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Swiderska K, Blackie CA, Maldonado-Codina C, Fergie M, Read ML, Morgan PB. Temporal variations in meibomian gland structure-A pilot study. Ophthalmic Physiol Opt 2024. [PMID: 38708449 DOI: 10.1111/opo.13321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 04/13/2024] [Accepted: 04/15/2024] [Indexed: 05/07/2024]
Abstract
PURPOSE To investigate whether there is a measurable change in meibomian gland morphological characteristics over the course of a day (12 h) and over a month. METHODS The study enrolled 15 participants who attended a total of 11 study visits spanning a 5-week period. To assess diurnal changes in meibomian glands, seven visits were conducted on a single day, each 2 h apart. For monthly assessment, participants attended an additional visit at the same time of the day every week for three consecutive weeks. Meibography using the LipiView® II system was performed at each visit, and meibomian gland morphological parameters were calculated using custom semi-automated software. Specifically, six central glands were analysed for gland length ratio, gland width, gland area, gland intensity and gland tortuosity. RESULTS The average meibomian gland morphological metrics did not exhibit significant changes during the course of a day or over a month. Nonetheless, certain individual gland metrics demonstrated notable variation over time, both diurnally and monthly. Specifically, meibomian gland length ratio, area, width and tortuosity exhibited significant changes both diurnally and monthly when assessed on a gland-by-gland basis. CONCLUSIONS Meibomian glands demonstrated measurable structural change over short periods of time (hours and days). These results have implications for innovation in gland imaging and for developing precision monitoring of gland structure to assess meibomian gland health more accurately.
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Affiliation(s)
- Kasandra Swiderska
- Eurolens Research, Division of Pharmacy and Optometry, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | | | - Carole Maldonado-Codina
- Eurolens Research, Division of Pharmacy and Optometry, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Martin Fergie
- Division of Informatics, Imaging and Data Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Michael L Read
- Eurolens Research, Division of Pharmacy and Optometry, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Philip B Morgan
- Eurolens Research, Division of Pharmacy and Optometry, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
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Swiderska K, Blackie CA, Maldonado-Codina C, Morgan PB, Read ML, Fergie M. A Deep Learning Approach for Meibomian Gland Appearance Evaluation. Ophthalmol Sci 2023; 3:100334. [PMID: 37920420 PMCID: PMC10618829 DOI: 10.1016/j.xops.2023.100334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 05/09/2023] [Accepted: 05/16/2023] [Indexed: 11/04/2023]
Abstract
Purpose To develop and evaluate a deep learning algorithm for Meibomian gland characteristics calculation. Design Evaluation of diagnostic technology. Subjects A total of 1616 meibography images of both the upper (697) and lower (919) eyelids from a total of 282 individuals. Methods Images were collected using the LipiView II device. All the provided data were split into 3 sets: the training, validation, and test sets. Data partitions used proportions of 70/10/20% and included data from 2 optometry settings. Each set was separately partitioned with these proportions, resulting in a balanced distribution of data from both settings. The images were divided based on patient identifiers, such that all images collected for one participant could end up only in one set. The labeled images were used to train a deep learning model, which was subsequently used for Meibomian gland segmentation. The model was then applied to calculate individual Meibomian gland metrics. Interreader agreement and agreement between manual and automated methods for Meibomian gland segmentation were also carried out to assess the accuracy of the automated approach. Main Outcome Measures Meibomian gland metrics, including length ratio, area, tortuosity, intensity, and width, were measured. Additionally, the performance of the automated algorithms was evaluated using the aggregated Jaccard index. Results The proposed semantic segmentation-based approach achieved average aggregated Jaccard index of mean 0.4718 (95% confidence interval [CI], 0.4680-0.4771) for the 'gland' class and a mean of 0.8470 (95% CI, 0.8432-0.8508) for the 'eyelid' class. The result for object detection-based approach was a mean of 0.4476 (95% CI, 0.4426-0.4533). Both artificial intelligence-based algorithms underestimated area, length ratio, tortuosity, widthmean, widthmedian, width10th, and width90th. Meibomian gland intensity was overestimated by both algorithms compared with the manual approach. The object detection-based algorithm seems to be as reliable as the manual approach only for Meibomian gland width10th calculation. Conclusions The proposed approach can successfully segment Meibomian glands; however, to overcome problems with gland overlap and lack of image sharpness, the proposed method requires further development. The study presents another approach to utilizing automated, artificial intelligence-based methods in Meibomian gland health assessment that may assist clinicians in the diagnosis, treatment, and management of Meibomian gland dysfunction. Financial Disclosures The authors have no proprietary or commercial interest in any materials discussed in this article.
