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Aihua Hou, Sharon Yeo, Jenhong Tan, Veerappan Anuradha, U Rajendra Acharya, Vidya Bhat, Louis Tong; Longitudinal changes in tear evaporation rates after eyelid warming therapies in meibomian gland dysfunction. Invest. Ophthalmol. Vis. Sci. 2016;57(12):5675.
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© ARVO (1962-2015); The Authors (2016-present)
Lid warming is currently the major treatment strategy used in meibomian gland dysfunction (MGD), a major cause of dry eye. We have recently conducted treatment of MGD using lid warming, and here, longitudinal changes of tear evaporation in these patients were evaluated.
Patients with MGD were enrolled from a dry eye clinic at Singapore National Eye Center in an interventional trial. These patients were treated with hot towel (n=22), EyeGiene® (n=22), Blephasteam® (n=22) twice daily or a single 12 minute session of Lipiflow® (n=24). Ocular surface infra-red thermography was performed at baseline, 4 weeks and 12 weeks after the treatment, and image features were extracted from the captured images.
The mean baseline of conjunctival tear evaporation (TE) rate (n=90) was 66.1 W/min (SD 21.1). The rates were not significantly different between genders, ages and different symptom severities, tear break up times, Schirmer test, corneal fluorescein staining or between treatment groups. Using general linear model (repeat measures), the conjunctival TE rate was reduced with time after treatment in all groups. A higher baseline evaporation rate (>=66 W/min) was associated with greater reduction of evaporation rate after treatment. Seven out of 10 thermography features at baseline were predictive of change in irritative symptoms after treatment.
Conjunctival TE rates can be effectively reduced by lid warming treatment in some patients. Thermography image features at baseline can be predictive of the response to lid warming therapy. For patients that do not have excessive TE, additional therapy, for example, anti-inflammatory therapy may be required to achieve clinical improvement.
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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