Syringing has limited reliability in differentiating nasolacrimal duct stenosis from functional delay.
Dacryocystography
Dacryoscintigraphy
Delay
Epiphora
Functional
Irrigation
Lacrimal scintigraphy
Lacrimal syringing
Nasolacrimal duct
Stenosis
Journal
Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie
ISSN: 1435-702X
Titre abrégé: Graefes Arch Clin Exp Ophthalmol
Pays: Germany
ID NLM: 8205248
Informations de publication
Date de publication:
Sep 2022
Sep 2022
Historique:
received:
14
10
2021
accepted:
31
03
2022
revised:
14
01
2022
pubmed:
24
4
2022
medline:
31
8
2022
entrez:
23
4
2022
Statut:
ppublish
Résumé
To elucidate the role of syringing in assessing nasolacrimal duct (NLD) stenosis and non-anatomical functional NLD delay. Consecutive adult patients with epiphora attending a tertiary lacrimal clinic from June 2011 to March 2021 were reviewed. Cases with evidence of canalicular stenosis or other identifiable causes of epiphora were excluded. Following syringing, patients were investigated with dacryocystography (DCG) and dacryoscintigraphy (DSG). The sensitivity and specificity of syringing were evaluated using the combined findings on DCG and DSG. A total of 289 symptomatic lacrimal systems (197 patients; mean age 65.5 ± 14.9 years, 66% females) were included. More than one-third of cases with both normal DCG and DSG were noted to have some degree of reflux on syringing (specificity = 65.1%, 95% CI 50.2-77.6%). The sensitivities were considerably low for NLD stenosis (i.e., stenosis on DCG and delay on DSG) and for functional NLD delay (i.e., normal DCG and delay on DSG), of which 43.7% (95% CI 32.2-55.9%) and 54.3% (95% CI 45.7-62.7%) had full patency on syringing, respectively (p = 0.17). Full patency on syringing was unreliable for ruling out NLD stenosis and functional delay. Furthermore, a positive syringing may be associated with functional NLD delay and cannot reliably differentiate it from stenosis.
Identifiants
pubmed: 35460361
doi: 10.1007/s00417-022-05654-1
pii: 10.1007/s00417-022-05654-1
pmc: PMC9418293
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
3037-3042Informations de copyright
© 2022. The Author(s).
Références
Cuthbertson FM, Webber S (2004) Assessment of functional nasolacrimal duct obstruction - a survey of ophthalmologists in the southwest. Eye 18:20–23. https://doi.org/10.1038/sj.eye.6700522
doi: 10.1038/sj.eye.6700522
pubmed: 14707959
Conway ST (1994) Evaluation and management of “functional” nasolacrimal blockage: results of a survey of the american society of ophthalmic plastic and reconstructive surgery. Ophthal Plast Reconstr Surg 10:185–187. https://doi.org/10.1097/00002341-199409000-00006
doi: 10.1097/00002341-199409000-00006
pubmed: 7947445
Irfan S, Cassels-Brown A, Nelson M (1998) Comparison between nasolacrimal syringing/probing, macrodacryocystography and surgical findings in the management of epiphora. Eye 12:197–202. https://doi.org/10.1038/eye.1998.47
doi: 10.1038/eye.1998.47
pubmed: 9683937
Peter NM, Pearson AR (2009) Comparison of dacryocystography and lacrimal scintigraphy in the investigation of epiphora in patients with patent but nonfunctioning lacrimal systems. Ophthal Plast Reconstr Surg 25:201–205. https://doi.org/10.1097/IOP.0b013e3181a2ef32
doi: 10.1097/IOP.0b013e3181a2ef32
pubmed: 19454931
Kim S, Yang S, Park J et al (2020) Correlation between lacrimal syringing test and dacryoscintigraphy in patients with epiphora. J Craniofac Surg 31:e442–e445. https://doi.org/10.1097/SCS.0000000000006389
doi: 10.1097/SCS.0000000000006389
pubmed: 32282674
Nixon J, Birchall IWJ, Virjee J (1990) The role of dacryocystography in the management of patients with epiphora. Br J Radiol 63:337–339. https://doi.org/10.1259/0007-1285-63-749-337
doi: 10.1259/0007-1285-63-749-337
pubmed: 2379059
Chan W, Malhotra R, Kakizaki H et al (2012) Perspective: what does the term functional mean in the context of epiphora? Clin Exp Ophthalmol 40:749–754. https://doi.org/10.1111/j.1442-9071.2012.02791.x
doi: 10.1111/j.1442-9071.2012.02791.x
pubmed: 22429759
