Objective image analysis of the meibomian gland area

Abstract

AimsTo evaluate objectively the meibomian gland area using newly developed software for non-invasive meibography.MethodsEighty eyelids of 42 patients without meibomian gland loss (meiboscore=0), 105 eyelids of 57 patients with loss of less than one-third total meibomian gland area (meiboscore=1), 13 eyelids of 11 patients with between one-third and two-thirds loss of meibomian gland area (meiboscore=2) and 20 eyelids of 14 patients with two-thirds loss of meibomian gland area (meiboscore=3) were studied. Lid borders were automatically determined. The software evaluated the distribution of the luminance and, by enhancing the contrast and reducing image noise, the meibomian gland area was automatically discriminated. The software calculated the ratio of the total meibomian gland area relative to the total analysis area in all subjects. Repeatability of the software was also evaluated.ResultsThe mean ratio of the meibomian gland area to the total analysis area in the upper/lower eyelids was 51.9±5.7%/54.7±5.4% in subjects with a meiboscore of 0, 47.7±6.0%/51.5±5.4% in those with a meiboscore of 1, 32.0±4.4%/37.2±3.5% in those with a meiboscore of 2 and 16.7±6.4%/19.5±5.8% in subjects with a meiboscore of 3.ConclusionsThe meibomian gland area was objectively evaluated using the developed software. This system could be useful for objectively evaluating the effect of treatment on meibomian gland dysfunction.

Meibography and meibomian gland measurements in ocular graft-versus-host disease

“…The objective classification system of the percentage of uMGA is strongly correlated to the subjective scoring system of Pult that is used in routine clinical practice. Arita et al 10 detected a similar correlation between subjective grading and objective measurements of the meibomian gland area. It can therefore be assumed that a subjective meibomian gland score is sufficient to detect meibomian gland areas in clinical practice.…”

“…For semiautomatic analysis of the uMGA, a method described by Arita et al was modified using Olympus Soft Imaging Solution's Cell F 3.4. 10 Only images with no disturbing light reflexes and correctly everted upper eyelid were selected for further analysis.…”

Effects of Eyelid Warming Devices on Tear Film Parameters in Normal Subjects and Patients with Meibomian Gland Dysfunction

“…44 Although current settings for meibomian gland imaging in vivo do not allow evaluation of the volume of meibum inside meibomian glands, they are sufficient to provide an indirect index of meibomian gland function. We have also developed methodology for quantitative evaluation of meibography images 27 and have applied such quantitation in the present study, revealing it to be sufficient for statistical analysis. Indeed, the difference in meibomian gland area between baseline and after repeated warming with Azuki no Chikara was 7.1% and 9.6% in normal subjects and patients with MGD, respectively.…”

“…26 Quantitative analysis of meibomian gland area was performed with the use of a newly developed program. 27 SPK score, TFBUT, meibum grade (MGD patients), Schirmer test value (for evaluation of tear film production without topical anesthesia), and eye surface temperatures (eyelid skin, tarsal conjunctiva, and central cornea) were also measured. For patients with MGD, digital pressure was applied to the upper tarsus, and meibum expression was evaluated semiquantitatively according to the following grades 4 : 0, clear meibum easily expressed; 1, cloudy meibum expressed with mild pressure; 2, cloudy meibum expressed with more than moderate pressure; and 3, meibum not expressed even with strong pressure.…”

Highlights from this issue

“…Arita and coworkers developed a non-contact infrared meibography technique for the non-contact observation of the Meibomian glands 3. Future studies may address the practicability of the new technique in clinical routine of patients with Meibomian gland dysfunctions or tumors.…”