Login Register Cart 0
Generic placeholder image

Current Medical Imaging

Editor-in-Chief

ISSN (Print): 1573-4056
ISSN (Online): 1875-6603

Back
Journal Home About Journal Editorial Board Journal Insight Current Issue Volumes/Issues
Subscribe
Research Article

Evaluation of Main Lacrimal Gland through Shear-wave Ultrasound Elastography in Patients with Low Schirmer Value

Author(s): Hakan Yılmaz and İrfan Botan Güneş*

Volume 20, 2024

Published on: 07 July, 2023

Article ID: e080623217778 Pages: 6

DOI: 10.2174/1573405620666230608091854

open_access

Open Access Journals Promotions 2
conference banner
Abstract

Objective: To compare main lacrimal gland values through shear-wave elastography (SWE) in patients with low Schirmer value and unspecified Sjögren's syndrome (SS) with healthy controls.

Materials and Methods: Admitted to the ophthalmology department with Schirmer value <10 mm, randomly selected 46 eyes of 46 patients evaluated for Sjögren's syndrome (SS) in the rheumatology department between December 2022 and April 2023 were classified as low Schirmer group (LSG). Randomly selected 48 eyes of 48 patients at a similar age with Schirmer value >10 mm were included as controls. Main lacrimal gland SWE measurements in LSG and control groups were recorded and compared as meter/second (m/sec).

Results: Mean SWE values of the main lacrimal gland were measured as 2.78 ± 0.66 m/sec and 2.26 ± 0.29 m/sec in LSG and controls. SWE measurements were significantly higher in LSG patients than in controls (p<0.001). No significant correlation was found in the analysis between the Schirmer and the main lacrimal gland SWE values in LSG patients (p=0.702, r=0.058). No significant correlation was also detected between the Schirmer and main lacrimal gland SWE values in controls (p=0.097, r=0.242). No significant relationship was also found between age, gender, body mass index (BMI), and SWE values (p=0.351, p=0.493, p=0.328, respectively).

Conclusion: Mean SWE value of the main lacrimal gland was determined as significantly higher in patients with aqueous lacrimal insufficiency without SS than in controls. We consider that SWE measurements may be an imaging method to support the diagnosis of aqueous lacrimal insufficiency and used in follow-ups of those with dry eye syndrome (DES) in the future.

Keywords: Dry eye syndromes, Elastography, Lacrimal gland, Medical imaging, Schirmer test, Ultrasonography.

