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Technologies for Objective Assessment of Dry Eye Disease

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A special issue of Applied Sciences (ISSN 2076-3417). This special issue belongs to the section "Applied Biosciences and Bioengineering".

Deadline for manuscript submissions: closed (30 August 2022) | Viewed by 10357

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Special Issue Editors

Dr. Alberto López-Miguel

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Guest Editor

1. Instituto de Oftalmobiología Aplicada, Universidad de Valladolid, 47002 Valladolid, Spain
2. Red Temática de Investigación Colaborativa en Oftalmología, Instituto de Salud Carlos III, 28220 Madrid, Spain
Interests: dry eye disease; refractive surgery; contact lenses; reliability of ophthalmic instruments

Dr. Itziar Fernández Martínez

E-Mail Website
Guest Editor

Instituto de Oftalmobiología Aplicada, Universidad de Valladolid, Valladolid, Spain
Department of Statistics and Operative Research, University of Valladolid, Valladolid, Spain
Interests: biostatistics; statistical methods in diagnostic studies; statistical computing; high-dimensional data; biomarkers

Special Issue Information

Dear Colleagues,

Dry eye disease (DED) is a multifactorial condition of the lacrimal functional unit causing loss of homeostasis of the tear film, which is usually accompanied by symptoms. The prevalence of DED varies depending on the geographical area; however, it affects millions of people worldwide and is one of the most commonly occurring conditions that drive patients to seek treatment.

Numerous clinical trials for DED have been carried out during the last two decades, however, most of them failed to get regulatory (i.e., FDA or EMA) approval. The TFOS DEWS II Clinical Trial Design Report stated that the main reason for these failures could be the lack of correlation between DED signs and symptoms. Thus, choosing an appropriate primary endpoint is essential for success. However, it is well-known that inherent variability is associated with most of the common DED signs because they are usually evaluated by an observer (i.e., corneal staining).

This Special Issue will address the current scientific developments carried out to increase the reliability of the clinical signs assessing DED. Papers are invited that investigate new or previous technology to increase the reliability of DED clinical signs, these innovative techniques could be already commercially available or still in the research phase. Topics of interest include the following: studies on image analysis (description or clinical validation) of the DED signs commonly observed in the ocular surface (including the whole cornea), lids, and Meibomian glands; studies on the application of technology, either commonly used in ophthalmic settings or not, to describe clinical signs that could be used to objectively assess DED.

Dr. Alberto López-Miguel
Dr. Itziar Fernández Martínez
Guest Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Applied Sciences is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

Dry eye disease
Clinical signs
Innovative technology
Image processing
Image metadata extraction
Automated image analysis

Published Papers (4 papers)

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Research

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12 pages, 1534 KiB

Open AccessArticle

New Method for the Automated Assessment of Corneal Nerve Tortuosity Using Confocal Microscopy Imaging

by Itziar Fernández, Amanda Vázquez, Margarita Calonge, Miguel J. Maldonado, Ana de la Mata and Alberto López-Miguel

Appl. Sci. 2022, 12(20), 10450; https://0-doi-org.brum.beds.ac.uk/10.3390/app122010450 - 17 Oct 2022

Cited by 4 | Viewed by 1529

Abstract

An automated tool for corneal nerve fiber tortuosity quantification from in vivo confocal microscopy (IVCM) is described and evaluated. The method is a multi-stage process based on the splitting of the corneal nerve fibers into individual segments, whose endpoints are an extreme or intersection of white pixels on a binarized image. Individual segment tortuosity is quantified in terms of the arc-chord ratio. Forty-three IVCM images from 43 laser-assisted in situ keratomileusis (LASIK) surgery patients were used for evaluation. Images from symptomatic dry eye disease (DED) post-LASIK patients, with (

n = 16

) and without (

n = 7

) ocular pain, and non-DED post-LASIK controls (

n = 20

) were assessed. The automated tortuosity measure was compared to a manual grading one, obtaining a moderate correlation (Spearman’s rank correlation coefficient =

0.49

p = 0.0008

). The new tortuosity index was significantly higher in post-LASIK patients with ocular pain than in control patients (

p = 0.001

), while no significant differences were detected with manual measurement (

p > 0.28

). The tortuosity quantification was positively correlated with the ocular surface disease index (OSDI) and a numeric rating scale (NRS) assessing pain (

p = 0.0012

and

p = 0.0051

, respectively). The results show good performance of the proposed automated methodology for the evaluation of corneal nerve tortuosity. Full article

(This article belongs to the Special Issue Technologies for Objective Assessment of Dry Eye Disease)

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Figure 1

9 pages, 579 KiB

Open AccessFeature PaperArticle

Ocular Surface Temperature in DED under Natural Non-Controlled Blinking Conditions

by Laura Rico-del-Viejo, Clara Llorens-Quintana, Irene Martínez-Alberquilla, David Madrid-Costa and María García-Montero

