Ocular surface evaluation

[caption id="attachment_17457" align="alignleft" width="1024"] Béatrice Cochener-Lamard MD, PhD[/caption] A new low-cost interferometry platform called Lacrydiag (Quantel) allows the quick, objective and non-invasive analysis of tear film and meibomian glands for the diagnosis of dry eye and can help monitor the efficacy of dry eye disease treatment, said Béatrice Cochener-Lamard MD, PhD, at the 37th Congress of the ESCRS. The Lacrydiag device provides assessment of tear film properties using interferometry ergonomic hand held device it has two removable magnetic cones, one for meniscus interferometry and the other for non-invasive break-up time (NIBUT). It also has a yellow filter that allows evaluation of the integrity of the ocular surface, said Dr Cochener-Lamard, University Hospital of Brest – CHU Morvan, Brest, France. In a validation study involving 100 patients from the general population with a mean age of 55 years (range 44-71 years), Prof Cochener-Lamard and her associates performed a range of measurements with the Lacrydiag device, including measurement of NIBUT, height of lacrimal meniscus, thickness of the tear film and meibography. They compared the automated analysis was with the clinical examination including break-up time (BUT) measurement, SPEED life questionnaire and Oxford score. They found a moderate correlation between the Lacrydiag meiboscale values and those of conventional meibography (r=0.595). They found that there was no correlation between the TBUT and NIBUT, with a mean variation of 2.35 seconds. Prof Cochener-Lamard pointed out that thresholds have not yet been set for the device. She noted that 30 of the patients were treated with the Eyelight (Topcon) device for meibomian gland disease, a photobiomodulation technology that uses an LED matrix at a specific wavelength to stimulate a healing response in the inner eyelid tissues. The inclusion criteria were grade 1 to 3 on the Lacrydiag meiboscale. The patients underwent two-to-four treatment sessions. SIGNIFICANT IMPROVEMENT At one month’s follow-up was there significant improvement in mean BUT, and there was also a significant improvement in the Oxford score. However, tear meniscus height and NIBUT measured with the Lacrydiag device did not change. On the other hand, meibography with the device showed a significant improvement. Regarding patient satisfaction, patients’ scores improved on the OSDI and SPEED quality of life questionnaire. Functional symptoms decreased in 73%. The main side-effect was erythema of facial skin, which disappeared after a couple of hours. However, there were two cases of herpetic keratitis, which occurred in the stroma in one patient with previous ocular herpes and in the epithelium of another patient without previous ocular herpes. Both cases resolved following antiviral therapy. Béatrice Cochener-Lamard: beatrice.cochener@ophtalmologie-chu29.fr

Tags: meibomian glands, ocular surface disease, tear film