title: A Simple Novel Technique of Infrared Meibography by Means of Spectral-Domain Optical Coherence Tomography: A Cross-Sectional Clinical Study.
abstract: OBJECTIVE
  To compare a novel spectral-domain optical coherence tomography (SD-OCT) technique with traditional lid transillumination for evaluation of meibomian glands (MGs) and to assess the relation of MG morphologic changes to the glandular atrophy.
  
  
  METHODS
  Evaluation of diagnostic technology.
  
  
  METHODS
  Sixty-one patients with obstructive MGD (30 men, 31 women; age [mean ± standard deviation] 45.1 ± 12.1 years), and 75 control subjects (32 men, 43 women; 44.1 ± 12.5 years) were recruited in order to have a balanced distribution of glandular features.
  
  
  METHODS
  Agreement between SD-OCT and lid transillumination examination for the detection of drop-out (partial or complete loss of MGs) and microscopic changes (i.e. shortening, distortion, segmentation and entanglement), as well as the relationship between morphological features and MG atrophy were evaluated.
  
  
  METHODS
  Agreement between the two meibographic techniques, bias in symmetry of classification, and association analysis between microscopic changes and MG dropout.
  
  
  RESULTS
  Overall agreement for all morphological features was substantial (Cohen kappa coefficient = 0.77; p<0.001), even if, the majority of disagreement occurred for cases with segmentation, where agreement was present in only 108 (81.82%) of 132 eyes with adequate images for interpretation, and where SD-OCT tended to diagnose more cases not detected by traditional lid transillumination (McNemar test, p<0.001). Moreover, segmentation and distortion pattern negatively correlated with the degree of drop-out, whereas shortening and entanglement pattern demonstrated only a weak correlation (Spearman's ρ was -0.691, -0.491, -0.359, -0.385, respectively).
  
  
  CONCLUSIONS
  Each method has its advantages but in general there was close agreement between these meibographic techniques, particularly for MG dropout, which supports the reliability of our novel, simple and patient-friendly SD-OCT approach.
authors: Department of Surgical Sciences, Eye Clinic, University of Cagliari, Cagliari, Italy.
authors: Pietro Emanuele
authors: PE
authors: Napoli
authors: Department of Surgical Sciences, Eye Clinic, University of Cagliari, Cagliari, Italy.
authors: Franco
authors: F
authors: Coronella
authors: Department of Surgical Sciences, Eye Clinic, University of Cagliari, Cagliari, Italy.
authors: Giovanni Maria
authors: GM
authors: Satta
authors: Department of Surgical Sciences, Eye Clinic, University of Cagliari, Cagliari, Italy.
authors: Claudio
authors: C
authors: Iovino
authors: Department of Surgical Sciences, Eye Clinic, University of Cagliari, Cagliari, Italy.
authors: Raffaele
authors: R
authors: Sanna
authors: Department of Surgical Sciences, Eye Clinic, University of Cagliari, Cagliari, Italy.
authors: Maurizio
authors: M
authors: Fossarello
mesh_terms: D000328:Adult; D001284:Atrophy; D003430:Cross-Sectional Studies; D005141:Eyelid Diseases / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008537:Meibomian Glands / Q000000981:diagnostic imaging* / Q000473:pathology; D008853:Microscopy; D008875:Middle Aged; D041623:Tomography, Optical Coherence / Q000379:methods*