{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T15:44:53Z","timestamp":1786549493474,"version":"build-2736575974"},"reference-count":45,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2025,4,10]],"date-time":"2025-04-10T00:00:00Z","timestamp":1744243200000},"content-version":"unspecified","delay-in-days":9,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,3,31]]},"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Measurement of tear film stability is central in dry eye disease (DED) diagnosis. In this study, we aimed to compare the performance of two methods of tear film stability measurement: non-invasive tear break-up time (NIBUT) and fluorescein tear film break-up time (FTBUT).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Cross-sectional study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting and participants<\/jats:title>\n                    <jats:p>The study involved 132 subjects of 65-year-old inhabitants of the Oslo region who were not seeking ophthalmic care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>\n                      The participants underwent a battery of DED tests, including NIBUT measured on Oculus Keratograph 5M and a traditional method using fluorescein drops (FTBUT). Oculus Keratograph 5M measures two types of NIBUT:; appearance time of the first dry spot (NIBUT\n                      <jats:sub>First<\/jats:sub>\n                      ) and average NIBUT\n                      <jats:sub>Avg<\/jats:sub>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      74 participants (56%) were female and 58 were male (44%). Subjects presented with varying degrees of DED signs and symptoms. Mean values of NIBUT\n                      <jats:sub>First<\/jats:sub>\n                      and FTBUT from all the participants were significantly different (6.2\u00b14.9 s vs 8.6\u00b16.2 s, p&lt;0.0001). There was also a significant difference between NIBUT\n                      <jats:sub>First<\/jats:sub>\n                      and NIBUT\n                      <jats:sub>Avg<\/jats:sub>\n                      values (6.2\u00b14.9 s vs 8.3\u00b15.5 s, p&lt;0.0001). In contrast, no difference was observed between FTBUT and NIBUT\n                      <jats:sub>Avg<\/jats:sub>\n                      values (8.6\u00b16.2 s vs 8.3\u00b15.5 s, p=0.655). The receiver operating characteristic curve analysis was performed to compare NIBUT and FTBUT in regards to other clinical tests (Ocular Surface Disease Index, ocular surface staining, blink interval, eye redness, corneal sensitivity, lid debris, Schirmer I test, tear osmolarity, meibum quality, meibum expressibility, lid hyperemia, tear meniscus height,. irregular lid margin, conjunctival hyperaemia, margin telangiectasia, lipid layer and meibomian gland drop-out). While FTBUT demonstrated results with area under the curve&gt;0.6, neither NIBUT\n                      <jats:sub>First<\/jats:sub>\n                      nor NIBUT\n                      <jats:sub>Avg<\/jats:sub>\n                      showed significant results.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      NIBUT\n                      <jats:sub>First<\/jats:sub>\n                      was shorter than FTBUT. Low correlation between NIBUT and FTBUT indicates that these diagnostic tests are not interchangeable. Other DED tests had correlation, though low, while NIBUT did not demonstrate correlation.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-090305","type":"journal-article","created":{"date-parts":[[2025,4,10]],"date-time":"2025-04-10T23:25:23Z","timestamp":1744327523000},"page":"e090305","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Comparison of non-invasive and fluorescein tear film break-up time in a 65-year-old Norwegian population: a cross-sectional study"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2566-8800","authenticated-orcid":false,"given":"Behzod","family":"Tashbayev","sequence":"first","affiliation":[{"name":"Department of Oral Surgery and Oral Medicine, University of Oslo, Oslo, Norway"},{"name":"Norwegian Dry Eye Clinic, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1773-3780","authenticated-orcid":false,"given":"Reza A","family":"Badian","sequence":"additional","affiliation":[{"name":"Norwegian Dry Eye Clinic, Oslo, Norway"},{"name":"Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiangjun","family":"Chen","sequence":"additional","affiliation":[{"name":"Norwegian Dry Eye Clinic, Oslo, Norway"},{"name":"Department of Clinical Dentistry, University of Oslo, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valeria","family":"Vitelli","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, University of Oslo, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1079-4361","authenticated-orcid":false,"given":"Neil","family":"Lagali","sequence":"additional","affiliation":[{"name":"Biomedical and Clinical Sciences, Link\u00f6ping University, Linkoping, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darlene","family":"Dartt","sequence":"additional","affiliation":[{"name":"Schepens Eye Research Institute of Massachusetts Eye and Ear, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lene Hystad","family":"Hove","sequence":"additional","affiliation":[{"name":"Department of Cariology and Gerodontology, University of Oslo, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janicke Liaaen","family":"Jensen","sequence":"additional","affiliation":[{"name":"Department of Oral Surgery and Oral Medicine, University of Oslo, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tor Paaske","family":"Utheim","sequence":"additional","affiliation":[{"name":"Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,4,10]]},"reference":[{"key":"2025120600543392000_15.4.e090305.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtos.2017.05.008"},{"key":"2025120600543392000_15.4.e090305.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2013.12.023"},{"key":"2025120600543392000_15.4.e090305.3","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9394(03)00218-6"},{"key":"2025120600543392000_15.4.e090305.4","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1007\/s40135-013-0009-1","article-title":"Dry Eye Disease: Impact on Quality of Life and Vision","volume":"1","author":"Uchino","year":"2013","journal-title":"Curr Ophthalmol Rep"},{"key":"2025120600543392000_15.4.e090305.5","doi-asserted-by":"publisher","DOI":"10.1097\/ICO.0b013e3181f7f363"},{"key":"2025120600543392000_15.4.e090305.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtos.2017.05.001"},{"key":"2025120600543392000_15.4.e090305.7","doi-asserted-by":"publisher","DOI":"10.1001\/archopht.1970.00990030091017"},{"key":"2025120600543392000_15.4.e090305.8","doi-asserted-by":"crossref","first-page":"865","DOI":"10.1111\/j.1755-3768.1969.tb03711.x","article-title":"Desiccation of the precorneal film. 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