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Affiliation(s)
- Kasandra Swiderska
- Eurolens Research, Division of Pharmacy and Optometry, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | | | - Carole Maldonado-Codina
- Eurolens Research, Division of Pharmacy and Optometry, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Philip B. Morgan
- Eurolens Research, Division of Pharmacy and Optometry, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Michael L. Read
- Eurolens Research, Division of Pharmacy and Optometry, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Martin Fergie
- Division of Informatics, Imaging and Data Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
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Swiderska K, Blackie CA, Maldonado-Codina C, Fergie M, Read ML, Morgan PB. Evaluation of Meibomian gland structure and appearance after therapeutic Meibomian gland expression. Clin Exp Optom 2023:1-11. [PMID: 37989323 DOI: 10.1080/08164622.2023.2251994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 08/21/2023] [Indexed: 11/23/2023] Open
Abstract
CLINICAL RELEVANCE Evaluating how Meibomian glands can change in appearance has the potential to advance the understanding of Meibomian gland health and may lead to enhanced diagnosis and therapy. BACKGROUND This work aimed to investigate Meibomian gland appearance after therapeutic Meibomian gland expression. METHODS Fifteen subjects attended three study visits over a two-week period. Meibography was performed before and after therapeutic Meibomian gland expression, the following day, and 2 weeks after expression. Six central glands were used to calculate Meibomian gland morphological parameters such as gland length ratio, gland width, gland area, gland tortuosity, and gland contrast. A custom semi-automated image analysis software was used to calculate Meibomian gland metrics. Furthermore, a high-resolution imaging system was developed to capture clear images of the Meibomian glands, free of any artefacts, which were used for precise calculations of Meibomian gland contrast. RESULTS The expression procedure had a significant impact on Meibomian gland contrast and length ratio immediately afterwards. The least square mean difference (95% CI) from baseline for Michelson contrast was -0.006 (-0.010, -0.001) and -1.048 (-2.063, -0.033) for simple contrast. The least square mean ratio of the gland length ratio immediately after the expression to baseline was 0.758 (0.618, 0.931). CONCLUSIONS Following therapeutic expression, Meibomian glands exhibit reduced brightness and length. However, within 24 h, they appear to recover and return to their baseline state, indicating a relatively short recovery time. This sheds light on whether meibography is solely focused on capturing gland structure or if it also captures acinar activity. The hyperreflective properties of lipids suggest that the decrease in contrast observed after expression could be attributed to a reduction in the visualisation of acini activity. A decrease in Meibomian gland length ratio implies that the loss of gland structure following treatment may be indicative of a temporary structural alteration.
