Objective image analysis of the meibomian gland area

Aims To evaluate objectively the meibomian gland area using newly developed software for non-invasive meibography. Methods Eighty eyelids of 42 patients without meibomian gland loss (meiboscore=0), 105 eyelids of 57 patients with loss of less than one-third total meibomian gland area (meiboscore=1), 13 eyelids of 11 patients with between one-third and two-thirds loss of meibomian gland area (meiboscore=2) and 20 eyelids of 14 patients with two-thirds loss of meibomian gland area (meiboscore=3) were studied. Lid borders were automatically determined. The software evaluated the distribution of the luminance and, by enhancing the contrast and reducing image noise, the meibomian gland area was automatically discriminated. The software calculated the ratio of the total meibomian gland area relative to the total analysis area in all subjects. Repeatability of the software was also evaluated. Results The mean ratio of the meibomian gland area to the total analysis area in the upper/lower eyelids was 51.9 +/- 5.7%/54.7 +/- 5.4% in subjects with a meiboscore of 0, 47.7 +/- 6.0%/51.5 +/- 5.4% in those with a meiboscore of 1, 32.0 +/- 4.4%/37.2 +/- 3.5% in those with a meiboscore of 2 and 16.7 +/- 6.4%/19.5 +/- 5.8% in subjects with a meiboscore of 3. Conclusions The meibomian gland area was objectively evaluated using the developed software. This system could be useful for objectively evaluating the effect of treatment on meibomian gland dysfunction.