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The Application of Infrared Imaging and Optical Coherence Tomography of the Lacrimal Punctum in Patients Undergoing Punctoplasty for Epiphora.
Ophthalmology 2017; 124(6):910-917O

Abstract

PURPOSE

To determine the application of imaging the stenotic lacrimal punctum with infrared photographs and optical coherence tomography (OCT) and to identify characteristics of the lacrimal punctum in patients who benefit from punctoplasty.

DESIGN

Case-control study.

PARTICIPANTS

Twenty patients with epiphora who were listed for punctoplasty and 20 healthy controls.

METHODS

Prospectively, 20 patients listed for punctoplasty were asked to rate their epiphora, using the Munk score, before and after punctoplasty. They also underwent preoperative OCT and infrared imaging of the affected punctum. They were divided into 2 groups, depending on whether the epiphora improved, and were compared with 20 healthy controls.

MAIN OUTCOME MEASURES

Measurements of puncta from infrared and OCT images were obtained along with Munk scores of patient epiphora.

RESULTS

The infrared image measurements were significantly smaller in those patients whose epiphora improved compared with those whose did not in both the area of the punctal aperture and in the maximum punctal diameter. Additionally, those patients with improvement in epiphora had a significantly smaller preoperative punctal diameter at 100 μm depth on OCT compared with healthy controls; this was not observed in patients whose epiphora failed to improve. There was no significant difference in the punctum diameter among the 3 groups at the punctum surface entrance or at 500 μm depth. Patients with epiphora had a higher tear meniscus within the punctum compared with healthy controls.

CONCLUSIONS

Lacrimal punctum infrared and OCT imaging may be helpful in predicting patients more likely to benefit symptomatically from punctoplasty, with patients with smaller puncta having greater symptomatic improvement. However, the results suggest that inner punctum diameter (not readily measurable by slit-lamp examination), rather than the surface diameter, is correlated with outcome. Additionally, OCT measurements of the tear meniscus height within the punctum may be related to the degree of epiphora.

Authors+Show Affiliations

Lacrimal Clinic, Moorfields Eye Hospital, London, United Kingdom.NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom.Lacrimal Clinic, Moorfields Eye Hospital, London, United Kingdom; NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom.Lacrimal Clinic, Moorfields Eye Hospital, London, United Kingdom; NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom. Electronic address: d.ezra@ucl.ac.uk.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

28318635

Citation

Timlin, Hannah M., et al. "The Application of Infrared Imaging and Optical Coherence Tomography of the Lacrimal Punctum in Patients Undergoing Punctoplasty for Epiphora." Ophthalmology, vol. 124, no. 6, 2017, pp. 910-917.
Timlin HM, Keane PA, Rose GE, et al. The Application of Infrared Imaging and Optical Coherence Tomography of the Lacrimal Punctum in Patients Undergoing Punctoplasty for Epiphora. Ophthalmology. 2017;124(6):910-917.
Timlin, H. M., Keane, P. A., Rose, G. E., & Ezra, D. G. (2017). The Application of Infrared Imaging and Optical Coherence Tomography of the Lacrimal Punctum in Patients Undergoing Punctoplasty for Epiphora. Ophthalmology, 124(6), pp. 910-917. doi:10.1016/j.ophtha.2017.01.054.
Timlin HM, et al. The Application of Infrared Imaging and Optical Coherence Tomography of the Lacrimal Punctum in Patients Undergoing Punctoplasty for Epiphora. Ophthalmology. 2017;124(6):910-917. PubMed PMID: 28318635.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The Application of Infrared Imaging and Optical Coherence Tomography of the Lacrimal Punctum in Patients Undergoing Punctoplasty for Epiphora. AU - Timlin,Hannah M, AU - Keane,Pearse A, AU - Rose,Geoffrey E, AU - Ezra,Daniel G, Y1 - 2017/03/17/ PY - 2016/12/13/received PY - 2017/01/28/revised PY - 2017/01/31/accepted PY - 2017/3/21/pubmed PY - 2017/7/18/medline PY - 2017/3/21/entrez SP - 910 EP - 917 JF - Ophthalmology JO - Ophthalmology VL - 124 IS - 6 N2 - PURPOSE: To determine the application of imaging the stenotic lacrimal punctum with infrared photographs and optical coherence tomography (OCT) and to identify characteristics of the lacrimal punctum in patients who benefit from punctoplasty. DESIGN: Case-control study. PARTICIPANTS: Twenty patients with epiphora who were listed for punctoplasty and 20 healthy controls. METHODS: Prospectively, 20 patients listed for punctoplasty were asked to rate their epiphora, using the Munk score, before and after punctoplasty. They also underwent preoperative OCT and infrared imaging of the affected punctum. They were divided into 2 groups, depending on whether the epiphora improved, and were compared with 20 healthy controls. MAIN OUTCOME MEASURES: Measurements of puncta from infrared and OCT images were obtained along with Munk scores of patient epiphora. RESULTS: The infrared image measurements were significantly smaller in those patients whose epiphora improved compared with those whose did not in both the area of the punctal aperture and in the maximum punctal diameter. Additionally, those patients with improvement in epiphora had a significantly smaller preoperative punctal diameter at 100 μm depth on OCT compared with healthy controls; this was not observed in patients whose epiphora failed to improve. There was no significant difference in the punctum diameter among the 3 groups at the punctum surface entrance or at 500 μm depth. Patients with epiphora had a higher tear meniscus within the punctum compared with healthy controls. CONCLUSIONS: Lacrimal punctum infrared and OCT imaging may be helpful in predicting patients more likely to benefit symptomatically from punctoplasty, with patients with smaller puncta having greater symptomatic improvement. However, the results suggest that inner punctum diameter (not readily measurable by slit-lamp examination), rather than the surface diameter, is correlated with outcome. Additionally, OCT measurements of the tear meniscus height within the punctum may be related to the degree of epiphora. SN - 1549-4713 UR - https://www.unboundmedicine.com/medline/citation/28318635/The_Application_of_Infrared_Imaging_and_Optical_Coherence_Tomography_of_the_Lacrimal_Punctum_in_Patients_Undergoing_Punctoplasty_for_Epiphora_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0161-6420(16)32308-9 DB - PRIME DP - Unbound Medicine ER -