgeführt.

Ergebnisse Das Durchschnittsalter der Teilnehmer in Gruppe 1 betrug 12,42 ± 3,40 Jahre, während es in Gruppe 2 12,59 ± 2,32 Jahre betrug (p = 0,758). Gruppe 1 umfasste 43 Frauen und 32 Männer, während Gruppe 2 44 Frauen und 41 Männer umfasste (p = 0,250). Die mittleren TMH-, TMA- und Schirmer-Test-Werte waren bei Kindern mit Vit-D-Mangel (Gruppe 1) signifikant niedriger als bei gesunden Kindern (Gruppe 2), mit p < 0,05 für alle Werte. Es wurde festgestellt, dass es keinen signifikanten Unterschied bez. des Werts für die mittleren TF-BUT- und OSDI-Scores gab (p = 0,029 und p = 0,596).

Schlussfolgerung Bei den Kindern mit Vit-D-Mangel wurden niedrigere TMH-, TMA- und Schirmer-Test-Werte festgestellt. Die bei diesen Parametern beobachteten Veränderungen waren bei den Teilnehmern mit niedrigeren Vit-D-Spiegeln ausgeprägter.

Conclusion Box

Already known:

• Vit-D deficiency has been found to have an association with DES.

• There is a demonstrated correlation between Vit-D deficiency, tear film dysfunction, and tear hyperosmolarity.

• It has been shown that significant conjunctival histopathological changes occur in children with Vit-D deficiency and that these changes are associated with Schirmer-1 test and TF-BUT measurements.

Newly described:

• DES is frequently observed in the pediatric population when it is examined by subgrouping according to the Vit-D level.

• AS-OCT is an easy method to determine tear film structure in children due to its noninvasive nature.

• The mean TMH and TMA was determined to be significantly lower in children with Vit-D deficiency.

Key words

dry eye syndrome - tear meniscus area - tear meniscus height - vitamin D deficiency

Schlüsselwörter

Syndrom des trockenen Auges - Bereich des Tränenmeniskus - Höhe des Tränenmeniskus - Vitamin-D-Mangel

Publication History

Received: 07 August 2022

Accepted: 29 November 2022

Accepted Manuscript online:
30 November 2022

Article published online:
16 February 2023

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