Red filter meibography by smartphones in patients with meibomian gland dysfunction: a validity and reliability study

BMJ Open Ophthalmol. 2024 Apr 12;9(1):e001266. doi: 10.1136/bmjophth-2023-001266.

Abstract

Objective: The objective of this study is to determine the validity and reliability of the red filter meibography by smartphone compared with infrared in assessing meibomian gland drop-out.

Methods and analysis: An analytical cross-sectional study was done with a total of 35 subjects (68 eyes) with suspected MGD based on symptoms and lid morphological abnormalities. Meibomian glands were photographed using two smartphones (Samsung S9 and iPhone XR) on a slit-lamp with added red filter. Images were assessed subjectively using meiboscore by the two raters and drop-out percentages were assessed by ImageJ.

Results: There was no agreement in meiboscore and a minimal level of agreement in drop-out percentages between red filter meibography and infrared. Inter-rater reliability showed no agreement between two raters. Intra-rater reliability demonstrated weak agreement in rater 1 and no agreement in rater 2.

Conclusion: Validity of the red filter meibography technique by smartphones is not yet satisfactory in evaluating drop-out. Further improvement on qualities of images must be done and research on subjective assessment was deemed necessary due to poor results of intrarater and inter-rater reliability.

Keywords: Diagnostic tests/Investigation; Imaging; Ocular surface.

MeSH terms

  • Cross-Sectional Studies
  • Humans
  • Meibomian Gland Dysfunction*
  • Meibomian Glands / diagnostic imaging
  • Reproducibility of Results
  • Smartphone