Abstract
Purpose:
Optical Coherence Tomography has recently been shown to have utlity in assessing tear meniscus as well as imaging meibomian glands. The purpose of this study is to utilitze optical coherence tomagraphy to quantify meibomian gland dysfunction both before and after various methods of treatment including artificial tears, warm compresses, lid scrubs, and oral doxycycline. This objective measurement of meibomian gland dysfunction after various forms of management can give better insight into efficacy of treatment.
Methods:
A group of 10 healthy subjects with no signficant meibomian glad dysfunction had optical coherence tomography imaging done of their meibomian glands both at baseline and 6 weeks later, and these images were used as controls. In contrast, a group of 10 subjects with documented severe meibomian gland dysfunction had ocular coherence tomagraphy taken of their meibomian glands both at baseline and again 6 weeks after various treatment modalities. An objective grading system was used to quantify the amount of meibomian gland dysfunction of each image, and the results were analyzed to try to find trends in improvment of meibomian gland dysfunction.
Results:
All 10 controls showed no significant meibomian gland disease both at baseline as well as at the 6 week re-evaluation mark. All 10 subjects from the experimental group showed 3-4+ meibomian gland dysfunction at baseline imaging and all showed various amounts of improvement by the 6 week re-evaluation mark. This study uses images to illustrate the amount of gland plugging in various meibomian gland dysfunction treatment modalities.
Conclusions:
This is the first study to show in an objective and quantitative fashion that warm compresses and lid scrubs actually do decrease meibomian gland dysfunction when done correctly. Additionally, it demonstrates the utility of optical coherence tomagraphy in diagnosing, following, and managing patients with severe meibomian gland dysfunction. Finally, the various images of this study illustrate and provide a better understanding of concepts like acinar atrophy, gland plugging, and decreased tear meniscus.