Examination of Gland Dropout Detected on Infrared Meibography by Using Optical Coherence Tomography Meibography

Abstract

Purpose: To elucidate the anatomic details of gland dropout detected on two-dimensional infrared (IR) meibography in cases of dry eye associated with meibomian gland dysfunction (MGD) by using three-dimensional optical coherence tomography (OCT) meibography. Methods: In this cross-sectional, observational case series, we enrolled gland dropout detected on IR meibography; the condition was then examined using a real-time swept-source OCT system. Accordingly, a series of 500 raster B-scan OCT images, with the gland dropout site (observed on IR imaging) at the center, were obtained and rendered as three-dimensional volume images. The OCT images were classified based on the anatomic details, including acini and ducts, at the meibomian glands (Group I, constricted acini; II, atrophic acini; III, no acini). Results: The percentage of disagreement between IR and OCT images for dropout detected on IR imaging was 49.45% (43 and 93 cases in group I and II, respectively). Loss of the meibomian glands on both IR and OCT imaging (Group III) was observed in 50.55% cases (133 and 6 cases of gland dropout at the partial and whole eyelid on IR imaging, respectively). The proportion of disagreement between IR and OCT images (Group I and II) was higher in the middle area (63/119, 53.39%), as compared to that in the nasal (34/73, 46.58%) or temporal areas of the eyelid (26/65, 40%). Conclusions: The loss of the meibomian glands, as observed on IR imaging, should be carefully interpreted, and OCT images may be useful to confirm the anatomic details of the meibomian glands.