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Gloria Wu, Vy-Vy Ngo, Amy Doan, Laura Billard, Elena Muro, Bryan Le; Heidelberg Spectralis Infrared Imaging for Dry Eye in Retina Patients: A New Technique. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4691.
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© ARVO (1962-2015); The Authors (2016-present)
A Novel Use of Heidelberg Spectralis Imaging for dry eye in retina patientsBackground: Dry eye disease can occur in patients with diabetes, uveitis, computer vision syndrome and post-operative retina-vitreous procedures. We propose the use of the Heidelberg Spectralis Infrared Imaging to evaluate and quantify dry eye symptoms in patients presenting in a retina practice.
Using the Heidelberg Spectralis, the Infrared imaging control panel was set at HRA +OCT, IR button: Intensity =100%, Field of view=30 degrees, Focus=15.00 Diopters, rate of acquisition of images=8.8/sec. The image of the patient's everted lower eyelid, was recorded, showing the Meibomian glands at the center of the camera. The digital camera was set at approximately 7.5 cm from the patient's eyelid. The images were printed and reviewed. A straight line was drawn bisecting the cornea at 12:00 to 6:00, extending to the tarsal conjunctiva. The height of the gland was measured for length using a mm ruler, which was photographed at the same magnification as the eyelid images.Patient criteria:Eligibility criteria: Patients with complaints of dry eye, diagnosis of diabetes, uveitis, decreased vision.Exclusion criteria: previous eyelid surgery, corneal disease, corneal opacities.Controls: patients without dry eye complaints, diagnosis included: retinal holes, migraines, headaches.
Results:n=4020 pts: avg=61.3 yrs, SD=11.5 (13 F, 7M)20 controls: avg=45.06, SD=19.44 (15F, 5M)Average length of glands: controls (avg=1.94 mm, SD=0.29mm); patients (avg=1.58mm, SD=0.32mm)Paired t-test: p=0.0011Loss of 30% or more of Meibomian glands: 3 controls vs 11 patients; No loss of Meibomian glands: 17 controls vs 9 patients(Chi-squared: p=0.008); Loss of 50% or more of Meibomian glands: 0 controls vs 6 pts; No loss of Meibomian glands: 20 controls vs 14 patients (Chi-squared: p=0.007).
This small study suggests that the Heidelberg Spectralis Infrared imaging modality may be useful in the diagnosis and ongoing monitoring of the loss of Meibomian glands as associated with dry eye symptoms. Our findings suggest that controls versus patients have different sized glands and varying states of loss of the glands. This imaging modality is conveniently accessible for retinal patients with dry eye.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
Meibomian Gland Measurements
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