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Gulias-Cañizo R, Rodríguez-Malagón ME, Botello-González L, Belden-Reyes V, Amparo F, Garza-Leon M. Applications of Infrared Thermography in Ophthalmology. Life (Basel) 2023; 13:life13030723. [PMID: 36983878 PMCID: PMC10053626 DOI: 10.3390/life13030723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 02/13/2023] [Accepted: 02/24/2023] [Indexed: 03/10/2023] Open
Abstract
Body temperature is one of the key vital signs for determining a disease’s severity, as it reflects the thermal energy generated by an individual’s metabolism. Since the first study on the relationship between body temperature and diseases by Carl Reinhold August Wunderlich at the end of the 19th century, various forms of thermometers have been developed to measure body temperature. Traditionally, methods for measuring temperature can be invasive, semi-invasive, and non-invasive. In recent years, great technological advances have reduced the cost of thermographic cameras, which allowed extending their use. Thermal cameras capture the infrared radiation of the electromagnetic spectrum and process the images to represent the temperature of the object under study through a range of colors, where each color and its hue indicate a previously established temperature. Currently, cameras have a sensitivity that allows them to detect changes in temperature as small as 0.01 °C. Along with its use in other areas of medicine, thermography has been used at the ocular level for more than 50 years. In healthy subjects, the literature reports that the average corneal temperature ranges from 32.9 to 36 °C. One of the possible sources of variability in normal values is age, and other possible sources of variation are gender and external temperature. In addition to the evaluation of healthy subjects, thermography has been used to evaluate its usefulness in various eye diseases, such as Graves’ orbitopathy, and tear duct obstruction for orbital diseases. The ocular surface is the most studied area. Ocular surface temperature is influenced by multiple conditions, one of the most studied being dry eye; other diseases studied include allergic conjunctivitis and pterygium as well as systemic diseases such as carotid artery stenosis. Among the corneal diseases studied are keratoconus, infectious keratitis, corneal graft rejection, the use of scleral or soft contact lenses, and the response to refractive or cataract surgery. Other diseases where thermographic features have been reported are glaucoma, diabetic retinopathy, age-related macular degeneration, retinal vascular occlusions, intraocular tumors as well as scleritis, and other inflammatory eye diseases.
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Affiliation(s)
- Rosario Gulias-Cañizo
- Centro de Investigación en Ciencias de la Salud, Universidad Anahuac México, Naucalpan de Juárez 52786, Mexico
| | - Maria Elisa Rodríguez-Malagón
- Division of Health Sciences, Department of Clinical Sciences, University of Monterrey, San Pedro Gaza García 66238, Mexico
| | - Loubette Botello-González
- Division of Health Sciences, Department of Clinical Sciences, University of Monterrey, San Pedro Gaza García 66238, Mexico
| | - Valeria Belden-Reyes
- Division of Health Sciences, Department of Clinical Sciences, University of Monterrey, San Pedro Gaza García 66238, Mexico
| | - Francisco Amparo
- Division of Health Sciences, Department of Clinical Sciences, University of Monterrey, San Pedro Gaza García 66238, Mexico
| | - Manuel Garza-Leon
- Division of Health Sciences, Department of Clinical Sciences, University of Monterrey, San Pedro Gaza García 66238, Mexico
- Correspondence:
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Németh O, Langenbucher A, Eppig T, Lepper S, Milioti G, Abdin A, Nagy ZZ, Seitz B, Szentmáry N. Correlation between Corneal Endothelial Cell Density and Central Ocular Surface Temperature in Normal and Keratoconus Eyes. Curr Eye Res 2020; 46:445-451. [PMID: 32847408 DOI: 10.1080/02713683.2020.1812087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
PURPOSE In keratoconus (KC), an increase of the corneal back surface area may result in endothelial cell density (ECD) decrease and an increase of the corneal front surface area in ocular surface temperature (OST) decrease due to increased heat dissipation. Along with these hypotheses, we aimed to analyse the correlation between ECD and central corneal OST in patients with KC and healthy controls. PATIENTS AND METHODS A total of 154 eyes with KC (mean age 36.1 ± 12.5 years) and 92 healthy eyes (mean age 36.4 ± 12.8 years) were examined. Corneal front and back surface area at the central 5 mm corneal diameter (FSA and BSA) were calculated based on Pentacam measurement data:FSA or BSA = 2×3.14×R(R-√R2-D/2)2,where R referred to corneal front or back surface radius of curvature and D to the corneal front or back surface diameter (5 mm for the present study), respectively.ECD was determined by specular microscopy (EM-3000) and central corneal OST by thermography (TG-1000). RESULTS ECD was significantly lower in KC (2498 ± 356/mm2) patients than in controls (2638 ± 294/mm2; p < .001). FSA (20.35 ± 0.26 mm2 vs. 20.17 ± 0.03 mm2) and BSA (20.84 ± 0.58 mm2 vs. 20.45 ± 0.08 mm2) were significantly higher in KC patients than in controls (p = .001; p < .001), but the average central corneal OST did not differ significantly between both groups (34.2 ± 0.6°C vs.34.3 ± 0.7°C; p = .62). OST at the corneal centre correlated weakly, positively with ECD (r = 0.2; p < .05), but OST did not correlate with FSA (r = 0.045) or BSA (r = 0.064). CONCLUSIONS Endothelial cell density seems to have a mild impact on central ocular surface temperature in keratoconus and normal subjects. This effect is not correlated to the corneal front or back surface area.
