To evaluate the tear meniscus in aqueous tear-deficient dry eye patients using Fourier-domain optical coherence tomography (FD-OCT) and to investigate the clinical usefulness of tear meniscus values.

The present study included 79 aqueous tear-deficient dry eyes and 50 normal eyes. Tear meniscus height (TMH), tear meniscus depth (TMD), and tear meniscus area (TMA) were imaged using FD-OCT and measured with computer calipers. Schirmer's test, tear break-up time, and corneal fluorescein staining were also performed and the correlations between the tests were analyzed. Additionally, the diagnostic power of tear meniscus values was compared using area under the receiver operating characteristic curve (AUROC).

Tear meniscus values were significantly decreased in the aqueous tear-deficient dry eye group ( p < 0.05). TMH, TMD, and TMA were positively correlated with Schirmer's test and tear break-up time ( p < 0.05), and TMH and TMD were negatively correlated with corneal fluorescein staining in the aqueous tear-deficient dry eye group ( p < 0.05). The AUROCs of TMH, TMD, and TMA were 0.978, 0.788, and 0.957, respectively.

Tear meniscus values measured using FD-OCT were significantly lower in aqueous tear-deficient dry eyes and were correlated with Schirmer's test, tear break-up time, and corneal fluorescein staining. Tear meniscus measurements obtained using FD-OCT can be useful clinical parameters for the diagnosis and treatment of aqueous tear-deficient dry eye.