Scanning Laser Ophthalmoscope Imaging is a diagnostic predictor of Dry Eye

Abstract

 

Purpose

 

To evaluate a unique reticular pattern noted in scanning laser ophthalmoscopy (SLO) best seen in the multi-color SLO imaging and was felt to be an objective indicator of corneal dryness.

 

Methods

 

Fifty-one (51) eyes were scanned using the Heidelberg Spectralis SLO. Multicolor, Blue reflectance and Green reflectance images were taken using three different wavelengths (486 nm, 518 nm, 815 nm). Tear break up time (TBUT), corneal staining and meibomian gland grading were then evaluated by masked examiner on the same day. Presence of corneal reticulations noted in any of the imaging modalities as evaluated by three observers separately and dry eye as dictated by the three parameters were then analyzed using the Pearson Correlation Coefficient test.

 

Results

 

Fifty-one (51) eyes of 26 patients were included in this study. Fifty (50%) percent were females; the mean age was 78 years old (57- 91). The reticular pattern predicted break up time and corneal staining. The strongest predictor was multicolor (p value <0.0001 with TBUT and p value 0.0007 with corneal staining). Green reflectance also had significant correlation (p value <0.0001 with TBUT and p value 0.0047 with corneal staining). Blue reflectance had the least correlation (p value 0.0029 with TBUT and 0.0715 with corneal staining). There was no association with meibomian gland dysfunction. This suggests the reticular SLO pattern correlates with ocular surface abnormalities and rapid evaporation in dry eye.

 

Conclusions

 

This is a newly described SLO phenomenon. This is a reticular reflex that appears to be originating from the tear film covering the corneal surface. This reticulation appears to be a very rapid and objective definable measure to characterize corneal dryness.