Abstract
Purpose :
The purpose of this study was to observe the absorption of lissamine green (LG) on the upper eyelid as a function of time and dosage (one vs two instillations). Two primary aims investigated LG staining intensity to determine: (1) the best time point, post-dye instillation, to view lid wiper epitheliopathy (LWE); (2) whether instillation of one or two drops is best to identify LWE.
Methods :
37 participants with LWE were enrolled in this study. 1% LG (10 μL) was applied to the superior bulbar conjunctiva in the OD. The eyelid was everted before digital photographs were captured. Photographs of the lid margin were taken at 1, 3, and 5 minutes post-LG dosing. Measurements were repeated in the same eye with two instillations of 1% LG (10 μL). Images were analyzed for stain intensity using a software suite (Advanced Concepts in Imaging Software, Saint Contest, FR) that automatically detects and measures dye stained-eye images. The data was analyzed using a linear mixed model with fixed effects of time, number of drops and their interaction.
Results :
Results showed that both main effects (drop dosing and time) were significant (drop p=0.002; time p<0.001). The analysis indicated that change in minimum intensity did occur over time, and that, overall a difference in minimum intensity exists between the drops conditions. In the 1 drop instillation condition, the increase in intensity of dye absorption was statistically significant between the 1-minute time inspection when compared to the 3-minute and 5-minute inspection times (p=0.017 and p=0.001, respectively). Similarly, for 2 drops of LG, the difference between 1 and 3 minutes (p=0.005) and between 1 and 5 minutes revealed more intense staining with the increased time (p=0.018). The peaks of the mean plots (5 minutes for single LG instillation and 3 minutes for double LG instillations) were also found to be different (p<0.003).
Conclusions :
The time point of visual inspection of LG staining and the amount of LG used should be purposeful when assessing LWE. This research suggests that one drop of LG is sufficient and a 3-minute to 5-minute delay in inspection is preferred over a 1-minute inspection.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.