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Eugene Appenteng Osae, Jens Horstmann, Uta Gehlsen, Sebastian E Siebelmann, Kwadwo Amoah, Angela Ofeibea, David Ben Kumah, Philipp Steven; Assessment of Meibomian Glands Using a Custom – Made Meibographer in Dry Eye Patients in Ghana. Invest. Ophthalmol. Vis. Sci. 2016;57(12):5670.
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© ARVO (1962-2015); The Authors (2016-present)
Dry eye disease (DED) is increasingly becoming a significant clinical problem in developing countries and or emerging economies. DED in these areas have prior to, been associated with infectious disease (Trachoma) and malnutrition but current trends of industrialization and modernization in these areas could lead to a shift to other forms of DED. Recent advances in the understanding of DED highlight Meibomian Gland Dysfunction (MGD) as a major cause of DED. Thus conducting meibography is important in the clinical evaluation of DED. Our purpose was to investigate the practicality of conducting meibography using a custom – made meibographer in a developing country.
We took meibographs of 18 upper eyelids and 12 lower eyelids per one eye in 30 subjects (17 females;mean age = 52.73 years ± 17.02 ), randomly selected from a population of patients visiting a private eye practice in Kumasi. Meibomian Glands (MG) were photographed using a simple infra-red video camera (Sunluxy SL – C221) adapted for near field imaging by an additional lens (+20dpt). Single frames were captured and the MG area determined by intensity threshold segmentation and area calculation with ImageJ software. The Meibomian Gland Loss (MGL) was quantified by outlining its area and expressing it as a percentage of the total MG area based on Pult’s grading scheme.Tear Film Break Up-Time (TBUT) was measured and symptoms of DED were evaluated using the SPEED II Questionnaire. Pearson’s correlation coefficient was ran to determine the correlations between MGL and age, SPEED II score and TBUT. Differences in sex groups were analyzed with U test. p< 0.05 was considered significant
Average MGL was (0.34±.26) for the upper and (0.52±0.27) for the lower eyelids. Correlations between MGL and age were significant (r= 0.87, p= 0.001). MGL was also significantly correlated with SPEED II scores (r= 0.91, p = 0.001) and TBUT (r= -0.84, p=0.001). SPEED II scores also showed a significant correlation with TBUT (r= -0.72, p=0.001). Differences in mean rank of MGL between males and females was not significant (U =73.5, p>0.05) .
Using a custom made meibographer examination of meibomian glands is feasible in developing countries with limited access to complex imaging systems. This pilot study demonstrates the benefit and cost effectiveness of a simple device by the observed significant correlations of MGL and DED symptoms.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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