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

• Published in: BMJ open ophthalmology 2024-04, Vol.9 (1), p.e001266
• Main Authors: Anissa, Gisela Haza, La Distia Nora, Rina, Widyawati, Syska, Sitompul, Ratna, Yusuf, Prasandhya Astagiri, Kekalih, Aria
• Format: Article
• Language: English
• Subjects: Agreements; Blood vessels; Cornea and Ocular Surface; Cross-Sectional Studies; Diagnostic tests/Investigation; Humans; Imaging; Meibomian Gland Dysfunction; Meibomian Glands - diagnostic imaging; Morphology; Ocular surface; Reproducibility of Results; Smartphone; Smartphones; Validity
• ISSN: 2397-3269; 2397-3269
• DOI: 10.1136/bmjophth-2023-001266

ObjectiveThe 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 analysisAn 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.ResultsThere 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.ConclusionValidity 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.