{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T19:16:26Z","timestamp":1783538186937,"version":"3.55.0"},"reference-count":47,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2021,9,6]],"date-time":"2021-09-06T00:00:00Z","timestamp":1630886400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,9,6]],"date-time":"2021-09-06T00:00:00Z","timestamp":1630886400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100003508","name":"Universitat de Val\u00e8ncia","doi-asserted-by":"publisher","award":["\u201cAtracci\u00f3 de Talent\u201d scholarship [UV-INV-PREDOC18F2-886420]"],"award-info":[{"award-number":["\u201cAtracci\u00f3 de Talent\u201d scholarship [UV-INV-PREDOC18F2-886420]"]}],"id":[{"id":"10.13039\/501100003508","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003176","name":"Ministerio de Educaci\u00f3n, Cultura y Deporte","doi-asserted-by":"publisher","award":["\u201cFormaci\u00f3n de Profesorado Universitario\u201d Scholarship FPU17\/03665"],"award-info":[{"award-number":["\u201cFormaci\u00f3n de Profesorado Universitario\u201d Scholarship FPU17\/03665"]}],"id":[{"id":"10.13039\/501100003176","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Universitat de Valencia"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Graefes Arch Clin Exp Ophthalmol"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>This study aimed to develop and validate new metrics to objectively assess the lipid layer thickness (LLT) through the analysis of grey intensity values obtained from the Placido disk pattern reflected onto the tear film.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Ocular surface parameters were measured using Oculus Keratograph 5\u00a0M in 94 healthy volunteers (43.8\u2009\u00b1\u200926.8\u00a0years). Subjects\u2019 LLT was subjectively classified into 4 groups using an interferometry-based grading scale. New metrics based on the intensity of the Placido disk images were calculated and compared between groups. The repeatability of the new metrics and their diagnostic ability was analysed through receiver operating characteristics (ROC) curves. The level of agreement between the new objective tool and the existing subjective classification scale was analysed by means accuracy, weighted Kappa index and <jats:italic>F<\/jats:italic>-measure.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Mean pixel intensity, median pixel intensity and relative energy at 5.33\u00a0s after blinking achieved the highest performance, with a correlation with LLT between <jats:italic>r<\/jats:italic>\u2009=\u20090.655 and 0.674 (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), sensitivity between 0.92 and 0.94, specificity between 0.79 and 0.81, area under the ROC curve between 0.89 and 0.91, accuracy between 0.76 and 0.77, weighted Kappa index of 0.77 and <jats:italic>F<\/jats:italic>-measure between 0.86 and 0.87.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>The analysis of grey intensity values in videokeratography can be used as an objective tool to assess LLT. These new metrics could be included in a battery of clinical tests as an easy, repeatable, objective and accessible method to improve the detection and monitoring of dry eye disease and meibomian gland dysfunction.<\/jats:p>\n                \n              <\/jats:sec>","DOI":"10.1007\/s00417-021-05378-8","type":"journal-article","created":{"date-parts":[[2021,9,6]],"date-time":"2021-09-06T04:02:30Z","timestamp":1630900950000},"page":"655-676","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Validation of a new objective method to assess lipid layer thickness without the need of an interferometer"],"prefix":"10.1007","volume":"260","author":[{"given":"Jos\u00e9 Vicente","family":"Garc\u00eda-Marqu\u00e9s","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristian","family":"Talens-Estarelles","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Santiago","family":"Garc\u00eda-L\u00e1zaro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8014-3279","authenticated-orcid":false,"given":"Alejandro","family":"Cervi\u00f1o","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,9,6]]},"reference":[{"key":"5378_CR1","doi-asserted-by":"publisher","first-page":"366","DOI":"10.1016\/j.jtos.2017.03.006","volume":"15","author":"MDP