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R. Arita, K. Inoue, A. Koo, S. Amano; A Novel Non-Contact Meibography Using an Infrared Filter and Camera. Invest. Ophthalmol. Vis. Sci. 2007;48(13):5658.
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Although meibography can detect morphological abnormalities in patients with meibomian gland dysfunction, it is not widely used due to its nuisance and patients’ discomfort during examination. To solve these problems, we have developed a non-contact and patient-friendly method of meibography that employs an infrared filter and an infrared CCD camera. The purpose of this study is to report morphological characteristics of meibomian glands in normal population observed with this meibography.
Our system of meibography is consisted of a slit-lamp (RO5000, Rodenstock) equipped with an infrared CCD camera (XC-EI50, Sony) and an infrared transmitting filter (IR-83, Hoya). No trans-illuminating light fibers were necessary. We observed meibomian glands in 67 normal eyes of 67 persons, whose mean ± standard deviation of age were 51.5 ± 16.9 years (range, 23-90). The upper and lower eyelids were turned over and meibomian glands were observed with our non-contact meibography. The partial or complete loss of meibomian glands were scored using subsequent grades (meibo-score) in each eyelid: grade 0 (no loss of meibomian glands), grade 1 (the lost area was less than 1/3 of total area of meibomian glands), grade 2 (the lost area was between 1/3 and 2/3 of total area of meibomian glands), grade 3 (the lost area was over 2/3 of total area of meibomian glands). The meibo-score in upper and lower eyelids were summed for each subject. The break-up time of the tear film (BUT) was measured and tear production was evaluated by Schirmer I test. The study adhered to the tenets of the Declaration of Helsinki and informed consent was obtained from all subjects before examinations.
Using our novel meibography, we could easily observe meibomian glands in all the subjects. No subjects complained of glare, discomfort, and pain during the examination. The meibo-score was 0 in 26 eyes (39 %), 1 in 18 eyes (27 %), 2 in 9 eyes (13 %), 3 in 9 eyes (13%), and 4 in 5 eyes (8 %). The mean BUT was 6.2 ± 2.2 seconds and the mean value of Schirmer I test was 17.1 ± 11.3 mm. There was a positive correlation between meibo-score and age (R = 0.33, P = .0065). There was no significant correlation between meibo-score and BUT, or tear production.
Our novel non-contact meibography is a useful and patient-friendly method to obtain information on the structure of meibomian glands. The partial or complete loss of meibomian glands increases with age.
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