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Sruthi Srinivasan, Kara L. Menzies, Luigina Sorbara, Lyndon W. Jones; Infra-red Imaging Of Meibomian Gland Structure Using A Novel Keratograph. Invest. Ophthalmol. Vis. Sci. 2012;53(14):591.
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To examine the ability of a novel non-contact device (Keratograph 4) to image the meibomian gland (MG) structures and their morphological changes in the upper and lower eyelids.
Thirty seven participants (Mean age 57.8 ± 8.5yrs; 3 males, 34 females; completed the Ocular Surface Disease Index (OSDI) questionnaire to assess dryness symptoms. Meibum secretion quality score, number of blocked gland orifices and meibum expressibility scores were assessed. The lower lid (LL) and upper lid (UL) of all subjects were everted and images of the MGs were taken using the Keratograph 4 (OCULUS). A MG drop-out score (MGDS) due to complete or partial gland loss of both lids was obtained using a subjective 4 grade scoring system, and digital analysis of the images using ImageJ was performed. Presence of tortuosity and visible acinar changes of the MGs were also noted.
MGDS for both lids was significantly positively correlated with the OSDI score (R = 0.51; p<0.05). The MGDS determined using the digital grading was also significantly positively correlated (UL: R=0.68, p<0.05; LL: R=0.42, p<0.05). The sum of the MGDS for both lids using the subjective grading scale was significantly different between the non-MGD and MGD group (1.3 ± 1.0 vs 3.1 ± 1.1; p=0.0004). MGDS assessment using the digital grading was significantly different between non-MGD (UL = 6% & LL = 8%) and MGD group (UL = 32% & LL = 42%; p=0.001). Tortuous MG was observed only on the upper lid in 6% of the participants. Visible acinar changes were noted in 40% of the study participants.
Infra-red meibography is now possible in a clinical setting using commercially available devices and meibography can help determine differences in MG structure in subjects symptomatic of dry eye.
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