Infrared meibography allows detection of dimensional changes in meibomian glands following intranasal neurostimulation.

ABSTRACT

PURPOSE: Patients with dry eye disease (DED) may suffer from decreased tear break-up time due to meibomian gland (MG) dysfunction. Infrared meibography (IR Meibography) uses infrared wavelength light to visualize meibomian glands in vivo. We aimed to explore the feasibility of using serial IR Meibography imaging to assess morphological changes in MGs as an indirect measure of functionality, following intranasal neurostimulation (ITN). METHODS: Fifteen DED subjects were prospectively enrolled in a single-center, single-arm study. Changes in MGs were captured using IR meibography (RTVUE-XR, Optovue, Inc. Fremont, CA, USA) on the lower eyelids before and after 3 min of ITN (TrueTear®, Allergan, Dublin, Ireland) use that delivers a microcurrent to sensory neurons of the nasal cavity. The same MGs were selected pre- and post-stimulation, and MG area and perimeter were analyzed by two masked observers. RESULTS: Mean (±SD) pre- and post-stimulation MG areas were 2,187.60 ± 635.88 µm2 and 1,933.20 ± 538.55 µm2, respectively. The mean change in area, 254.49 µm2, representing an 11.6% reduction following ITN use, was statistically significant (p = 0.001). Mean (±SD) pre- and post-stimulation MG perimeters were 235.9 ± 51.38 µm and 222.2 ± 47.72 µm, respectively. The mean change in perimeter, 13.7 µm, representing a 5.81% reduction following ITN use, was statistically significant (p = 0.012). CONCLUSIONS: Our study shows that IR meibography can be used to detect immediate changes in gland area and perimeter, an indirect measure of MG activity following intervention by ITN.