Willcox","year":"2017","unstructured":"Willcox MDP, Arg\u00fceso P, Georgiev GA et al (2017) TFOS DEWS II tear film report. Ocul Surf 15:366\u2013403. https:\/\/doi.org\/10.1016\/j.jtos.2017.03.006","journal-title":"Ocul Surf"},{"key":"5378_CR2","doi-asserted-by":"publisher","first-page":"4900","DOI":"10.1167\/iovs.13-11878","volume":"54","author":"P Ewen King-Smith","year":"2013","unstructured":"Ewen King-Smith P, Reuter KS, Braun RJ et al (2013) Tear film breakup and structure studied by simultaneous video recording of fluorescence and tear film lipid layer images. Investig Ophthalmol Vis Sci 54:4900\u20134909. https:\/\/doi.org\/10.1167\/iovs.13-11878","journal-title":"Investig Ophthalmol Vis Sci"},{"key":"5378_CR3","doi-asserted-by":"publisher","first-page":"539","DOI":"10.1016\/j.jtos.2017.05.001","volume":"15","author":"JS Wolffsohn","year":"2017","unstructured":"Wolffsohn JS, Arita R, Chalmers R et al (2017) TFOS DEWS II Diagnostic Methodology report. Ocul Surf 15:539\u2013574. https:\/\/doi.org\/10.1016\/j.jtos.2017.05.001","journal-title":"Ocul Surf"},{"key":"5378_CR4","doi-asserted-by":"publisher","first-page":"S31","DOI":"10.1016\/S1367-0484(98)80035-0","volume":"21","author":"J-P Guillon","year":"1998","unstructured":"Guillon J-P (1998) Non-invasive tearscope plus routine for contact lens fitting. Contact Lens Anterior Eye 21:S31\u2013S40. https:\/\/doi.org\/10.1016\/S1367-0484(98)80035-0","journal-title":"Contact Lens Anterior Eye"},{"key":"5378_CR5","doi-asserted-by":"publisher","first-page":"2058","DOI":"10.1016\/j.ophtha.2009.04.037","volume":"116","author":"R Arita","year":"2009","unstructured":"Arita R, Itoh K, Maeda S et al (2009) Proposed diagnostic criteria for obstructive meibomian gland dysfunction. Ophthalmology 116:2058-2063.e1. https:\/\/doi.org\/10.1016\/j.ophtha.2009.04.037","journal-title":"Ophthalmology"},{"key":"5378_CR6","doi-asserted-by":"publisher","first-page":"2006","DOI":"10.1167\/iovs.10-6997f","volume":"52","author":"A Tomlinson","year":"2011","unstructured":"Tomlinson A, Bron AJ, Korb DR et al (2011) The international workshop on meibomian gland dysfunction: report of the diagnosis subcommittee. Investig Ophthalmol Vis Sci 52:2006\u20132049. https:\/\/doi.org\/10.1167\/iovs.10-6997f","journal-title":"Investig Ophthalmol Vis Sci"},{"key":"5378_CR7","doi-asserted-by":"publisher","first-page":"382","DOI":"10.1097\/01.ico.0000148291.38076.59","volume":"24","author":"JJ Nichols","year":"2005","unstructured":"Nichols JJ, Berntsen DA, Mitchell GL, Nichols KK (2005) An assessment of grading scales for meibography images. Cornea 24:382\u2013388. https:\/\/doi.org\/10.1097\/01.ico.0000148291.38076.59","journal-title":"Cornea"},{"key":"5378_CR8","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1016\/j.cmpb.2013.04.007","volume":"111","author":"B Remeseiro","year":"2013","unstructured":"Remeseiro B, Penas M, Barreira N et al (2013) Automatic classification of the interferential tear film lipid layer using colour texture analysis. Comput Methods Programs Biomed 111:93\u2013103. https:\/\/doi.org\/10.1016\/j.cmpb.2013.04.007","journal-title":"Comput Methods Programs Biomed"},{"key":"5378_CR9","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1080\/02713683.2017.1393092","volume":"43","author":"M Markoulli","year":"2018","unstructured":"Markoulli M, Duong TB, Lin M, Papas E (2018) Imaging the tear film: a comparison between the Subjective Keeler Tearscope-PlusTM and the Objective Oculus\u00ae Keratograph 5M and LipiView\u00ae interferometer. Curr Eye Res 43:155\u2013162. https:\/\/doi.org\/10.1080\/02713683.2017.1393092","journal-title":"Curr Eye Res"},{"key":"5378_CR10","unstructured":"Remeseiro B, Penedo MG, Garc\u00eda-Res\u00faa C et al (2014) Dry eye characterization by analyzing tear film images. In:\u00a0Ng EYK, Acharya-Rajendra U, Rangayyan RM, Suri JS (eds) Ophthalmological imaging and applications, 1st edn.