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Julie Schallhorn, Mary Durbin, Alexandre R Tumlinson, Angelina Covita; Multimodal Imaging of the Eyelid Margin and Meibomian Glands Using Optical Coherence Tomography. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4643.
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© ARVO (1962-2015); The Authors (2016-present)
Meibomian gland disease is a significant source of ocular morbidity, and is a common cause of dry eye syndrome. Multiple modalities exist to examine the Meibomian glands and lid margins, but the majority of these require dedicated equipment. We describe here the use of a widespread and widely available imaging technique, optical coherence tomography (OCT), in lid margin and Meibomian gland imaging.
The upper and lower eyelid margins and tarsal palpebral conjunctiva of the upper and lower eyelids were imaged in one eye of 10 healthy volunteers without clinical or symptomatic evidence of dry eye using a spectral domain OCT device equipped with an anterior segment lens, the Cirrus 5000 (Zeiss, Dublin, CA). Lid eversion was used for palpebral imaging. Slit lamp-mounted camera photographs of the same areas were also captured. The OCT device includes a scanning ophthalmoscope (SLO) for alignment and reference, and these images were taken. The OCT angiography 3x3 cube scan pattern was used for vasculature imaging. Eye tracking was turned off to facilitate rapid capture. Manual re-segmentation after capture was performed on the images if necessary.
Successful image capture was performed on all 10 subjects. The OCT angiography images demonstrated the superficial eyelid margin vasculature with periodic absences of flow (Figure 1) that corresponded to the orifices of the Meibomian glands on structural imaging (Figure 2). In 7/10 cases, multiple captures were necessary to remove motion artifact from the OCT angiography images. The Meibomian gland orifices were visible on the structural OCT images. Imaging of the tarsal conjunctiva and plate with OCT angiography revealed the conjunctival vasculature; deeper segmentation of the OCT angiography images revealed the peri-glandular vascular plexus. On the SLO images, the morphology of the Meibomian glands was easily visible and compared favorably to slit lamp images.
Imaging of the eyelid margin and Meibomian glands is possible with OCT and OCT angiography, and high quality images of eyelid margin vessels, conjunctival vessels, and Meibomian glans are obtainable. Further studies are necessary to evaluate this technique in patients with Meibomian gland disease.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
Figure 1: OCT angiography image of eyelid margin.
Figure 2: En-face OCT structural projection of eyelid margin.
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