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

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.