\u00a0New York, pp 449\u2013475"},{"key":"5378_CR11","doi-asserted-by":"publisher","first-page":"677","DOI":"10.1007\/s10044-014-0402-x","volume":"18","author":"B Remeseiro","year":"2015","unstructured":"Remeseiro B, Oliver KM, Tomlinson A et al (2015) Automatic grading system for human tear films. Pattern Anal Appl 18:677\u2013694. https:\/\/doi.org\/10.1007\/s10044-014-0402-x","journal-title":"Pattern Anal Appl"},{"key":"5378_CR12","doi-asserted-by":"publisher","unstructured":"da Cruz LB, Souza JC, de Sousa JA, et al (2020) Interferometer eye image classification for dry eye categorization using phylogenetic diversity indexes for texture analysis. Comput Methods Programs Biomed 188. https:\/\/doi.org\/10.1016\/j.cmpb.2019.105269","DOI":"10.1016\/j.cmpb.2019.105269"},{"key":"5378_CR13","doi-asserted-by":"publisher","unstructured":"Hwang H, Jeon H-J, Yow KC, et al (2017) Image-based quantitative analysis of tear film lipid layer thickness for meibomian gland evaluation. Biomed Eng Online 16. https:\/\/doi.org\/10.1186\/s12938-017-0426-8","DOI":"10.1186\/s12938-017-0426-8"},{"key":"5378_CR14","doi-asserted-by":"publisher","first-page":"538","DOI":"10.1097\/ICO.0b013e31824d0d04","volume":"32","author":"C Garc\u00eda-Res\u00faa","year":"2013","unstructured":"Garc\u00eda-Res\u00faa C, Fern\u00e1ndez MJG, Gonz\u00e1lez Penedo MF et al (2013) New software application for clarifying tear film lipid layer patterns. Cornea 32:538\u2013546. https:\/\/doi.org\/10.1097\/ICO.0b013e31824d0d04","journal-title":"Cornea"},{"key":"5378_CR15","doi-asserted-by":"publisher","first-page":"527","DOI":"10.1007\/s11517-016-1534-5","volume":"55","author":"D Peteiro-Barral","year":"2017","unstructured":"Peteiro-Barral D, Remeseiro B, M\u00e9ndez R, Penedo MG (2017) Evaluation of an automatic dry eye test using MCDM methods and rank correlation. Med Biol Eng Comput 55:527\u2013536. https:\/\/doi.org\/10.1007\/s11517-016-1534-5","journal-title":"Med Biol Eng Comput"},{"key":"5378_CR16","doi-asserted-by":"publisher","first-page":"253","DOI":"10.1007\/s00138-008-0155-x","volume":"21","author":"D Wu","year":"2010","unstructured":"Wu D, Boyer KL, Nichols JJ, King-Smith PE (2010) Texture based prelens tear film segmentation in interferometry images. Mach Vis Appl 21:253\u2013259. https:\/\/doi.org\/10.1007\/s00138-008-0155-x","journal-title":"Mach Vis Appl"},{"key":"5378_CR17","doi-asserted-by":"crossref","unstructured":"Ramos L, Penas M, Remeseiro B, et al (2011) Texture and color analysis for the automatic classification of the eye lipid layer. Lect. Notes Comput. Sci. (including Subser. Lect. Notes Artif. Intell. Lect. Notes Bioinformatics) 6692 LNCS:66\u201373","DOI":"10.1007\/978-3-642-21498-1_9"},{"key":"5378_CR18","doi-asserted-by":"publisher","first-page":"2410","DOI":"10.1364\/OL.44.002410","volume":"44","author":"Y Bai","year":"2019","unstructured":"Bai Y, Nichols JJ (2019) In vivo thickness measurement of the lipid layer and the overall tear film by interferometry. Opt Lett 44:2410\u20132413. https:\/\/doi.org\/10.1364\/OL.44.002410","journal-title":"Opt Lett"},{"key":"5378_CR19","doi-asserted-by":"publisher","unstructured":"Lu H, Wang MR, Wang J, Shen M (2014) Tear film measurement by optical reflectometry technique. J Biomed Opt 19. https:\/\/doi.org\/10.1117\/1.JBO.19.2.027001","DOI":"10.1117\/1.JBO.19.2.027001"},{"key":"5378_CR20","doi-asserted-by":"publisher","first-page":"356","DOI":"10.1016\/j.jtos.2018.12.003","volume":"17","author":"Y Bai","year":"2019","unstructured":"Bai Y, Ngo W, Nichols JJ (2019) Characterization of the thickness of the tear film lipid layer using high resolution microscopy. Ocul Surf 17:356\u2013359. https:\/\/doi.org\/10.1016\/j.jtos.2018.12.003","journal-title":"Ocul Surf"},{"key":"5378_CR21","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1016\/j.preteyeres.2017.02.002","volume":"58","author":"Y