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Affiliation(s)
- Orsolya Németh
- Rolf M. Schwiete Center for Limbal Stem Cell and Congenital Aniridia Research, Homburg/Saar, Germany.,Department of Ophthalmology, Markusovszky University Teaching Hospital, Szombathely, Hungary.,Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | | | - Timo Eppig
- Experimental Ophthalmology, Saarland University, Homburg/Saar, Germany
| | - Sabine Lepper
- Department of Ophthalmology, Saarland University Medical Center, Homburg/Saar, Germany
| | - Georgia Milioti
- Department of Ophthalmology, Saarland University Medical Center, Homburg/Saar, Germany
| | - Aladin Abdin
- Department of Ophthalmology, Saarland University Medical Center, Homburg/Saar, Germany
| | - Zoltán Zsolt Nagy
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - Berthold Seitz
- Department of Ophthalmology, Saarland University Medical Center, Homburg/Saar, Germany
| | - Nóra Szentmáry
- Rolf M. Schwiete Center for Limbal Stem Cell and Congenital Aniridia Research, Homburg/Saar, Germany.,Department of Ophthalmology, Semmelweis University, Budapest, Hungary
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Ocular Surface Disease Index and Ocular Thermography in Keratoconus Patients. J Ophthalmol 2020; 2020:1571283. [PMID: 32190382 PMCID: PMC7063878 DOI: 10.1155/2020/1571283] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Revised: 01/04/2020] [Accepted: 02/04/2020] [Indexed: 11/17/2022] Open
Abstract
Purpose Keratoconus (KC) has been defined as a “noninflammatory” corneal disease, but recent studies have noted a potential inflammatory origin. We analysed the Ocular Surface Disease Index (OSDI) and ocular surface temperature (OST) in KC patients compared to controls. Patients and Methods. A total of 179 eyes in 90 patients with KC (topographic keratoconus classification 0-1 to 4, age 36.1 ± 12.5 years, 65.9% males) and 82 eyes in 41 controls (age 36.4 ± 12.8 years, 47.6% males) were examined. The participants completed the OSDI questionnaire and underwent corneal topography, tomography, and thermography. Additional outcome measures were vision- and discomfort-related OSDI subscores and mean OST at the corneal centre during 10 seconds of sustained eye opening after blinking. Results The OSDI score (31.4 ± 22.4 vs. 17.5 ± 17.9) and vision- (17.7 ± 14.6 vs. 10.5 ± 13.2) and discomfort-related (14.3 ± 10.7 vs. 9.4 ± 10.5) OSDI subscores were significantly higher in KC patients than in controls (p < 0.001). We found no significant difference in the central corneal OST (34.2 ± 0.6°C vs. 34.2 ± 0.7°C; p < 0.001). We found no significant difference in the central corneal OST (34.2 ± 0.6°C vs. 34.2 ± 0.7°C; p < 0.001). We found no significant difference in the central corneal OST (34.2 ± 0.6°C vs. 34.2 ± 0.7°C; r > 0.174, p < 0.001). We found no significant difference in the central corneal OST (34.2 ± 0.6°C vs. 34.2 ± 0.7°C; r > 0.174, r > 0.174, Conclusion KC patients had increased OSDI scores and vision- and discomfort-related OSDI subscores without an increase in the OST compared to a normal population. OSDI score/subscores weakly correlate with SAI and SRI but do not correlate with OST in KC patients or controls. Vision- and discomfort-related symptoms of KC have to be managed in parallel in ophthalmological practice, but the necessity of anti-inflammatory treatment cannot be verified through ocular thermography.
