Abstract

Imaging has become indispensable in the diagnosis and management of diseases in the posterior part of the eye. In recent years, imaging techniques for the anterior segment are also gaining importance and are nowadays routinely used in clinical practice. Ocular surface disease is often synonymous with dry eye disease, but also refers to other conditions of the ocular surface, such as Meibomian gland dysfunction or keratitis and conjunctivitis with different underlying causes, i.e., allergies or infections. Therefore, correct differential diagnosis and treatment of ocular surface diseases is crucial, for which imaging can be a helpful tool. A variety of imaging techniques have been introduced to study the ocular surface, such as anterior segment optical coherence tomography, in vivo confocal microscopy, or non-contact meibography. The present review provides an overview on how these techniques can be used in the diagnosis and management of ocular surface disease and compares them to clinical standard methods such as slit lamp examination or staining of the cornea or conjunctiva. Although being more cost-intensive in the short term, in the long term, the use of ocular imaging can lead to more individualized diagnoses and treatment decisions, which in turn are beneficial for affected patients as well as for the healthcare system. In addition, imaging is more objective and provides good documentation, leading to an improvement in patient follow-up and education.

Highlights

  • The ocular surface consists of the tear film, conjunctiva, cornea, eyelids and lacrimal glands.The term “ocular surface disease (OSD)” is frequently synonymous for dry eye disease (DED), which in Diagnostics 2020, 10, 589; doi:10.3390/diagnostics10080589 www.mdpi.com/journal/diagnosticsDiagnostics 2020, 10, 589 its strict sense is not correct since DED is a condition that belongs to a group of ocular surface disorders, which includes blepharitis, Meibomian gland dysfunction (MGD), allergic eye diseases and other conditions affecting the ocular surface [1].Many diseases can cause ocular surface disorders

  • While for the posterior segment, OCT has become the gold-standard in the diagnosis and follow-up of many diseases such as age-related macular degeneration [149], diabetic retinopathy [150] and glaucoma [151], imaging techniques for the ocular surface are not well established

  • The techniques introduced in this review represent promising approaches, they are still more cost intensive than clinical standard tests at the slit lamp such as determination of TBUT or corneal fluorescein staining

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Summary

Introduction

The ocular surface consists of the tear film, conjunctiva, cornea, eyelids and lacrimal glands.The term “ocular surface disease (OSD)” is frequently synonymous for dry eye disease (DED), which in Diagnostics 2020, 10, 589; doi:10.3390/diagnostics10080589 www.mdpi.com/journal/diagnosticsDiagnostics 2020, 10, 589 its strict sense is not correct since DED is a condition that belongs to a group of ocular surface disorders, which includes blepharitis, Meibomian gland dysfunction (MGD), allergic eye diseases and other conditions affecting the ocular surface [1].Many diseases can cause ocular surface disorders. The ocular surface consists of the tear film, conjunctiva, cornea, eyelids and lacrimal glands. The term “ocular surface disease (OSD)” is frequently synonymous for dry eye disease (DED), which in Diagnostics 2020, 10, 589; doi:10.3390/diagnostics10080589 www.mdpi.com/journal/diagnostics. Diagnostics 2020, 10, 589 its strict sense is not correct since DED is a condition that belongs to a group of ocular surface disorders, which includes blepharitis, Meibomian gland dysfunction (MGD), allergic eye diseases and other conditions affecting the ocular surface [1]. Many diseases can cause ocular surface disorders. We start this review paper with a summary of the most frequent forms of OSD where imaging may add clinical value in differential diagnosis and follow-up.

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