Bai","year":"2017","unstructured":"Bai Y, Nichols JJ (2017) Advances in thickness measurements and dynamic visualization of the tear film using non-invasive optical approaches. Prog Retin Eye Res 58:28\u201344. https:\/\/doi.org\/10.1016\/j.preteyeres.2017.02.002","journal-title":"Prog Retin Eye Res"},{"key":"5378_CR22","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1016\/j.optom.2013.07.006","volume":"6","author":"D Alonso-Caneiro","year":"2013","unstructured":"Alonso-Caneiro D, Szczesna-Iskander DH, Iskander DR et al (2013) Application of texture analysis in tear film surface assessment based on videokeratoscopy. J Optom 6:185\u2013193. https:\/\/doi.org\/10.1016\/j.optom.2013.07.006","journal-title":"J Optom"},{"key":"5378_CR23","doi-asserted-by":"publisher","first-page":"892","DOI":"10.1097\/OPX.0000000000000643","volume":"92","author":"S Wu","year":"2015","unstructured":"Wu S, Hong J, Tian L et al (2015) Assessment of bulbar redness with a newly developed keratograph. Optom Vis Sci 92:892\u2013899. https:\/\/doi.org\/10.1097\/OPX.0000000000000643","journal-title":"Optom Vis Sci"},{"key":"5378_CR24","doi-asserted-by":"publisher","first-page":"S382","DOI":"10.1097\/ICL.0000000000000501","volume":"44","author":"W Xie","year":"2018","unstructured":"Xie W, Zhang X, Xu Y, Yao Y-F (2018) Assessment of tear film and bulbar redness by keratograph 5M in pediatric patients after orthokeratology. Eye Contact Lens 44:S382\u2013S386. https:\/\/doi.org\/10.1097\/ICL.0000000000000501","journal-title":"Eye Contact Lens"},{"key":"5378_CR25","doi-asserted-by":"publisher","first-page":"859","DOI":"10.1007\/978-1-4615-5359-5_121","volume":"438","author":"J-P Guillon","year":"1998","unstructured":"Guillon J-P (1998) Use of the tearscope plus and attachments in the routine examination of the marginal dry eye contact lens patient. Adv Exp Med Biol 438:859\u2013867","journal-title":"Adv Exp Med Biol"},{"key":"5378_CR26","doi-asserted-by":"publisher","first-page":"395","DOI":"10.1038\/eye.1991.65","volume":"5","author":"AJ Bron","year":"1991","unstructured":"Bron AJ, Benjamin L, Snibson GR (1991) Meibomian gland disease. Classification and grading of lid changes. Eye 5:395\u2013411. https:\/\/doi.org\/10.1038\/eye.1991.65","journal-title":"Eye"},{"key":"5378_CR27","doi-asserted-by":"publisher","first-page":"1266","DOI":"10.1001\/archopht.1995.01100100054027","volume":"113","author":"J Shimazaki","year":"1995","unstructured":"Shimazaki J, Sakata M, Tsubota K (1995) Ocular surface changes and discomfort in patients with meibomian gland dysfunction. Arch Ophthalmol 113:1266\u20131270. https:\/\/doi.org\/10.1001\/archopht.1995.01100100054027","journal-title":"Arch Ophthalmol"},{"key":"5378_CR28","doi-asserted-by":"publisher","first-page":"E760","DOI":"10.1097\/OPX.0b013e3182512ac1","volume":"89","author":"H Pult","year":"2012","unstructured":"Pult H, Nichols JJ (2012) A review of meibography. Optom Vis Sci 89:E760-769","journal-title":"Optom Vis Sci"},{"key":"5378_CR29","doi-asserted-by":"publisher","first-page":"166","DOI":"10.4103\/2228-7477.175873","volume":"6","author":"M Esmaeili","year":"2016","unstructured":"Esmaeili M, Dehnavi A, Rabbani H, Hajizadeh F (2016) Three-dimensional segmentation of retinal cysts from spectral-domain optical coherence tomography images by the use of three-dimensional curvelet based K-SVD. J Med Signals Sens 6:166\u2013171","journal-title":"J Med Signals Sens"},{"key":"5378_CR30","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1080\/17434440.2019.1557517","volume":"16","author":"N Mart\u00ednez-Albert","year":"2019","unstructured":"Mart\u00ednez-Albert N, Esteve-Taboada JJ, Mont\u00e9s-Mic\u00f3 R et al (2019) Repeatability assessment of biometric measurements with different refractive states and age using a swept-source biometer. Expert Rev Med Devices 16:63\u201369. https:\/\/doi.org\/10.1080\/17434440.2019.1557517","journal-title":"Expert Rev Med