Hurwitz JJ, Victor WH (1985) The role of sophisticated radiological testing in the assessment and management of epiphora. Ophthalmology 92:407–413. https://doi.org/10.1016/S0161-6420(85)34032-0
doi: 10.1016/S0161-6420(85)34032-0
pubmed: 3887266
Rose JDG, Clayton CB (1985) Scintigraphy and contrast radiography for epiphora. Br J Radiol 58:1183–1186. https://doi.org/10.1259/0007-1285-58-696-1183
doi: 10.1259/0007-1285-58-696-1183
pubmed: 3842629
Nagi KS, Meyer DR (2010) Utilization patterns for diagnostic imaging in the evaluation of epiphora due to lacrimal obstruction: a national survey. Ophthal Plast Reconstr Surg 26:168–171. https://doi.org/10.1097/IOP.0b013e3181b8c747
doi: 10.1097/IOP.0b013e3181b8c747
pubmed: 20489540
Sia PI, Curragh D, Howell S, Selva D (2019) Interobserver agreement on interpretation of conventional dacryocystography and dacryoscintigraphy findings: a retrospective single-centre study. Clin Exp Ophthalmol 47:713–717. https://doi.org/10.1111/ceo.13502
doi: 10.1111/ceo.13502
pubmed: 30866143
Vonica OA, Obi E, Sipkova Z et al (2017) The value of lacrimal scintillography in the assessment of patients with epiphora. Eye 31:1020–1026. https://doi.org/10.1038/eye.2017.20
doi: 10.1038/eye.2017.20
pubmed: 28257135
pmcid: 5519266
Kashkouli MB, Kempster RC, Galloway GD, Beigi B (2005) Monocanalicular versus bicanalicular silicone intubation for nasolacrimal duct stenosis in adults. Ophthalmic Plast Reconstr Surg 21:142–147. https://doi.org/10.1097/01.IOP.0000155524.04390.7B
doi: 10.1097/01.IOP.0000155524.04390.7B
pubmed: 15778670
Moscato EE, Dolmetsch AM, Silkiss RZ, Seiff SR (2012) Silicone intubation for the treatment of epiphora in adults with presumed functional nasolacrimal duct obstruction. Ophthalmic Plast Reconstr Surg 28:35–39. https://doi.org/10.1097/IOP.0b013e318230b110
doi: 10.1097/IOP.0b013e318230b110
pubmed: 22262288
Wearne MJ, Pitts J, Frank J, Rose GE (1999) Comparison of dacryocystography and lacrimal scintigraphy in the diagnosis of functional nasolacrimal duct obstruction. Br J Ophthalmol 83:1032–1035. https://doi.org/10.1136/bjo.83.9.1032
doi: 10.1136/bjo.83.9.1032
pubmed: 10460770
pmcid: 1723188
Sahlin S, Rose GE (2001) Lacrimal drainage capacity and symptomatic improvement after dacryocystorhinostomy in adults presenting with patent lacrimal drainage systems. Orbit 20:173–179. https://doi.org/10.1076/orbi.20.3.173.2622
doi: 10.1076/orbi.20.3.173.2622
pubmed: 12045909
Cheung LM, Francis IC, Stapleton F, Wilcsek G (2007) Symptom assessment in patients with functional and primary acquired nasolacrimal duct obstruction before and after successful dacryocystorhinostomy surgery: a prospective study. Br J Ophthalmol 91:1671–1674. https://doi.org/10.1136/bjo.2007.119834
doi: 10.1136/bjo.2007.119834
pubmed: 17584998
pmcid: 2095493
Jones LT, Linn ML (1969) The diagnosis of the causes of epiphora. Am J Ophthalmol 67:751–754. https://doi.org/10.1016/S0002-9394(69)91002-2
doi: 10.1016/S0002-9394(69)91002-2
Guzek JP, Ching AS, Hoang TA et al (1997) Clinical and radiologic lacrimal testing in patients with epiphora. Ophthalmology 104:1875–1881. https://doi.org/10.1016/S0161-6420(97)30013-X
doi: 10.1016/S0161-6420(97)30013-X
pubmed: 9373120
Sagili S, Selva D, Malhotra R (2012) Lacrimal scintigraphy: “interpretation more art than science.” Orbit 31:77–85
doi: 10.3109/01676830.2011.648797
Hurwitz JJ (1978) Investigation and treatment of epiphora due to lid laxity. Trans Ophthalmol Soc U K 98:69–70
pubmed: 285514
Sasaki T, Nagata Y, Sugiyama K (2005) Nasolacrimal duct obstruction classified by dacryoendoscopy and treated with inferior meatal dacryorhinotomy. Part I: Positional Diagnosis of Primary Nasolacrimal Duct Obstruction With Dacryoendoscope. Am J Ophthalmol 140:1065-1069.e1. https://doi.org/10.1016/j.ajo.2005.07.038
doi: 10.1016/j.ajo.2005.07.038
pubmed: 16376652
Bae SH, Park J, Lee JK (2021) Comparison of digital subtraction dacryocystography and dacryoendoscopy in patients with epiphora. Eye 35:877–882. https://doi.org/10.1038/s41433-020-0990-1
doi: 10.1038/s41433-020-0990-1
pubmed: 32467631