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Konieczka K, Schoetzau A, Koch S, Hauenstein D, Flammer J. Cornea Thermography: Optimal Evaluation of the Outcome and the Resulting Reproducibility. Transl Vis Sci Technol 2018; 7:14. [PMID: 29888112 PMCID: PMC5991773 DOI: 10.1167/tvst.7.3.14] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 04/05/2018] [Indexed: 11/24/2022] Open
Abstract
Purpose The aim of the study was to establish a standardized quantitative evaluation of corneal temperature (CT) that includes anchoring reference points in the topography and minimization of artifacts. We further investigated the distribution and the short- and long-term reproducibility of the CT values, as well as the influence of the core temperatures. Methods The CT values in both eyes of 40 healthy subjects were measured through thermography. These examinations took place over the course of four visits within 2 consecutive weeks. At each visit, the CTs were measured twice in both eyes with intervals of 15 minutes between measurements. Results CT values were not significantly different between the right and left eyes and their distribution was nearly normal. The CTs increased slightly when measured twice over the 15-minute intervals (short-term reproducibility) but remained stable over a period of 2 weeks (long-term reproducibility). In addition, the CT values depended on the core temperatures. Conclusions Ocular surface thermography is a fast and noninvasive examination. The methods of optimized and standardized evaluation of the CT values facilitate comparisons and follow-ups. Translational Relevance Thermography can be used clinically and scientifically only if both the measurement and its evaluation are efficient and standardized and if the outcomes are highly reproducible.
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Affiliation(s)
- Katarzyna Konieczka
- University of Basel, Department of Ophthalmology, Mittlere Strasse 91, CH-4031 Basel, Switzerland
| | - Andreas Schoetzau
- University of Basel, Department of Ophthalmology, Mittlere Strasse 91, CH-4031 Basel, Switzerland
| | - Simone Koch
- University of Basel, Department of Ophthalmology, Mittlere Strasse 91, CH-4031 Basel, Switzerland
| | - Daniela Hauenstein
- University of Basel, Department of Ophthalmology, Mittlere Strasse 91, CH-4031 Basel, Switzerland
| | - Josef Flammer
- University of Basel, Department of Ophthalmology, Mittlere Strasse 91, CH-4031 Basel, Switzerland
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Abstract
Pain associated with mechanical, chemical, and thermal heat stimulation of the ocular surface is mediated by trigeminal ganglion neurons, while cold thermoreceptors detect wetness and reflexly maintain basal tear production and blinking rate. These neurons project into two regions of the trigeminal brain stem nuclear complex: ViVc, activated by changes in the moisture of the ocular surface and VcC1, mediating sensory-discriminative aspects of ocular pain and reflex blinking. ViVc ocular neurons project to brain regions that control lacrimation and spontaneous blinking and to the sensory thalamus. Secretion of the main lacrimal gland is regulated dominantly by autonomic parasympathetic nerves, reflexly activated by eye surface sensory nerves. These also evoke goblet cell secretion through unidentified efferent fibers. Neural pathways involved in the regulation of meibomian gland secretion or mucin release have not been identified. In dry eye disease, reduced tear secretion leads to inflammation and peripheral nerve damage. Inflammation causes sensitization of polymodal and mechano-nociceptor nerve endings and an abnormal increase in cold thermoreceptor activity, altogether evoking dryness sensations and pain. Long-term inflammation and nerve injury alter gene expression of ion channels and receptors at terminals and cell bodies of trigeminal ganglion and brainstem neurons, changing their excitability, connectivity and impulse firing. Perpetuation of molecular, structural and functional disturbances in ocular sensory pathways ultimately leads to dysestesias and neuropathic pain referred to the eye surface. Pain can be assessed with a variety of questionaires while the status of corneal nerves is evaluated with esthesiometry and with in vivo confocal microscopy.
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Static and Dynamic Measurement of Ocular Surface Temperature in Dry Eyes. J Ophthalmol 2016; 2016:7285132. [PMID: 27433352 PMCID: PMC4940548 DOI: 10.1155/2016/7285132] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Revised: 06/07/2016] [Accepted: 06/08/2016] [Indexed: 11/17/2022] Open
Abstract
Purpose. To study ocular surface temperature (OST) in dry eyes by static and dynamic measures. Methods. OST was recorded on 62 dry eyes and 63 age- and sex-matched controls. Static measures were study of absolute OST at t = 0, 5, and 10 s after eye opening. Dynamic measures were study of mean change and net change in OST over 10 s of sustained eye opening. Ten OST indices studied were temperatures of the geometric center of the cornea (GCC), extreme temporal (T1) and nasal conjunctiva (T4), midtemporal (CT) and nasal conjunctiva (CN), temporal (LT) and nasal (LN) limbus, and mean (MOST), maximum (Max T), and minimum (Min T) temperatures of the region of interest. Results. For static measures, dry eyes recorded significantly lower GCC, MOST, Min T, Max T, T4, CT, LT, LN, and CN. For dynamic measures, dry eyes had significantly steeper regression line of mean change (corresponding to greater net change) for Max T 5 s onward and T4 at 3 s onward. Conclusions. Both static and dynamic measures of the OST were valuable and can be used as clinical tool to assess dry eye.
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