Devices"},{"key":"5378_CR31","doi-asserted-by":"publisher","first-page":"2598","DOI":"10.1016\/j.jcrs.2015.06.029","volume":"41","author":"C McAlinden","year":"2015","unstructured":"McAlinden C, Khadka J, Pesudovs K (2015) Precision (repeatability and reproducibility) studies and sample-size calculation. J Cataract Refract Surg 41:2598\u20132604. https:\/\/doi.org\/10.1016\/j.jcrs.2015.06.029","journal-title":"J Cataract Refract Surg"},{"key":"5378_CR32","doi-asserted-by":"publisher","first-page":"931","DOI":"10.1016\/j.ijnurstu.2009.10.001","volume":"47","author":"JM Bland","year":"2010","unstructured":"Bland JM, Altman DG (2010) Statistical methods for assessing agreement between two methods of clinical measurement. Int J Nurs Stud 47:931\u2013936. https:\/\/doi.org\/10.1016\/j.ijnurstu.2009.10.001","journal-title":"Int J Nurs Stud"},{"key":"5378_CR33","doi-asserted-by":"crossref","unstructured":"Sokolova M, Japkowicz N, Szpakowicz S (2006) Beyond accuracy, F-score and ROC: a family of discriminant measures for performance evaluation. In: AAAI Workshop - technical report. pp 24\u201329","DOI":"10.1007\/11941439_114"},{"key":"5378_CR34","first-page":"360","volume":"37","author":"AJ Viera","year":"2005","unstructured":"Viera AJ, Garrett JM (2005) Understanding interobserver agreement: the kappa statistic. Fam Med 37:360\u2013363","journal-title":"Fam Med"},{"key":"5378_CR35","doi-asserted-by":"publisher","first-page":"159","DOI":"10.2307\/2529310","volume":"33","author":"JR Landis","year":"1977","unstructured":"Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33:159\u2013174. https:\/\/doi.org\/10.2307\/2529310","journal-title":"Biometrics"},{"key":"5378_CR36","first-page":"223","volume":"52","author":"GH Rosenfield","year":"1986","unstructured":"Rosenfield GH, Fitzpatrick-Lins K (1986) A coefficient of agreement as a measure of thematic classification accuracy. Photogramm Eng Remote Sens 52:223\u2013227","journal-title":"Photogramm Eng Remote Sens"},{"key":"5378_CR37","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1037\/h0026256","volume":"70","author":"J Cohen","year":"1968","unstructured":"Cohen J (1968) Weighted kappa: Nominal scale agreement provision for scaled disagreement or partial credit. Psychol Bull 70:213\u2013220. https:\/\/doi.org\/10.1037\/h0026256","journal-title":"Psychol Bull"},{"key":"5378_CR38","doi-asserted-by":"publisher","first-page":"1104","DOI":"10.1016\/j.ajo.2013.01.008","volume":"155","author":"Y Eom","year":"2013","unstructured":"Eom Y, Lee J-S, Kang S-Y et al (2013) Correlation between quantitative measurements of tear film lipid layer thickness and meibomian gland loss in patients with obstructive meibomian gland dysfunction and normal controls. Am J Ophthalmol 155:1104-1110.e2. https:\/\/doi.org\/10.1016\/j.ajo.2013.01.008","journal-title":"Am J Ophthalmol"},{"key":"5378_CR39","doi-asserted-by":"publisher","first-page":"E310","DOI":"10.1097\/OPX.0b013e318244e487","volume":"89","author":"H Pult","year":"2012","unstructured":"Pult H, Riede-Pult BH, Nichols JJ (2012) Relation between upper and lower lids\u2019 meibomian gland morphology, tear film, and dry eye. Optom Vis Sci 89:E310\u2013E315. https:\/\/doi.org\/10.1097\/OPX.0b013e318244e487","journal-title":"Optom Vis Sci"},{"key":"5378_CR40","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1016\/j.ajo.2010.07.019","volume":"151","author":"E Hosaka","year":"2011","unstructured":"Hosaka E, Kawamorita T, Ogasawara Y et al (2011) Interferometry in the evaluation of precorneal tear film thickness in dry eye. Am J Ophthalmol 151:18-23.e1. https:\/\/doi.org\/10.1016\/j.ajo.2010.07.019","journal-title":"Am J Ophthalmol"},{"key":"5378_CR41","doi-asserted-by":"publisher","first-page":"1549","DOI":"10.1097\/ICO.0b013e3182a7f3e1","volume":"32","author":"D Finis","year":"2013","unstructured":"Finis D, Pischel N, Schrader S, Geerling G (2013) Evaluation of lipid layer thickness measurement of the tear film as a diagnostic tool for Meibomian gland dysfunction. Cornea 