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Stephen Grenon, Scott Liddle, Joshua Grenon, Jeff Rosino, Nathan Luck, Caroline A Blackie, Donald R Korb; A Novel Meibographer with Dual Mode Standard Noncontact Surface Infrared Illumination and Infrared Transillumination. Invest. Ophthalmol. Vis. Sci. 2014;55(13):26.
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© ARVO (1962-2015); The Authors (2016-present)
To report a meibographer capable of combining standard noncontact surface infrared (IR) illumination with IR transillumination, imaging in a dual mode, with the goal of providing more accurate imaging and visualization of meibomian gland morphology in the eyelids.
The dual mode imaging captures two separate images, 1/30 second apart, using the custom proprietary lid-flipper/trans-illuminator device and a high resolution IR camera. The two images are displayed separately or combined into a single image to increase the amount of visible detail and image contrast. The investigational device was used on 15 eligible, fully consented individuals. 11 of the subjects had 30% or more gland truncation/atrophy while 4 of the subjects had zero atrophy (as determined by standard non-contact IR meibography) and served as ‘controls’. The standard noncontact images were visually compared to the processed dual mode image. The examiner was required to determine if the dual mode provided 1) more detailed/ less ambiguous images from which to grade gland atrophy and other gland characteristics such as duct dilation; 2) discernable differences in the percentage of gland atrophy.
The mean age of the participants was 46.6+/-16.9 (5 males and 10 females). In all cases (even the ‘controls’), the definition and visible detail was consistently better with the dual mode meibographer, rendering image details significantly easier to discern. The dual mode meibographer also revealed that meibomian glands which can appear truncated or absent with standard non-contact IR may be present when viewed with the dual mode technique indicating discernable differences in the percentage of gland atrophy as measured with the standard vs. the dual mode technique.
The dual mode combination of standard noncontact surface IR with transilluminated IR offers more accurate estimation of gland morphology. Since standard noncontact IR only visualizes the surface, details regarding meibomian gland morphology which may not be viewed with the standard noncontact IR are revealed with dual mode technique. More accurate gland morphology data may partially explain why previous reports show little to no correlation between meibomian gland morphology and meibomian gland function.
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