Effect of Lid-Wiper Epitheliopathy on the Corneal Epithelial Thickness Distribution: A Novel Semiautomatic Quantitative Method

Abstract Purpose To explore a novel semi-automatic quantitative method for detecting lid-wiper epitheliopathy (LWE) and analyze its impact on the distribution of corneal epithelial thickness (CET). Methods A total of 36 eyes from 36 adults were included in this study. The lid wipers were stained with lissamine green strips, and the stained areas were recorded using a digital slit-lamp biomicroscopy and analyzed using ImageJ software. Factors such as age, sex, and refraction were included as variables that influenced LWE. The CET was divided into 25 regions and recorded using spectral-domain optical coherence tomography. Results Methodological consistency and repeatability were verified through intra- and inter-operator intraclass correlation coefficients (ICCs), with values of 0.889 and 0.922, respectively. After adjusting for age, sex, and spherical equivalent refraction (SER), a negative correlation was observed between LWE and epithelial thickness. Specifically, negative correlations were observed in the nasal, subnasal, and inferior regions within the 2–5 mm range; subnasal and infratemporal regions within the 5–7 mm range; and the infratemporal region within the 7–9 mm range. Conclusion This study validated a novel method for assessing the severity of LWE by quantitatively analyzing the LWE area. Additionally, LWE is associated with thinning of the inferior corneal epithelium.