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Affiliation(s)
- Kasandra Swiderska
- Eurolens Research, Division of Pharmacy and Optometry, The University of Manchester, Manchester, UK
| | - Caroline A Blackie
- Medical Affairs Department, Johnson & Johnson Surgical Vision, Inc, Irvine, CA, USA
| | - Carole Maldonado-Codina
- Eurolens Research, Division of Pharmacy and Optometry, The University of Manchester, Manchester, UK
| | - Martin Fergie
- Division of Informatics, Imaging and Data Sciences, The University of Manchester, Manchester, UK
| | - Michael L Read
- Eurolens Research, Division of Pharmacy and Optometry, The University of Manchester, Manchester, UK
| | - Philip B Morgan
- Eurolens Research, Division of Pharmacy and Optometry, The University of Manchester, Manchester, UK
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Swiderska K, Blackie CA, Maldonado-Codina C, Fergie M, Morgan PB, Read ML. Development of Artefact-Free Imaging System for Accurate Meibomian Gland Reflectivity Assessment. Transl Vis Sci Technol 2023; 12:9. [PMID: 36749580 PMCID: PMC9919613 DOI: 10.1167/tvst.12.2.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Purpose To develop and evaluate a custom imaging system to provide high-resolution, wide depth-of-field, reflection-free, multispectral infrared (IR) imaging of the Meibomian glands. Methods Lower eyelids of 15 volunteers were everted to obtain multispectral images of the Meibomian glands with custom imaging setup. Photographs were captured at 10 different ISO settings (from underexposure to overexposure) and using nine IR imaging filters (ranging from 600 nm to 1000 nm in 50-nm steps). Meibomian gland contrast (simple and Michelson) was calculated for the images to choose an optimal wavelength for Meibomian gland imaging and to determine differences in contrast across individuals. Results The overall linear regression model showed a significant effect of wavelength on Meibomian gland contrast (Simple contrast: F = 7.24, P < 0.0001; Michelson contrast: F = 7.19, P < 0.0001). There was a significant negative correlation between Meibomian gland contrast and Meibomian gland depth for 750-nm IR filter (ρs= -0.579; P = 0.026). Conclusions Meibomian gland contrast varies across individuals and depends on Meibomian gland depth. IR filter of 750 nm is the optimal choice for Meibomian gland imaging because it provides images of greatest contrast. Translational Relevance This study adds to our understanding of Meibomian gland imaging. It has successfully demonstrated that Meibomian glands that are deeper in the tarsal plate require longer wavelengths for imaging.
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Affiliation(s)
- Kasandra Swiderska
- Eurolens Research, Division of Pharmacy and Optometry, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | | | - Carole Maldonado-Codina
- Eurolens Research, Division of Pharmacy and Optometry, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Martin Fergie
- Division of Informatics, Imaging and Data Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Philip B. Morgan
- Eurolens Research, Division of Pharmacy and Optometry, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Michael L. Read
- Eurolens Research, Division of Pharmacy and Optometry, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
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Morgan PB, Murphy PJ, Gifford KL, Gifford P, Golebiowski B, Johnson L, Makrynioti D, Moezzi AM, Moody K, Navascues-Cornago M, Schweizer H, Swiderska K, Young G, Willcox M. CLEAR - Effect of contact lens materials and designs on the anatomy and physiology of the eye. Cont Lens Anterior Eye 2021; 44:192-219. [PMID: 33775377 DOI: 10.1016/j.clae.2021.02.006] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 02/01/2021] [Indexed: 12/19/2022]
Abstract
This paper outlines changes to the ocular surface caused by contact lenses and their degree of clinical significance. Substantial research and development to improve oxygen permeability of rigid and soft contact lenses has meant that in many countries the issues caused by hypoxia to the ocular surface have largely been negated. The ability of contact lenses to change the axial growth characteristics of the globe is being utilised to help reduce the myopia pandemic and several studies and meta-analyses have shown that wearing orthokeratology lenses or soft multifocal contact lenses can reduce axial length growth (and hence myopia). However, effects on blinking, ptosis, the function of Meibomian glands, fluorescein and lissamine green staining of the conjunctiva and cornea, production of lid-parallel conjunctival folds and lid wiper epitheliopathy have received less research attention. Contact lens wear produces a subclinical inflammatory response manifested by increases in the number of dendritiform cells in the conjunctiva, cornea and limbus. Papillary conjunctivitis is also a complication of all types of contact lenses. Changes to wear schedule (daily disposable from overnight wear) or lens materials (hydrogel from SiHy) can reduce papillary conjunctivitis, but the effect of such changes on dendritic cell migration needs further study. These changes may be associated with decreased comfort but confirmatory studies are needed. Contact lenses can affect the sensitivity of the ocular surface to mechanical stimulation, but whether these changes affect comfort requires further investigation. In conclusion, there have been changes to lens materials, design and wear schedules over the past 20+ years that have improved their safety and seen the development of lenses that can reduce the myopia development. However, several changes to the ocular surface still occur and warrant further research effort in order to optimise the lens wearing experience.
