The impact of dry eye disease on retinal image quality in children

Dry eye disease (DED) is increasingly prevalent, resultinginhigher morbidityamong children. This study evaluates the impact of DED severity on visual quality using double-pass technology, focusing on dynamic observation of the ocular light scatter in pediatric DED cases.In this non-interventional, cross-sectional study, a mild DED group (37 cases, 37 eyes), a moderate DED group (40 cases, 40 eyes), and a control group of healthy children (35 cases, 35 eyes) were examined. Measurements included the Schirmer I test, tear film break-up time (BUT), and vision-related quality of life assessments using the Modified Ocular Surface Disease Index (OSDI) questionnaires. Participants underwent visual quality analysis using double-pass technology, which measured the modulation transfer function cut-off frequency value (MTF cutoff), Strehl ratio (SR), objective scatter index (OSI), and OQAS-II value (OQAS-II value OV100%, OQAS-II value OV 20%, and OQAS-II value OV 9%) under natural conditions. Additionally, dynamic changes in OSI post-blinking, Tear film mean-OSI (TFM-OSI), and the corresponding standard deviation OSI (SD-OSI) were recorded.Statistically significant differences were observed among the groups in modulation transfer function cutoff, Strehl ratio, OSI, OQAS-II value OV 100 %, OQAs-II value OV 20 %, OQAs-II value OV 9 %, tear film mean OSI, and standard deviation OSI (P < 0.05). As DED severity increased, tear film mean OSI significantly rose, while modulation transfer function cutoff, strehl ratio, OQAS-II value OV 100 %, OQAS-II value OV 20 %, OQAS-II value OV 9 % notably declined. All optical quality parameters were correlated with BUT, with no association observed with age, sex, or Schirmer I test.Dual-channel technology objectively assesses visual quality in pediatric DED, demonstrating that tear film scattering significantly affects retinal imaging and visual quality in children with DED.