September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Subjective and Objective Assessment of Meibography Images
Author Affiliations & Notes
  • Jiaxin Xiao
    Faculty of Medicine, University of Oslo, Oslo, Norway
    The Norwegian Dry Eye Clinic, Oslo, Norway
  • Muhammed Yasin Adil
    Faculty of Medicine, University of Oslo, Oslo, Norway
    The Norwegian Dry Eye Clinic, Oslo, Norway
  • Jonatan Olafsson
    Faculty of Medicine, University of Oslo, Oslo, Norway
  • Tor Paaske Utheim
    Unit of Regenerative Medicine, Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
    Vestre Viken Hospital Trust, Vestre Viken Hospital Trust, Drammen, Norway
  • Sten Ræder
    The Norwegian Dry Eye Clinic, Oslo, Norway
  • Øygunn Aass Utheim
    Department of Ophthalmology, Oslo University Hospital, Oslo, Norway
  • Neil S Lagali
    Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
  • Darlene A Dartt
    Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, United States
  • Xiangjun Chen
    SynsLaser Clinic, Oslo, Norway
    The Norwegian Dry Eye Clinic, Oslo, Norway
  • Footnotes
    Commercial Relationships   Jiaxin Xiao, None; Muhammed Yasin Adil, None; Jonatan Olafsson, None; Tor Utheim, None; Sten Ræder, None; Øygunn Utheim, None; Neil Lagali, None; Darlene Dartt, None; Xiangjun Chen, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 5677. doi:
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    • Get Citation

      Jiaxin Xiao, Muhammed Yasin Adil, Jonatan Olafsson, Tor Paaske Utheim, Sten Ræder, Øygunn Aass Utheim, Neil S Lagali, Darlene A Dartt, Xiangjun Chen; Subjective and Objective Assessment of Meibography Images. Invest. Ophthalmol. Vis. Sci. 2016;57(12):5677.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To assess the reliability of subjective grading and objective assessment of meibography in patients with symptoms of dry eye disease (DED)

Methods : Infrared meibography images (OCULUS Keratograph® 5M) of 100 right eyes of 100 patients (41 females and 59 males; age 47.5±1.5 years, range 11 to 82) were analyzed by two experienced observers. Meiboscore of the upper lid (UL) and the lower lid (LL) were evaluated by subjective grading of the proportion of meibomian gland (MG) loss (grade 0:≤25%; grade 1: 26-50%; grade 2: 51-75%; grade 3: >75%). Subsequently, objective image analysis using ImageJ was performed to evaluate MG loss (100-grade scale) in the UL and LL, as well as the MG length,and tortuosity in the UL. Intraobserver and interobserver intraclass correlation coefficients (ICCs) were calculated.

Results : The meiboscore and MG loss in UL demonstrated good intraobserver repeatability and interobserver reproducibility (ICC≥ 0.90). The MG length in the UL, meiboscore and MG loss in the LL showed good repeatability (ICC≥0.90) and reproducibility (ICC≥0.88). The MG tortuosity had lower intraobserver repeatability (ICC= 0.88) and interobserver reproducibility (ICC= 0.76). The meiboscore in the UL correlated strongly with MG loss (r=0.85, p=<0.001), MG length (r=-0.70, p<0.001), and tortuosity (r=-0.57, p<0.001) in the UL. Moreover, it correlated weakly with meiboscore (r=0.30, p=0.002) and MG loss (r= 0.296, p=0.003) in the LL. The meiboscore in the LL correlated strongly with MG loss in the LL, but only weakly with MG loss (r= 0.254, p=0.011), MG length (r=0.253, p=0.011), and MG tortuosity (r=-0.248, p=0.013) in the UL.

Conclusions : Subjective meiboscore grading and objective assessment of MG loss and MG length were highly repeatable and reproducible. The four-level subjective meiboscore correlated strongly with objective MG loss and is effective for quick MG assessment.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

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