Appl. Sci. 2022, 12(9), 4596; https://0-doi-org.brum.beds.ac.uk/10.3390/app12094596 - 02 May 2022

Viewed by 1575

Abstract

Infrared (IR) thermography is a tool to non-invasively assess the tear film temperature. The aim was to analyze ocular surface temperature (OST) variations in dry eye disease (DED) and control eyes under natural non-controlled blinking conditions. Imaging was performed with a thermal camera (FLIR Systems Inc.) at 30 Hz framerate in 79 participants (39 DED (62.5% women, average age 48 ± 20 years) and 40 control (46.2 % women, average age 38 ± 13 years)) using non-contact IR thermography camera. Data acquisitions were performed in natural blinking conditions for 40 s. IR images were analyzed using a custom algorithm that calculates the OST indexes: mean OST, OST at the start and at the end, minimum and maximum OST, and tear evaporation rate (TER). No significant differences were found between groups in any thermal parameter analyzed (paired comparisons t-test, p > 0.05). In conclusion, the findings of this study did not reveal significant differences between DED and control eyes under natural non-controlled blinking conditions. However, the presence of clinical signs in the control group may affect the results, highlighting the role of DED diagnosis criteria. Full article

(This article belongs to the Special Issue Technologies for Objective Assessment of Dry Eye Disease)

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8 pages, 2302 KiB

Open AccessArticle

Agreement of Tear Break-Up Time and Meniscus Height between Medmont E300 and Visionix VX120+

by Elena Martínez-Plaza, Ainhoa Molina-Martín and David P. Piñero

Appl. Sci. 2022, 12(9), 4589; https://0-doi-org.brum.beds.ac.uk/10.3390/app12094589 - 30 Apr 2022

Cited by 3 | Viewed by 1931

Abstract

The goal of this study was to analyze the agreement between the Medmont E300 and the Visionix VX120+ systems in terms of non-invasive tear break-up time (NIBUT) and tear meniscus height (TMH) measurements. A total of 60 eyes (30 healthy subjects) were enrolled. NIBUT and TMH were evaluated with Medmont E300; first NIBUT, NIBUT50%, and TMH were evaluated with Visionix VX120+. Both evaluations were performed in a random order by the same clinician for right, left, and both eyes. The Medmont E300 provided significantly higher NIBUT than Visionix VX120+ for first NIBUT in right, left, and both eyes (p ≤ 0.003) and NIBUT50% in left and both eyes (p ≤ 0.042). The TMH measured with VX120+ was significantly higher than with Medmont E300 considering both eyes (p = 0.037). No significant correlations were found between both devices for either NIBUT (p ≥ 0.11) or TMH (p ≥ 0.09). Passing–Bablok regression analyses revealed poor agreement between devices for NIBUT and TMH outcomes. VX120+ is expected to provide substantial lower first NIBUT values than the NIBUT measured by Medmont E300. Clinicians should consider not using both instruments as interchangeable for dry eye diagnosis. Full article

(This article belongs to the Special Issue Technologies for Objective Assessment of Dry Eye Disease)

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Review

Jump to: Research

15 pages, 2725 KiB

Open AccessFeature PaperReview

Advances in the Noninvasive Diagnosis of Dry Eye Disease

by Luca Di Cello, Marco Pellegrini, Aldo Vagge, Massimiliano Borselli, Lorenzo Ferro Desideri, Vincenzo Scorcia, Carlo E. Traverso and Giuseppe Giannaccare

Appl. Sci. 2021, 11(21), 10384; https://0-doi-org.brum.beds.ac.uk/10.3390/app112110384 - 05 Nov 2021

Cited by 17 | Viewed by 4524

Abstract

Dry eye disease (DED) is a multifactorial disease that represents one of the most common ophthalmologic conditions encountered in everyday clinical practice. Traditional diagnostic tests for DED, such as subjective questionnaires, tear film break-up time and the Schirmer test, are often associated with poor reproducibility and reliability, which make the diagnosis, follow-up, and management of the disease challenging. New advances in imaging technologies enable objective and reproducible measurements of DED parameters, thus making the diagnosis a multimodal imaging-based process. The aim of this review is to summarize all the current and emerging diagnostic tools available for the diagnosis and monitoring of DED, such as non-invasive tear breakup time, thermography, anterior segment optical coherence tomography, meibography, interferometry, in vivo confocal microscopy, and optical quality assessment. Although there is not a gold standard imaging technique, new multi-imaging-integrated devices are precious instruments to help clinicians to better cope with the diagnostic complexity of DED. Full article

(This article belongs to the Special Issue Technologies for Objective Assessment of Dry Eye Disease)

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