OPHTALMOLOGY –EYE DISEASES
Acta Ophthalmol. 2010 Aug;88(5):e154-9. doi: 10.1111/j.1755-3768.2010.01941.x. Epub 2010 Jun 10.
The application of temperature measurement of the eyes by digital infrared thermal imaging as a prognostic factor of methylprednisolone pulse therapy for Graves’ ophthalmopathy.
Shih SR1, Li HY, Hsiao YL, Chang TC.
Abstract
PURPOSE:
Graves’ ophthalmopathy (GO) involves autoimmune process resulting in proptosis, congestion, oedema and diplopia. Werner’s NOSPECS classification and clinical activity score (CAS) of GO cannot objectively describe the inflammatory status. Digital infrared thermalimaging (DITI) detects local temperature and may reflect the degree of orbital inflammation. The aim of this study was to evaluate the clinical application of the eye temperature measured by DITI.
METHODS:
Forty-six patients with GO receiving intravenously methylprednisolone pulse therapy (MPT) were included in this study. Local temperatures of the lateral orbit, upper eyelid, inner caruncle, medial conjunctiva, lateral conjunctiva, lower eyelid and cornea were measured with DITI before and after MPT. CAS, proptosis, eye movement (EOM) and diplopia were also recorded. Improvement of CAS was defined as at least one point decrease at either side of the eye, which was 0.5 score decrease as to the average of bilateral CAS.
RESULTS:
Local temperatures of the eyes decreased after MPT. The mean value of temperature (MT) of 12 points including the lateral orbit, upper eyelid, inner caruncle, medial conjunctiva, lateral conjunctiva and lower eyelid of both eyes before MPT was 32.65 degrees . The mean change of MT after MPT (DeltaT) was -0.22 degrees. DeltaT significantly negative-correlated with basal MT (correlation coefficient=-0.54, p=0.004). Higher baseline MT and CAS before MPT correlated with higher possibility of improvement of CAS after MPT (p=0.013 and 0.012, respectively). Baseline MT and CAS together correlated with improvement of CAS after MPT better than baseline CAS alone could do (area under the receiver operating characteristic curve: 82.81% and 66.63%, respectively).
CONCLUSIONS:
Basal temperature of the eyes measured by DITI was an objective indicator of inflammation of GO. Combining CAS and MT could better predict the outcome of MPT than CAS alone.
http://www.ncbi.nlm.nih.gov/pubmed/20553230
Graefes Arch Clin Exp Ophthalmol. 2008 Jan;246(1):45-9. Epub 2007 Jul 26.
Application of digital infrared thermal imaging in determining inflammatory state and follow-up effect of methylprednisolone pulse therapy in patients with Graves’ ophthalmopathy.
Abstract
BACKGROUND:
Inflammation can cause a local increase in temperature. Digital infrared thermal imaging (DITI) has been used to monitor the temperature distribution of human skin. Graves’ ophthalmopathy (GO) is an autoimmune disease, and patients are treated with immunosuppressive agents if the ophthalmopathy is at an inflammatory state. The aim of the present study was to elucidate the feasibility ofDITI in determining inflammatory state and follow-up effect of methylprednisolone pulse therapy in patients with GO.
METHODS:
Digital infrared thermal imaging was used to measure local temperatures of lateral orbit (reference point), upper eyelid, caruncle, medial conjunctiva, lateral conjunctiva, lower eyelid, and cornea, and to make thermal density plots in 14 patients (28 eyes) with GO including inflammatory signs (mean clinical activity score 2.5), and 16 normal controls (32 eyes). We also performed methylprednisolone pulse therapy in 11 patients (22 eyes) with active GO, and measured clinical activity score and local temperatures before and after treatment. The focal change in temperature after treatment and the correlation between temperature variation and change in clinical activity score were then analyzed. Thermal density plots were also compared.
RESULTS:
Local temperatures of the caruncle, medial conjunctiva, lateral conjunctiva, and lower eyelid of the patients were significantly higher than those of normal controls. In the 11 GO patients treated with methylprednisolone pulse therapy, the temperatures of the caruncle, medial conjunctiva, and lower eyelid were significantly decreased after treatment. Temperature variation significantly and positively correlated with a change in clinical activity score (correlation coefficient = 0.8, n = 22, p = 0.000). The temperature decreased after treatment in patients who were responsive to methylprednisolone pulse therapy, and the thermal density plot was close to that of normal controls.
