Ultra-high resolution optical coherence tomography for monitoring tear meniscus volume in dry eye after topical cyclosporine treatment

PURPOSE This study was designed to determine the ability of ultra-high-resolution optical coherence tomography (UHR-OCT) to monitor tear meniscus volume after dry eye treatment with Restasis(®) (0.05% cyclosporine). METHODS UHR-OCT was used to image the upper and lower tear menisci (height and volume) in 14 consecutive dry eye patients at baseline. The treatment group was initiated on daily Restasis and measurements were repeated at 1 and 2 months while on treatment. All measurements were performed immediately after a blink. RESULTS The baseline tear meniscus volumes were 0.40 ± 0.19 μL (upper) and 0.43 ± 0.18 μL (lower). In the treatment group, tear meniscus heights showed significant increases of both upper (post-hoc test with Bonferroni correction: P = 0.003) and lower (P = 0.0003) tear menisci, after 1 month on Restasis. The tear meniscus volumes in the treatment group after 1 month of Restasis showed significant increases of both upper (P = 0.007) and lower (P = 0.007) tear menisci. At 2 months, the increase of the tear meniscus was still evident in all measured variables compared with baseline (P < 0.05). CONCLUSION UHR-OCT offers a promising tool for monitoring dry eye treatment. With this method, a measurable increase in tear meniscus volume was evident after 1 month of treatment with Restasis in dry eye patients.