32:1549\u20131553. https:\/\/doi.org\/10.1097\/ICO.0b013e3182a7f3e1","journal-title":"Cornea"},{"key":"5378_CR42","doi-asserted-by":"publisher","first-page":"149","DOI":"10.1016\/S1542-0124(12)70150-7","volume":"2","author":"AJ Bron","year":"2004","unstructured":"Bron AJ, Tiffany JM (2004) The contribution of meibomian disease to dry eye. Ocul Surf 2:149\u2013164. https:\/\/doi.org\/10.1016\/S1542-0124(12)70150-7","journal-title":"Ocul Surf"},{"key":"5378_CR43","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1016\/j.clae.2012.04.002","volume":"35","author":"N Best","year":"2012","unstructured":"Best N, Drury L, Wolffsohn JS (2012) Clinical evaluation of the oculus keratograph. Contact Lens Anterior Eye 35:171\u2013174. https:\/\/doi.org\/10.1016\/j.clae.2012.04.002","journal-title":"Contact Lens Anterior Eye"},{"key":"5378_CR44","doi-asserted-by":"publisher","first-page":"369","DOI":"10.1016\/j.survophthal.2007.04.009","volume":"52","author":"GN Foulks","year":"2007","unstructured":"Foulks GN (2007) The correlation between the tear film lipid layer and dry eye disease. Surv Ophthalmol 52:369\u2013374. https:\/\/doi.org\/10.1016\/j.survophthal.2007.04.009","journal-title":"Surv Ophthalmol"},{"key":"5378_CR45","doi-asserted-by":"publisher","first-page":"1485","DOI":"10.1109\/JBHI.2013.2294732","volume":"18","author":"B Remeseiro","year":"2014","unstructured":"Remeseiro B, Bolon-Canedo V, Peteiro-Barral D et al (2014) A methodology for improving tear film lipid layer classification. IEEE J Biomed Heal Informatics 18:1485\u20131493. https:\/\/doi.org\/10.1109\/JBHI.2013.2294732","journal-title":"IEEE J Biomed Heal Informatics"},{"key":"5378_CR46","doi-asserted-by":"crossref","unstructured":"Hosmer DW, Lemeshow S, Sturdivant RX (2013) Applied logistic regression. Hoboken, New Jersey","DOI":"10.1002\/9781118548387"},{"key":"5378_CR47","doi-asserted-by":"publisher","first-page":"562","DOI":"10.1016\/j.clae.2019.04.004","volume":"42","author":"L Rico-del-Viejo","year":"2019","unstructured":"Rico-del-Viejo L, Ben\u00edtez-del-Castillo JM, G\u00f3mez-Sanz FJ et al (2019) The influence of meibomian gland loss on ocular surface clinical parameters. Contact Lens Anterior Eye 42:562\u2013568. https:\/\/doi.org\/10.1016\/j.clae.2019.04.004","journal-title":"Contact Lens Anterior Eye"}],"container-title":["Graefe's Archive for Clinical and Experimental Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00417-021-05378-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00417-021-05378-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00417-021-05378-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,1,24]],"date-time":"2022-01-24T08:07:38Z","timestamp":1643011658000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00417-021-05378-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9,6]]},"references-count":47,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2022,2]]}},"alternative-id":["5378"],"URL":"https:\/\/doi.org\/10.1007\/s00417-021-05378-8","relation":{},"ISSN":["0721-832X","1435-702X"],"issn-type":[{"value":"0721-832X","type":"print"},{"value":"1435-702X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,9,6]]},"assertion":[{"value":"26 May 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 August 2021","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 August 2021","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 September 2021","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All procedures performed in studies involving human participants were in accordance with the ethical standards of the University of Valencia and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Informed consent was obtained from all individual participants included in the study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"The funding sources had no role in the design of the study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclaimer"}},{"value":"The authors declare no competing interests.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}