CONCLUSIONS:
Digital infrared thermal imaging might be helpful in evaluating the inflammatory state of GO and the follow-up effect of methylprednisolone pulse therapy.
http://www.ncbi.nlm.nih.gov/pubmed/17653750
Cont Lens Anterior Eye. 2016 Feb 13. pii: S1367-0484(16)30010-8. doi: 10.1016/j.clae.2016.01.010. [Epub ahead of print]
Repeatability of infrared ocular thermography in assessing healthy and dry eyes.
Tan LL1, Sanjay S2, Morgan PB3.
Author information
Abstract
PURPOSE:
To investigate the inter-image, inter-occasion and inter-examiner repeatability of NEC infrared thermo-tracer TH 9260 in assessing healthy and dry eyes.
METHODS:
Ocular surface temperature (OST) was recorded using NEC infrared thermo-tracer TH 9260 on 21 healthy and 15 dry eyes. Data from the right eyes were analyzed. Marking of the ocular surface and OST acquisition was performed using a new ‘diamond’ demarcation method. Twelve OST indices were obtained at three different time points following a blink: 0s, 5s and 10s. Inter-image, inter-occasion and inter-examiner repeatability of the infrared ocular thermography was evaluated by calculating coefficients of repeatability (COR).
RESULTS:
Ten out of the twelve tested OST indices had good repeatability with small inter-image variability (%COR: 0.2-0.9), inter-occasion variability (%COR: 2.1-3.7) and inter-examiner variability (%COR: 1.5-3.7) for the three studied time points. Two of the OST indices (temperature standard deviation of the region of interest and radial temperature difference) had poor repeatability with much larger inter-image variability (%COR: 8.9-140.7), inter-occasion variability (%COR: 47.5-153.5) and inter-examiner variability (%COR: 54.7-142.0) for the three studied time points.
CONCLUSIONS:
Most of the metrics adopted in this assessment can be considered to be highly repeatable.
Copyright © 2016 Elsevier Ltd. All rights reserved.
KEYWORDS:
Dry eye; Infrared ocular thermography; Ocular surface temperature; Repeatability
http://www.ncbi.nlm.nih.gov/pubmed/26883768
Temperatures of the Ocular Surface, Lid, and Periorbital Regions of Sjögren’s, Evaporative, and Aqueous-Deficient Dry Eyes Relative to Normals.
Abreau K1, Callan C1, Kottaiyan R1, Zhang A2, Yoon G3, Aquavella JV1, Zavislan J2, Hindman HB4.
Author information
Abstract
PURPOSE:
To compare the temperatures of the ocular surface, eyelid, and periorbital skin in normal eyes with Sjögren’s syndrome (SS) eyes, evaporative dry eyes (EDE), and aqueous deficient dry eyes (ADDE).
METHODS:
10 eyes were analyzed in each age-matched group (normal, SS, EDE, and ADDE). A noninvasive infrared thermal camera captured two-dimensional images in three regions of interest (ROI) in each of three areas: the ocular surface, the upper eyelid, and the periorbital skin within a controlled environmental chamber. Mean temperatures in each ROI were calculated from the videos. Ocular surface time-segmented cooling rates were calculated over a 5-s blink interval.
RESULTS:
Relative to normal eyes, dry eyes had lower initial central OSTs (SS -0.71°C, EDE -0.55°C, ADDE -0.95°C, KW P<.0001) and lower central upper lid temperatures (SS -0.24°C, ADDE -0.51°C, and EDE -0.54°C, KW P<.0001). ADDE eyes had the lowest initial central OST (P<.0001), while EDE eyes had the lowest central lid temperature and lower periorbital temperatures (P<.0001). Over the 5-s interblink interval, the greatest rate of temperature loss occurred following eyelid opening, but varied by group (normals -0.52, SS -0.73, EDE -0.63, and ADDE -0.75°C/s). The ADDE group also had the most substantial heat loss over the 5-s interblink interval (-0.97°C).
CONCLUSIONS:
Differences in OST may be related to thermal differences in lids and periorbita along with an altered tear film.Thermography of the ocular surface, lids, and surrounding tissues may help to differentiate between different etiologies of dry eye.
Copyright © 2016 Elsevier Inc. All rights reserved.
KEYWORDS:
dry eye; eye lid temperature; infrared thermography; ocular surface temperature; periorbital temperature; thermal measurements
http://www.ncbi.nlm.nih.gov/pubmed/26505667
Subjective Discomfort Symptoms Are Related to Low Corneal Temperature in Patients With Evaporative Dry Eye.
