Novel Approaches for Imaging-Based Diagnosis of Ocular Surface Disease

Abstract

Imaging has become indispensable in the diagnosis and management of diseases in the posterior part of the eye. In recent years, imaging techniques for the anterior segment are also gaining importance and are nowadays routinely used in clinical practice. Ocular surface disease is often synonymous with dry eye disease, but also refers to other conditions of the ocular surface, such as Meibomian gland dysfunction or keratitis and conjunctivitis with different underlying causes, i.e., allergies or infections. Therefore, correct differential diagnosis and treatment of ocular surface diseases is crucial, for which imaging can be a helpful tool. A variety of imaging techniques have been introduced to study the ocular surface, such as anterior segment optical coherence tomography, in vivo confocal microscopy, or non-contact meibography. The present review provides an overview on how these techniques can be used in the diagnosis and management of ocular surface disease and compares them to clinical standard methods such as slit lamp examination or staining of the cornea or conjunctiva. Although being more cost-intensive in the short term, in the long term, the use of ocular imaging can lead to more individualized diagnoses and treatment decisions, which in turn are beneficial for affected patients as well as for the healthcare system. In addition, imaging is more objective and provides good documentation, leading to an improvement in patient follow-up and education.

Management of belantamab mafodotin-associated corneal events in patients with relapsed or refractory multiple myeloma (RRMM)

“…Eye examinations for patients receiving belamaf should include both slit lamp examination of the cornea and BCVA assessment 23 , 24 . The slit lamp microscope allows detailed eye examination 25 . All slit lamp examinations should include fluorescein staining to show abnormalities in the corneal surface 25 .…”

“…The slit lamp microscope allows detailed eye examination 25 . All slit lamp examinations should include fluorescein staining to show abnormalities in the corneal surface 25 . Patients who received belamaf may present with superficial punctate keratopathy, MECs, or both.…”

Confocal Microscopy and Anterior Segment Optical Coherence Tomography Imaging of the Ocular Surface and Bleb Morphology in Medically and Surgically Treated Glaucoma Patients: A Review

“…Several structures can be analyzed including bulbar and palpebral conjunctiva, cornea, limbus, and MGs; in detail, it has been used to the examine the GCs’ and MGs’ density, the Vogt’s palisades and transition epithelium of the corneoscleral limbus, corneal epithelial and endothelial cell density, stromal keratocytes, and several parameters related to the sub-basal corneal nerve plexus [ 37 ].…”

“…In the field of glaucoma, AS-OCT allows to visualize the aqueous outflow pathways, the anterior chamber angle anatomy, and function, and to evaluate the alterations induced by IOP-lowering agents on the ocular surface including corneal epithelia, tear film, and tear meniscus ( Table 1 and Table 2 ) [ 37 , 70 , 71 ].…”

Polyethylene eye-cover versus artificial teardrops in the prevention of ocular surface diseases in comatose patients: A prospective multicenter randomized triple-blinded three-arm clinical trial

“…Due to the ICU patients’ life-threatening conditions, the eye care and symptoms of the OSD are often given low priority. OSD indicates damage to the surface layers of the eye, specifically, the corneal epithelial and conjunctiva, which is clinically diagnosed based on the slit lamp examination using different dyes such as fluorescein [ 3 ]. OSD is associated with different risk factors, with the most common being impaired secretion and distribution of tear film over the ocular surface, altered tear components concentration due to lack of blinking, incomplete lid closure (lagophthalmos), and lid or conjunctival edema occurring with the use of ventilator [ 4 – 9 ].…”