Abstract
Purpose :
Meibomian gland dysfunction (MGD), a significant component in dry eye disease, is characterized by blockage of meibomian gland ducts, thickening of gland contents, cysts, and the eventual disappearance of damaged glands. Tear breakup time (TBUT) is a clinical test used to assess evaporative dry eye disease. In this study, we aim to determine the correlation between meibomian gland dropout and TBUT.
Methods :
In- house volunteers with self-described dry eye were recruited. After applying topical sodium fluorescein, a video image sequence (4 frames per second) of the ocular surface was recorded using a modified split-scanning ophthalmoscope CLARUSTM 500 (ZEISS, Dublin, CA). The device was configured with filters to isolate the dye fluorescence signal. Based on the recorded video, the TBUT was determined. The lower lids were everted and the meibomian glands were imaged with a CLARUS 500 slit-scanning ophthalmoscope using near-infrared illumination. These images were graded using the following criteria: 0 = no MGD, 1 = Mild MGD, 2 = Moderate MGD, 3 = Severe MGD.
Results :
Sixteen eyes of 8 subjects (mean age 43.29, SD 14.89, range 24-63) were imaged. Figure 1 displays the TBUT values for different levels of MGD. Figure 2 displays an example of tear film breakup in a severe MGD case. The white arrow indicates the area of tear breakup. More meibomian gland drop out was associated with a shorter tear breakup time.
Conclusions :
In this study, the appearance of meibomian glands directly correlates with TBUT, with more severe MGD associated with shorter TBUT. Changes to the amount or quality of the oil may have contributed to the dropout in MGD subjects. An ophthalmic imaging system with the facility to record fluorescence image sequences of the ocular surface, in conjunction with the ability to capture near-IR reflectance images, was used for documentation of dry-eye disease. Such functionality may benefit clinical workflow in the management of dry-eye symptoms, as well as patient education.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.