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Lacrimal scintigraphy: "interpretation more art than science"
Suresh Sagili1, Dinesh Selva, Raman Malhotra
1Corneoplastic Unit, Queen Victoria Hospital, East Grinstead, West Sussex, United Kingdom.
Orbit (Amsterdam, Netherlands)
|April 12, 2012
Summary
Lacrimal scintigraphy (LS) detects tear drainage abnormalities in many patients with epiphora. However, LS may not precisely locate blockages and its ability to differentiate nasolacrimal duct (NLD) stenosis from pump failure needs further study.
Area of Science:
- Ophthalmology
- Nuclear Medicine
Background:
- Epiphora, or excessive tearing, affects many patients with patent lacrimal systems.
- Lacrimal scintigraphy (LS) is frequently used to evaluate tear drainage abnormalities.
Purpose of the Study:
- To assess the utility and limitations of lacrimal scintigraphy (LS) in diagnosing epiphora.
- To explore LS's effectiveness in differentiating nasolacrimal duct (NLD) stenosis from lacrimal pump failure.
Main Methods:
- Review of literature on lacrimal scintigraphy (LS) techniques, data, and interpretation.
- Analysis of qualitative versus quantitative LS methods for diagnosing tear drainage issues.
Main Results:
- LS identifies abnormalities in 80%-95% of symptomatic epiphora patients and up to 40% of asymptomatic individuals.
- LS lacks precise anatomic detail for localizing blockages and its ability to distinguish NLD stenosis from pump failure is uncertain.
- LS provides limited additional information in cases of complete NLD obstruction or severe stenosis.
Conclusions:
- Lacrimal scintigraphy (LS) is valuable for detecting tear drainage delays but has limitations in precise localization and differentiating specific pathologies.
- Variations in LS methodology and interpretation complicate its widespread application and reliability.
