Invention And Clinical Application Of Domestic Noncontact Infrared Meibography

Part 1 Invention of Domestic Noncontact Infrared MeibographyObjective To invent domestic noncontact infrared meibography.Methods The infrared filter, CCD camera and slit lamp microscope were used to structure the domestic noncontact infrared meibography. The meibomian glands were observed using the noncontact infrared meibography. Four evaluation measures were used to evaluate the degree of meibomian gland loss and morphological changes.Results Clear images of meibomian glands were acquired by domestic noncontact infrared meibography. Both the two measures of counting the percent area of meibomian gland acini were useful. The central rectangle method was faster and more convenient. The closed curve method was more sensitive to early diagnosis.Conclusion The domestic noncontact infrared meibography could as a routine clinical examination and popularize in basic hospitals.Part 2 Analysis of Infrared Imaging of Meibomian Glands in MGDPatientsObjective To investigate and analyze the infrared imaging of meibomian glands in MGD patients.Methods Noninterventional and observational study. 70 eyes from 35 patients which were diagnosed as MGD during January 2014 to January 2015 were collected as a group and 70 eyes from 35 healthy volunteers were as a control group. The meibomian glands were observed using the noncontact infrared meibography. To analyze the relationship between the infrared imaging of meibomian glands and the eyelids or sex. To compare the infrared imaging of meibomian glands in different age groups.Results Missing area score of the upper eyelid meibomian gland and the percent central area of the upper eyelid meibomian gland acini had significant difference with the lower eyelids both in MGD group and the control group(P<0.05). Missing area score of meibomian gland, percent central area of the upper eyelid meibomian gland acini, percent whole area of the upper eyelid meibomian gland acini and meibomian gland morphological change score in the two groups had no significant difference between male and female patients(P>0.05). These four parameters in MGD group had significant difference with the control group both in 20-39 years and 40-59 years subjects(P<0.05). But these four parameters in MGD group had no significant difference with the control group in 60-79 years subjects(P>0.05).Conclusions The degree of meibomian gland loss in upper eyelids was more than the lower eyelids. There were no different degree of meibomian gland loss and morphological changes between male and female patients. But the degree of meibomian gland loss was associated with age. The degree of meibomian gland loss in MGD group was more than the control group of young and middle-aged. The meibomian gland loss in elderly people had less significance to diagnosis of MGD.Part 3 Analysis of Infrared Imaging of Meibomian Glands in OcularGraft- Versus-Host Disease PatientsObjective To investigate the meibomian gland morphology of ocular graftversus-host disease patients. To analyze factors causing ocular GVHD in patients with meibomian gland missing.Methods Noninterventional and observational study. 100 eyes from 50 patients which were diagnosed as ocular GVHD during June 2012 to December 2015 were collected as a group and 40 eyes from 20 healthy volunteers were as a control group. The meibomian glands were observed using the noncontact infrared meibography.Results Missing area score of meibomian gland, percent central area of the upper eyelid meibomian gland acini and percent whole area of the upper eyelid meibomian gland acini in o GVHD group had significant difference with the control group(P<0.05). Missing area score of meibomian gland, percent central area of the upper eyelid meibomian gland acini and percent whole area of the upper eyelid meibomian gland acini in o GVHD group had no significant difference between male and female patients(P>0.05). These three parameters in o GVHD group also had no significant difference between different matchings of HLA(P>0.05), as well as different ways of transplantation(P>0.05). These three parameters in o GVHD group were not associated with age or post-transplant course(P>0.05).Conclusions There were different degrees of meibomian gland loss and morphological changes. Noncontact infrared meibography should be included in routine examination before and after the transplantation. More attention should be payed to the meibomian gland when ophthalmologists check ocular surface, which contributes to the diagnosis and treatment of o GVHD.