first_pagesettingsOrder Article Reprints Open AccessArticle Feasibility of Tear Meniscus Height Measurements Obtained with a Smartphone-Attachable Portable Device and Agreement of the Results with Standard Slit Lamp Examination by Massimiliano Borselli 1,†ORCID,Mario Damiano Toro 2,3,†ORCID,Costanza Rossi 1,Andrea Taloni 1,Rohan Khemlani 4,5,Shintato Nakayama 4,6,Hiroki Nishimura 4,6ORCID,Eisuke Shimizu 4,6ORCID,Vincenzo Scorcia 1ORCID andGiuseppe Giannaccare 7,*ORCID 1 Department of Ophthalmology, University Magna Græcia of Catanzaro, 88100 Catanzaro, Italy 2 Department of Ophthalmology, Federico II University Hospital, 80131 Naples, Italy 3 Department of Ophthalmology, Medical University of Lublin, 20-093 Lublin, Poland 4 OUI Inc., Tokyo 160-0022, Japan 5 Yokohama Keiai Eye Clinic, Yokohama 240-0065, Japan 6 Department of Ophthalmology, Keio University School of Medicine, Tokyo 160-0016, Japan 7 Eye Clinic, Department of Surgical Sciences, University of Cagliari, 09124 Cagliari, Italy * Author to whom correspondence should be addressed. † These authors contributed equally to this work. Diagnostics 2024, 14(3), 316; https://doi.org/10.3390/diagnostics14030316 Submission received: 22 December 2023 / Revised: 26 January 2024 / Accepted: 29 January 2024 / Published: 1 February 2024 (This article belongs to the Special Issue Medical Optical Imaging: Current Diagnostics, Therapeutic and Surgical Applications in Ophthalmology—2nd Edition) Downloadkeyboard_arrow_down Browse Figures Versions Notes Abstract Purpose: We aimed to evaluate the feasibility of using a novel device, the Smart Eye Camera (SEC), for assessing tear meniscus height (TMH) after fluorescein staining and the agreement of the results with measurements obtained using standard slit lamp examination. Methods: TMH was assessed using both SEC and conventional slit lamp examination. The images were analyzed using the software ImageJ 1.53t (National Institutes of Health, Bethesda, MD, USA). A common measurement unit scale was established based on a paper strip, which was used as a calibration marker to convert pixels into metric scale. A color threshold was applied using uniform parameters for brightness, saturation, and hue. The images were then binarized to black and white to enhance the representation of the tear menisci. A 2 mm area around the upper and lower meniscus in the central eye lid zone was selected and magnified 3200 times to facilitate manual measurement. The values obtained using SEC were compared with those obtained with a slit lamp. Results: The upper and lower TMH values measured using the SEC were not statistically different from those obtained with a slit lamp (0.209 ± 0.073 mm vs. 0.235 ± 0.085, p = 0.073, and 0.297 ± 0.168 vs. 0.260 ± 0.173, p = 0.275, respectively). The results of Bland–Altman analysis demonstrated strong agreement between the two instruments, with a mean bias of −0.016 mm (agreement limits: −0.117 to 0.145 mm) for upper TMH and 0.031 mm (agreement limits: −0.306 to 0.368 mm) for lower TMH. Conclusions: The SEC demonstrated sufficient validity and reliability for assessing TMH in healthy eyes in a clinical setting, demonstrating concordance with the conventional slit lamp examination.
Feasibility of Tear Meniscus Height Measurements Obtained with a Smartphone-Attachable Portable Device and Agreement of the Results with Standard Slit Lamp Examination
Giannaccare G.
Ultimo
2024-01-01
Abstract
first_pagesettingsOrder Article Reprints Open AccessArticle Feasibility of Tear Meniscus Height Measurements Obtained with a Smartphone-Attachable Portable Device and Agreement of the Results with Standard Slit Lamp Examination by Massimiliano Borselli 1,†ORCID,Mario Damiano Toro 2,3,†ORCID,Costanza Rossi 1,Andrea Taloni 1,Rohan Khemlani 4,5,Shintato Nakayama 4,6,Hiroki Nishimura 4,6ORCID,Eisuke Shimizu 4,6ORCID,Vincenzo Scorcia 1ORCID andGiuseppe Giannaccare 7,*ORCID 1 Department of Ophthalmology, University Magna Græcia of Catanzaro, 88100 Catanzaro, Italy 2 Department of Ophthalmology, Federico II University Hospital, 80131 Naples, Italy 3 Department of Ophthalmology, Medical University of Lublin, 20-093 Lublin, Poland 4 OUI Inc., Tokyo 160-0022, Japan 5 Yokohama Keiai Eye Clinic, Yokohama 240-0065, Japan 6 Department of Ophthalmology, Keio University School of Medicine, Tokyo 160-0016, Japan 7 Eye Clinic, Department of Surgical Sciences, University of Cagliari, 09124 Cagliari, Italy * Author to whom correspondence should be addressed. † These authors contributed equally to this work. Diagnostics 2024, 14(3), 316; https://doi.org/10.3390/diagnostics14030316 Submission received: 22 December 2023 / Revised: 26 January 2024 / Accepted: 29 January 2024 / Published: 1 February 2024 (This article belongs to the Special Issue Medical Optical Imaging: Current Diagnostics, Therapeutic and Surgical Applications in Ophthalmology—2nd Edition) Downloadkeyboard_arrow_down Browse Figures Versions Notes Abstract Purpose: We aimed to evaluate the feasibility of using a novel device, the Smart Eye Camera (SEC), for assessing tear meniscus height (TMH) after fluorescein staining and the agreement of the results with measurements obtained using standard slit lamp examination. Methods: TMH was assessed using both SEC and conventional slit lamp examination. The images were analyzed using the software ImageJ 1.53t (National Institutes of Health, Bethesda, MD, USA). A common measurement unit scale was established based on a paper strip, which was used as a calibration marker to convert pixels into metric scale. A color threshold was applied using uniform parameters for brightness, saturation, and hue. The images were then binarized to black and white to enhance the representation of the tear menisci. A 2 mm area around the upper and lower meniscus in the central eye lid zone was selected and magnified 3200 times to facilitate manual measurement. The values obtained using SEC were compared with those obtained with a slit lamp. Results: The upper and lower TMH values measured using the SEC were not statistically different from those obtained with a slit lamp (0.209 ± 0.073 mm vs. 0.235 ± 0.085, p = 0.073, and 0.297 ± 0.168 vs. 0.260 ± 0.173, p = 0.275, respectively). The results of Bland–Altman analysis demonstrated strong agreement between the two instruments, with a mean bias of −0.016 mm (agreement limits: −0.117 to 0.145 mm) for upper TMH and 0.031 mm (agreement limits: −0.306 to 0.368 mm) for lower TMH. Conclusions: The SEC demonstrated sufficient validity and reliability for assessing TMH in healthy eyes in a clinical setting, demonstrating concordance with the conventional slit lamp examination.
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