Versura P1, Giannaccare G, Fresina M, Campos EC.
Author information
Abstract
PURPOSE:
To measure the corneal temperature in patients with dry eye (DE) and to correlate the values with subjective discomfort symptoms.
METHODS:
Twenty-four patients with DE (scored as DEWS severity grade 2 to 3) and 15 age-matched normal control subjects were enrolled. Subjective symptoms of discomfort were scored with an Ocular Surface Disease Index questionnaire, and a 100-mm horizontal visual analog scale (VAS) technique was used to measure symptom intensity. Schirmer I test, tear film breakup time (TFBUT), and Oxford grade scoring were performed in all subjects. Dynamic infrared noncontact thermal imaging (Tomey TG 1000) was used to measure the central corneal temperature (CCT). After training, subjects were asked to maintain their eyes forcedly open and to signal the discomfort onset time (DOT). The temperature was measured at eye opening (T0) and every second during 10 seconds of sustained eye opening (T10). The first discomfort sensation onset time (DOT) was also recorded. Temperature values were correlated with the clinical tests, Ocular Surface Disease Index, VAS, and DOT, and data were statistically evaluated (significance P < 0.05).
RESULTS:
The corneal temperature immediately after eye opening was significantly lower in patients with DE than in controls, in correlation to the subject age, VAS, and TFBUT. A 3-phase cooling profile in patients with DE and a point of highest decrease (HD) in both groups were identified. DOT occurred earlier in patients with DE than in controls (5.9 vs. 15.9 seconds) and was strongly correlated to the VAS, TFBUT, and CCT-HD.
CONCLUSIONS:
Subjective sensation of discomfort occurred earlier in patients with DE than in controls, in correlation to low corneal temperatures and enhanced tear evaporation.
http://www.ncbi.nlm.nih.gov/pubmed/26114824
Ophthalmologe. 2015 Sep;112(9):746-51. doi: 10.1007/s00347-014-3210-1.
[Interobserver and intraobserver reliability of corneal surface temperature measurements with the TG-1000 thermograph in normal eyes].
[Article in German]
Pattmöller M1, Wang J2,3, Pattmöller J2, Zemova E2, Eppig T4, Seitz B2, Szentmáry N2, Langenbucher A4.
Author information
Abstract
PURPOSE:
The aim of this study was to analyze the reliability of temperature measurements with the ocular TG-1000 thermograph in a setup of sequential measurements performed by one observer (intraobserver) and a sequence of measurements performed by different observers (interobserver) in normal subjects without pathologies of the anterior segment of the eye.
PATIENTS AND METHODS:
A total of 50 right eyes from 50 individuals (mean age 29.1 ± 7.9 years) without ocular pathologies or history of ocular surgery were enrolled in this prospective monocentric clinical case series. Eyes with signs of dry eye syndrome (based on a positive McMonnies questionnaire) were excluded from the study. Corneal surface temperature measurements were performed by three examiners to assess interobserver reliability. In addition, in a subgroup of 22 individuals, a sequence of 3 measurements were performed by 1 of the examiners to examine intraobserver reliability. Corneal surface temperature was measured within an interval of 10 s (11 frames) on a region of interest of 16 ± 12 mm (320 ± 240 pixels). Central and mid-peripheral local temperatures at 3 mm (3, 6, 9 and 12 o’clock) were extracted and analyzed from the raw data.
RESULTS:
The ocular TG-1000 thermograph yielded consistent results for the interobserver as well as intraobserver conditions in measuring corneal surface temperature in the center as well as mid-periphery of the cornea. Cronbach’s alpha was 0.9 or higher at all corneal locations, which proves a high consistency of results for the interobserver and intraobserver measurements. The average corneal surface temperature ranged between 34.0 °C and 34.7 °C with a slight decrease from the upper temporal (9 and 12 o’clock) to the lower nasal (3 and 6 o’clock) quadrants.
CONCLUSION:
The TG-1000 thermograph yielded consistent results of corneal surface temperature in individuals without anterior segment pathologies or history of ocular surgery. With the option of raw data export (11 frames within 10 s with a lateral resolution of 320 × 240 pixels) the thermograph offers a wide range of new diagnostic options for a spatiotemporal analysis of corneal surface temperature.
KEYWORDS:
Cornea; Non-contact infrared imaging; Normal subjects; Surface temperature; Thermography
http://www.ncbi.nlm.nih.gov/pubmed/25578820