Abstract
Purpose: :
To compare optical coherence tomography findings between patients with meibomian gland dysfunction (MGD) and normal controls in order to elucidate a novel diagnostic criterion for MGD.
Methods: :
24 eyes from 12 patients (7 diagnosed with MGD, 5 controls) were imaged with an ultra high resolution anterior segment optical coherence tomography. Each eye underwent two image captures; at baseline and after lid massage. Images were analyzed with Image J to isolate and measure highly reflective particles resting on corneal surface at both time points. Results were compared across diagnostic groups.
Results: :
At baseline, both MGD and controls had similar amount of highly reflective particles on the ocular surface (10.50 vs. 10.00 respectively). After lid massage MGD eyes, on average, saw an increase in amount of particles (+1.79) as opposed to control eyes which on average experienced a decrease in particles (-0.70). In control eyes, the average (SD) amount of particles was 10.50 (SD=4.50) pre-massage and 9.80 (SD=2.66) post-massage (p=0.58). In MGD eyes, change was in the opposite direction with the amount particles 10.00 (SD=3.88) pre-massage and 11.79 (SD=3.79) post-massage (p=0.22). The distribution of the pre-post massage differences was substantially skewed in the control group so the differences were compared non-parametrically (Mann-Whitney test) and approached, but did not achieve statistical significance (p=0.056). Median post minus pre differences in the MBG and control groups were 2.5 and -0.5, respectively. A similar result was found with percent changes (p=0.064) which averaged 33% increase in the MGD group and -4.5% in the control group.
Conclusions: :
It was observed that after lid massage patients with MGD appeared to have an increase in highly reflective ocular surface particles compared to controls. We believe these reflective particles to be evidence of improper meibum secretion. These same particles can be analyzed to produce a quantitative assessment of MGD.
Keywords: cornea: surface mucins • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • imaging/image analysis: clinical