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Affiliation(s)
- Philip B Morgan
- Eurolens Research, Division of Pharmacy and Optometry, University of Manchester, UK.
| | - Paul J Murphy
- University of Waterloo, School of Optometry and Vision Science, Waterloo, Canada
| | - Kate L Gifford
- School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Australia
| | - Paul Gifford
- School of Optometry and Vision Science, UNSW Sydney, Australia
| | | | - Leah Johnson
- CooperVision Specialty EyeCare, Gilbert, AZ, United States
| | - Dimitra Makrynioti
- School of Health Rehabilitation Sciences, University of Patras (Aigio), Greece
| | - Amir M Moezzi
- Centre for Ocular Research and Education, University of Waterloo, Canada
| | - Kurt Moody
- Johnson & Johnson Vision Care, Jacksonville, FL, United States
| | | | | | - Kasandra Swiderska
- Eurolens Research, Division of Pharmacy and Optometry, University of Manchester, UK
| | | | - Mark Willcox
- School of Optometry and Vision Science, UNSW Sydney, Australia
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Spiewankiewicz B, Stelmachów J, Sawicki W, Cendrowski K, Wypych P, Swiderska K. The effectiveness of hysteroscopic polypectomy in cases of female infertility. CLIN EXP OBSTET GYN 2003; 30:23-5. [PMID: 12731738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
The authors, based on their own material, evaluated the value of hysteroscopic treatment of endometrial polyps in a group of infertile women. Polypectomy was performed in 25 patients using either endoscopic microscissors or electric loop. Follow-up hysteroscopy was performed after two months as an integral part of the treatment. All the patients were observed for 12 months. The primary intrauterine investigation was complete in all patients without regard to kind of instrument which was confirmed by second-look hysteroscopy. About 80% of the patients who underwent surgery conceived. Restoration of reproductive ability did not depend on the size of the removed lesion.
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Affiliation(s)
- B Spiewankiewicz
- Department of Obstetrics and Gynecology, 2nd Faculty of Medicine, The Medical University of Warsaw, Poland
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Nekanda-Trepka A, Jarosz M, Kamiński W, Witkowski M, Swiderska K. [A case of Menetrier disease]. Wiad Lek 1994; 47:541-3. [PMID: 7716944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- A Nekanda-Trepka
- Kliniki Chorób Metaboliczych i Gastroenterologii Instytutu Zywności i Zywienia w Warszawie
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Górnicki K, Swiderska K. [Location of changes in the gastric mucosa stump in patients operated on by the Hoffmeister-Finsterer method for gastric and duodenal ulcers]. Wiad Lek 1987; 40:305-9. [PMID: 3617755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Swiderski G, Swiderska K, Chmielak F. [The problem of general multimorbidity in spinal patients in old age]. Z Orthop Ihre Grenzgeb 1986; 124:457-60. [PMID: 3776329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Górnicki K, Swiderska K. [Late comparative evaluation of changes in the gastric mucosa after the surgical treatment of gastric and duodenal ulcers by the Hoffmeister-Finsterer method]. Pol Tyg Lek 1986; 41:176-80. [PMID: 3714556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Sarosiek J, Bernacka K, Maciejewska J, Musiatowicz B, Swiderska K. [Malignant lymphoma with myocardial involvement and progessive exophthalmos]. Pol Tyg Lek 1978; 33:1891-2. [PMID: 724558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Swiderski G, Swiderska K. [Internal parameters of radiological assessment of lumbar spine position (author's transl)]. Pol Przegl Radiol Med Nukl 1978; 42:343-7. [PMID: 748867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Swiderski G, Swiderska K. [Radiological external parameters of lumbosacral spine position (author's transl)]. Pol Przegl Radiol Med Nukl 1978; 42:291-4. [PMID: 714756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Musiatowicz B, Swiderska K. [Teratocarcinoma of the anterior mediastinum]. Patol Pol 1974; 25:175-8. [PMID: 4827995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Swiderski G, Swiderska K, Bielecki M. [Spondylogoniometer and its application in flexibility measurement of the spine]. Beitr Orthop Traumatol 1973; 20:593-600. [PMID: 4779752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Kurasz S, Musiatowicz B, Borzuchowska A, Swiderska K. [Histological and histochemical changes in the suprarenal cortex of rabbits infected experimentally with Salmonella typhimurium combined with irradiation (author's transl)]. Zentralbl Bakteriol Orig A 1973; 224:463-71. [PMID: 4131381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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