Dataset Information

Validation of Alternative Methods for Detecting Meibomian Gland Dropout Without an Infrared Light System: Red Filter for Simple and Effective Meibography.

ABSTRACT: PURPOSE:To evaluate the validity and reliability of alternative methods for evaluating meibomian gland (MG) dropout without using an infrared light system: red-filtered or isolated red-channel images (RCIs) of the everted eyelid. METHODS:We evaluated MG dropout in the everted upper and lower eyelids of 125 eyes of 64 patients with good-quality infrared meibography images (IMIs) and color digital photographs with and without a red filter. Red-filtered images (RFIs) were converted to black and white and adjusted for contrast/brightness [adjusted red-filtered images (aRFIs)]. RCIs were computationally isolated from color digital photographs obtained without a red filter. After randomization, the total meiboscore (0-6) was evaluated by 2 independent evaluators (interobserver reliability) masked to the image origin, and again after a 30-day interval (intraobserver reliability). RESULTS:The meiboscores evaluated using the RFI, aRFI, and RCI were strongly positively correlated with those evaluated using the IMI (RFI: ? = 0.788; aRFI: ? = 0.735; RCI: ? = 0.630; all P < 0.001, Spearman correlation analysis). Linear-weighted ?-values (?w) showed substantial agreement between the RFI and IMI (?w = 0.676, 95% CI = 0.594-0.759). The RFI had substantial intraobserver reliability (?w = 0.735, 95% CI = 0.685-0.785) and moderate interobserver reliability (?w = 0.467, 95% CI = 0.371-0.563). Computational adjustment of RFIs did not enhance the validity or reliability, and RCIs had limitations in some cases. CONCLUSIONS:MGs were successfully visualized using a red filter on a slit lamp and showed substantial agreement with visualization using the standard infrared method. Although interobserver reliability was only moderate, this alternative technique may be useful for evaluating MG dropout when an infrared meibography device is not available.

SUBMITTER: Lee SM

PROVIDER: S-EPMC6455092 | biostudies-literature | 2019 May

REPOSITORIES: biostudies-literature

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Validation of Alternative Methods for Detecting Meibomian Gland Dropout Without an Infrared Light System: Red Filter for Simple and Effective Meibography.

Lee Sang-Mok SM Park Inwon I Goo Yong Ho YH Choi Dongchul D Shin Min Chul MC Kim Eun Chul EC Alkwikbi Hassan Fallaj HF Kim Man Soo MS Hwang Ho Sik HS

Cornea 20190501 5

<h4>Purpose</h4>To evaluate the validity and reliability of alternative methods for evaluating meibomian gland (MG) dropout without using an infrared light system: red-filtered or isolated red-channel images (RCIs) of the everted eyelid.<h4>Methods</h4>We evaluated MG dropout in the everted upper and lower eyelids of 125 eyes of 64 patients with good-quality infrared meibography images (IMIs) and color digital photographs with and without a red filter. Red-filtered images (RFIs) were converted t ...[more]

PMID: 30789441

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Project description:BackgroundMeibomian gland dysfunction (MGD), one of the most common ocular surface diseases, can induce dry eye and reduce patients' quality of life. Methodological limitations have resulted in contradictory interpretations of gland function. This study sought to investigate the correlation between meibography signal intensity (SI) and meibomian gland (MG) function and to validate an MGD classification strategy based on different levels of SI.MethodsA multicenter, cross-sectional analysis was conducted on 817 eyes from 361 patients with MGD and 52 healthy controls. Additionally, 78 eyes from 39 patients with MGD who had undergone LipiFlow treatment were recruited for longitudinal analyses. The SI value was obtained via meibography using an automated analyzer, and all participants underwent ocular surface examinations. A cross-sectional analysis was performed to determine SI distribution and its relationship to clinical characteristics via a generalized estimating equation model. Longitudinal analyses were conducted on the treatment cohort using a mixed-effects model to explore the outcome in different SI levels.ResultsRegression analysis revealed significant correlations between SI and lipid layer thickness (β=0.016), meibum expressibility (β=-0.676), meibum quality (β=-0.251), and fluorescein-stained tear-film break-up time (FBUT) (β=0.064) (all P values <0.001 for the above associations). Low-level SI MGD cases exhibited the most severe clinical signs, including the worst meibum expressibility (16% for level 3) and quality scores (19% for level 3), the shortest FBUT (3.82±0.13 s), and the thinnest lipid layer (65.68±2.58 nm), (all P values <0.05, respectively). Patients with medium SI showed the lowest ocular surface disease index (OSDI) value (26.64±1.06), the longest FBUT (4.56±0.08 s), and the thickest lipid layer (80.20±2.90 nm). After treatment, the high SI values reduced significantly at each follow-up point compared to baseline (all P values <0.05). The medium SI group demonstrated the greatest improvement in symptoms and signs, followed by the high SI group, and the low SI group.ConclusionsAutomated measurements of SI can effectively reflect MG secretory activity. The proposed low, medium, and high SI classifications represent different functional subtypes of MGD.

Dataset Information

Validation of Alternative Methods for Detecting Meibomian Gland Dropout Without an Infrared Light System: Red Filter for Simple and Effective Meibography.

Publications

Validation of Alternative Methods for Detecting Meibomian Gland Dropout Without an Infrared Light System: Red Filter for Simple and Effective Meibography.

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