Dacryoscintigraphy in Measurement of Tear Clearance in Patients With Meibomian Gland Dysfunction

Sunday, April 27, 2014: 1:26 PM
Room 150 (Boston Convention and Exhibition Center)
Adam Kemeny-Beke, MD, PhD, University of Debrecen, Debrecen, Hungary

Narrative Responses:

To measure tear-clearance in Meibomian Gland Dysfunction (MGD) patients with a dynamic nuclear medicine method, dacryoscintigraphy (DSCI).

36 patients were examined including 14 healthy volunteers and
22 MGD patients. One drop of a solution with 10 MBq 99mTc sodium pertechnetate was instilled with a micropipette into the lacrimal lake of both eyes. Measurements were performed according to a dynamic data acquisition protocol, which resulted in summed DSCI images. Data were also evaluated in special regions of interest (ROIs) separately, and consecutive time activity curves were created. Tear break up time (TBUT) and Schirmer I test were also performed prior to DSCI measurements. Tear clearance (T ½) values were calculated based on the activity curves.

The clearance (T ½) values were 6.38 min (SD±1.9) in MGD patients and 29.78 (SD±8.28) in normal controls, respectively. The difference was significant (p<0.01). Schirmer I test values were 7.35 (SD±4.96) in MGD patients and 16.28 (SD±8.62) in the control group. TBUT values were 5.36 (SD±2.62) in MGD patients and 15.15 (SD±2.38) in normal patients.

Tear clearance values were significantly higher in MGD patients than is normal volunteers, which may be the result of increased drainage of tear from the eyes towards the nasal cavity in MGD patients. The reasons for increased drainage in MGD patients without reflex tearing are yet to be investigated.