[1]
Masoudi S. Biochemistry of human tear film: A review. Exp Eye Res 2022; 220: 109101.
[http://dx.doi.org/10.1016/j.exer.2022.109101]
[2]
Koh S, Tung CI, Inoue Y, Jhanji V. Effects of tear film dynamics on quality of vision. Br J Ophthalmol 2018; 102(12): 1615-20.
[http://dx.doi.org/10.1136/bjophthalmol-2018-312333]
[3]
Stevens S. Schirmer’s test. Community Eye Health 2011; 24(76): 45.
[4]
Clinch TE, Benedetto DA, Felberg NT, Laibson PR. Schirmer’s Test. Arch Ophthalmol 1983; 101(9): 1383-6.
[http://dx.doi.org/10.1001/archopht.1983.01040020385009]
[5]
Hughes GK, Miszkiel KA. Imaging of the lacrimal gland. Semin Ultrasound CT MR 2006; 27(6): 476-91.
[http://dx.doi.org/10.1053/j.sult.2006.09.002]
[6]
Giovagnorio F, Pace F, Giorgi A. Sonography of lacrimal glands in Sjögren syndrome. J Ultrasound Med 2000; 19(8): 505-9.
[http://dx.doi.org/10.7863/jum.2000.19.8.505]
[7]
Seceleanu A, Pop S, Preda D, Szabo I, Rogojan L, Seceleanu R. Imaging aspects of the lacrimal gland in Sjögren syndrome - case report. Oftalmologia 2008; 52(4): 35-9.
[8]
Ferraioli G, Barr RG, Farrokh A, et al. How to perform shear wave elastography. Part I. Med Ultrason 2022; 24(1): 95-106.
[http://dx.doi.org/10.11152/mu-3217]
[9]
Badea I, Tamas-Szora A, Chiorean I, et al. Acoustic Radiation Force Impulse quantitative elastography: A new noninvasive technique for the evaluation of parotid glands. A preliminary study in controls and in patients with irradiated nasopharyngeal carcinoma. Med Ultrason 2015; 17(3): 308-14.
[http://dx.doi.org/10.11152/mu.2013.2066.173.iub]
[10]
Zemanova M. Shear wave elastography in ophthalmic diagnosis. J Fr Ophtalmol 2019; 42(1): 73-80.
[http://dx.doi.org/10.1016/j.jfo.2018.05.006]
[11]
Świecka M, Paluch Ł, Pietruski P, Maślińska M, Zakrzewski J, Kwiatkowska B. Applicability of shear wave elastography for lacrimal gland evaluation in primary Sjögren syndrome. Pol Arch Intern Med 2023; 133(2)16397
[http://dx.doi.org/10.20452/pamw.16397]
[12]
Corominas H, de Agustín J. Ultrasound and elastography in Sjögren’s syndrome. Med Clin 2020; 155(6): 254-5.
[http://dx.doi.org/10.1016/j.medcli.2020.04.021]
[13]
Chia EM, Mitchell P, Rochtchina E, Lee AJ, Maroun R, Wang JJ. Prevalence and associations of dry eye syndrome in an older population: The blue mountains eye study. Clin Exp Ophthalmol 2003; 31(3): 229-32.
[http://dx.doi.org/10.1046/j.1442-9071.2003.00634.x]
[14]
Schaumberg DA, Sullivan DA, Buring JE, Dana MR. Prevalence of dry eye syndrome among US women. Am J Ophthalmol 2003; 136(2): 318-26.
[http://dx.doi.org/10.1016/S0002-9394(03)00218-6]
[15]
Messmer EM. The pathophysiology, diagnosis, and treatment of dry eye disease. Dtsch Arztebl Int 2015; 112(5): 71-82.
[http://dx.doi.org/10.3238/arztebl.2015.0071]
[16]
Lemp MA, Crews LA, Bron AJ, Foulks GN, Sullivan BD. Distribution of aqueous-deficient and evaporative dry eye in a clinic-based patient cohort: A retrospective study. Cornea 2012; 31(5): 472-8.
[http://dx.doi.org/10.1097/ICO.0b013e318225415a]
[17]
The definition and classification of dry eye disease: Report of the Definition and Classification Subcommittee of the International Dry Eye Workshop. Ocul Surf 2007; 5(2): 75-92.
[http://dx.doi.org/10.1016/S1542-0124(12)70081-2]
[18]
Tong L, Chaurasia SS, Mehta JS, Beuerman RW. Screening for meibomian gland disease: Its relation to dry eye subtypes and symptoms in a tertiary referral clinic in Singapore. Invest Ophthalmol Vis Sci 2010; 51(7): 3449-54.
[http://dx.doi.org/10.1167/iovs.09-4445]
[19]
Jacobi C, Cursiefen C. Ophthalmological complications in Sjögren's syndrome. Z Rheumatol 2010; 69(1): 32-40.
[http://dx.doi.org/10.1007/s00393-009-0517-4]
[20]
Doctor MB, Basu S. Lacrimal gland insufficiency in aqueous deficiency dry eye disease: Recent advances in pathogenesis, diagnosis, and treatment. Semin Ophthalmol 2022; 37(7-8): 801-12.
[http://dx.doi.org/10.1080/08820538.2022.2075706]
[21]
Singh S, Shanbhag SS, Basu S. Palpebral lobe of the human lacrimal gland: Morphometric analysis in normal versus dry eyes. Br J Ophthalmol 2021; 105(10): 1352-7.
[http://dx.doi.org/10.1136/bjophthalmol-2020-316929]
[22]
Badarinza M, Serban O, Maghear L, et al. Multimodal ultrasound investigation (grey scale, Doppler and 2D-SWE) of salivary and lacrimal glands in healthy people and patients with diabetes mellitus and/or obesity, with or without sialosis. Med Ultrason 2019; 21(3): 257-64.
[http://dx.doi.org/10.11152/mu-2164]
[23]
Świecka M, Maślińska M, Paluch Ł, Zakrzewski J, Kwiatkowska B. Imaging methods in primary Sjögren’s syndrome as potential tools of disease diagnostics and monitoring. Reumatologia 2019; 57(6): 336-42.
[http://dx.doi.org/10.5114/reum.2019.91273]
[24]
Wang X, Wang A, Zhan X, Xu L, Chang X, Dong F. Value of conventional ultrasound and shear wave elastography in assessing disease activity and prognosis in female patients with Sjögren’s syndrome. Clin Exp Rheumatol 2022; 40(12): 2350-6.
[http://dx.doi.org/10.55563/clinexprheumatol/20028h]
[25]
Stern ME, Schaumburg CS, Pflugfelder SC. Dry eye as a mucosal autoimmune disease. Int Rev Immunol 2013; 32(1): 19-41.
[http://dx.doi.org/10.3109/08830185.2012.748052]
[26]
Stevenson W, Chauhan SK, Dana R. Dry eye disease: An immune-mediated ocular surface disorder. Arch Ophthalmol 2012; 130(1): 90-100.
[http://dx.doi.org/10.1001/archophthalmol.2011.364]
[27]
Goyal S, Chauhan SK, El Annan J, Nallasamy N, Zhang Q, Dana R. Evidence of corneal lymphangiogenesis in dry eye disease: A potential link to adaptive immunity? Arch Ophthalmol 2010; 128(7): 819-24.
[http://dx.doi.org/10.1001/archophthalmol.2010.124]
[28]
Kimura-Hayama E, Criales-Vera S, Azpeitia-Espinosa L, et al. Elastographic ultrasound: An additional image tool in Sjögren’s syndrome. Int J Rheum Dis 2018; 21(6): 1293-300.
[http://dx.doi.org/10.1111/1756-185X.13292]

Rights & Permissions Print Cite
Article Metrics
28
1
Wayfinder Image
Open Access Journals Promotions
© 2024 Bentham Science Publishers | Privacy Policy