Posters

A new method to document Marx's line (ML) using the fundus fluorescein angiography filters of fundus cameras

Poster Details

First Author: T.Rajaratnam UK

Co Author(s):    T. Rajaratnam   A. Venkatesh   J. Smith   D. Beddall   A. Sharma        

Abstract Details

Purpose:

Meibomian gland dysfunction (MGD) is an extremely common condition, however grading and classifying the disorder remains very difficult. It is demanding to quantify the expression of meibum on clinical examination, meaning MGD is mainly a qualitatively documented diagnosis in everyday practice. ML acts as a marker for the lid mucocutaneous junction (MCJ), and its location has been shown to vary in MGD patients and has been correlated with other assessments of meibomian gland function. We present a method to more accurately visualise ML with photography for documentation, which could permit simple quantitative analysis of MGD.

Setting:

This study was conducted at the Moorfields Eye Centre in Bedford Hospital, UK.

Methods:

A total of 10 patients were recruited from the dry eye clinic, with photographs taken of their 20 eyes. In these patients, 1% fluorescein dye solution was instilled into the eye. The upper and lower eyelid margins were then imaged using a dedicated fluorescein angiography fundus camera (TOPCON TRC-50DX) equipped with fluorescein excitation and barrier filters.

Results:

In all 20 images ML could be imaged and was clearly demarcated with good contrast. The whole lid can be imaged with ML and distinct meibomian glands clearly visible, and both the upper and lower lid lengths could be imaged in their entirety. These images could then be saved on to computer systems for potential future analysis. Visualisation and documentation of the disposition of ML could enable further classification of MGD and monitoring of disease progression.

Conclusions:

This novel technique permits simple documentation of Marx's line, allowing for quantification of the grade of MGD. Our method may also allow for the visualization of any ocular surface staining in the same image. This means that the grade of MGD, which is associated with the disposition of Marx’s line, can be simultaneously documented with the resultant ocular surface manifestations of dry eye disease (e.g. corneal superficial punctate epithelial erosions).

Financial Disclosure:

None