Pena Verdeal, HugoGarcía Queiruga, JacoboSabucedo Villamarín, BelénGarcía Resúa, CarlosGiráldez Fernández, María JesúsYebra-Pimentel Vilar, Eva2025-07-232025-07-232025-07-23Pena-Verdeal, H.; Garcia- Queiruga, J.; Sabucedo-Villamarin, B.; Garcia-Resua, C.; Giraldez, M.J.; Yebra-Pimentel, E. Advancing Diagnostics with Semi-Automatic Tear Meniscus Central Area Measurement for Aqueous Deficient Dry Eye Discrimination. Medicina 2025, 61, 1322. hps://doi.org/ 10.3390/medicina61081322https://hdl.handle.net/10347/42576Background and Objectives: To clinically validate a semi-automatic measurement of Tear Meniscus Central Area (TMCA) to differentiate between Non-Aqueous Deficient Dry Eye (Non-ADDE) and Aqueous Deficient Dry Eye (ADDE) patients. Materials and Methods: 120 volunteer participants were included in the study. Following TFOS DEWS II diagnostic criteria, a battery of tests was conducted for dry eye diagnosis: Ocular Surface Disease Index questionnaire, tear film osmolarity, tear film break-up time, and corneal staining. Additionally, lower tear meniscus videos were captured with Tearscope illumination and, separately, with fluorescein using slit-lamp blue light and a yellow filter. Tear meniscus height was measured from Tearscope videos to differentiate Non-ADDE from ADDE participants, while TMCA was obtained from fluorescein videos. Both parameters were analyzed using the open-source software NIH ImageJ. Results: Receiver Operating Characteristics analysis showed that semi-automatic TMCA evaluation had significant diagnostic capability to differentiate between Non-ADDE and ADDE participants, with an optimal cut-off value to differentiate between the two groups of 54.62 mm2 (Area Under the Curve = 0.714 ± 0.051, p < 0.001; specificity: 71.7%; sensitivity: 68.9%). Conclusions: The semi-automatic TMCA evaluation showed preliminary valuable results as a diagnostic tool for distinguishing between ADDE and Non-ADDE individuals.eng© 2025 by the authors. Published by MDPI on behalf of the Lithuanian University of Health Sciences. Licensee MDPI, Basel, Swierland. This article is an open access article distributed under the terms and conditions of the Creative Commons Aribution (CC BY) licenseAttribution 4.0 Internationalhttp://creativecommons.org/licenses/by/4.0/Tear meniscus central areaAqueous deficient dry eyeTear filmDiagnostic method220915 Optometríajournal article10.3390/medicina61081322open access