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Michael Watson, Endri Angjeli, Brian Orrick, Stephanie Baba, Manfred Franke, Mark Holdbrook, George W Ousler, David A Hollander, Michelle Senchyna; Effect of the Intranasal Tear Neurostimulator on Meibomian Glands. Invest. Ophthalmol. Vis. Sci. 2017;58(8):4387.
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© ARVO (1962-2015); The Authors (2016-present)
The Intranasal Tear Neurostimulator (ITN) delivers a small electrical current to sensory neurons of the nasal cavity that stimulate the nasolacrimal reflex to induce tear production. Meibum expression is typically achieved though coordinated muscular activity of the orbicularis and Riolan’s muscles, both of which are innervated by the cranial nerve CN-VII.The purpose of this study was to investigate whether use of the ITN produces activity on the meibomian glands.
25 dry eye subjects were enrolled in a crossover, 4-visit study consisting of screening and baseline visits followed by two application visits, in which subjects received a single treatment of approximately 8 minutes (ITN or extranasal control) in randomized order. The following lid margin assessments were made: lower eyelid (LEL), lower central meibomian gland(LCMG) and tear film (TF) temperature through thermal video capture (FLIR A655sc); lipid layer thickness prior to and immediately following application through Tearscope visualization, and comparison of these results to the Guillon Tear Film Scale. All data are shown as change vs. baseline measured immediately prior to treatment in Mean±SD. Mean data were compared using a paired t-test (temperature data) or Wilcoxon signed-rank test (LLT data). P values < 0.05 were considered statistically significant.
See Table. All lid margin assessments were significantly improved by ITN treatment.
Use of the ITN results in a statistically significant increase in the temperature of LEL, LCMG and TF, as well as an increase in lipid layer thickness. These data demonstrate that neural stimulation with the ITN results in both lacrimal and meibomian gland secretion.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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