Meibography: A Japanese Perspective

Abstract

Meibography allows observation of meibomian glands in an objective and repeatable manner. Original meibography systems were invasive and not readily adopted by ophthalmology clinics. The development of noncontact infrared meibography allowed the rapid and noninvasive observation of meibomian glands, and such systems have now been widely adopted for standard examinations in dry eye clinics. Noncontact meibography has also spurred research into meibomian glands and has been applied to evaluation of their structure and status in various ocular surface diseases. Although the images obtained by meibography are objective and repeatable, the interpretation of these images is subjective, with the relationship between image features and actual gland structure and composition remaining unclear. Additional clinical and basic research with regard to the interpretation of meibography images is thus necessary. Future improvements to meibography will likely provide new insights into the pathophysiology of meibomian gland diseases as well as enhance its contribution to the diagnosis and evaluation of treatments for such diseases.

The influence of meibomian gland loss on ocular surface clinical parameters

“…NIM has been proven to be a useful technique for non-invasive observation of MG morphology in order to help physicians improve DED diagnosis and treatments. [7,33,34] The aim of the study is to assess the correlation between MGL and some other ocular surface parameters. Accordingly, first it has to be determined if both (UL suggested the assessment the MGL of both eyelids.…”

Imaging of meibomian glands: from bench to bedside and back

“…Meibography is the approach with the longest history and the highest level of evidence and IR meibography is an important evolution, allowing non-invasive examination, without the contact of an illuminating probe with the patient's skin [2,7,8]. This technique, based on the high reflectivity of healthy MGs, allows to visualize the wholetarsal plate and to quantify the area of MGs drop-out (meiboscore) [2] (dark areas).…”

“…Several groups used this technique to assess MGD patients and to describe MGs changes associated to different conditions, including aging [2], contact lens wear, ocular allergy, and severe inflammatory ocular surface diseases [7,8].…”

“…IR meibography showed promising results a diagnostic test for MGD, with sensitivity and specificity of 49.3% and 64.5%, respectively, if used as a single test, and excellent diagnostic accuracy if used in combination with clinical and/or functional examinations [2,7,8]. It's increasingly used in clinical practice for MGD diagnosis and follow-up and it has been included in clinical trials as a surrogate endpoint.…”

“…Although, IR meibography itself is objective and repeatable, interpretation of the resulting images remains subjective. In other words, it's still unclear the exact meaning of the "dark drop-out areas", which might reflect a complete loss of MGs or loss or degeneration of lipid content within a relatively intact gland structure [7].…”