Korean J Ophthalmol.  2015 Feb;29(1):1-6. 10.3341/kjo.2015.29.1.1.

Dacryoscintigraphic Findings in the Children with Tearing

• Kim HC
• Cho AR
• Lew H

• KMID: 2360131
• DOI: http://doi.org/10.3341/kjo.2015.29.1.1

Abstract

PURPOSE
To investigate the diagnostic effectiveness of dacryoscintigraphy in children with tearing; to evaluate tear clearance rate as a diagnostic factor of dacryoscintigraphy in children with tearing; and to analyze the results of treatment according to dacryoscintigraphic findings in children with tearing.
METHODS
Between January 2010 and April 2014, 176 eyes of 88 children with tearing (49 boys and 39 girls; mean age, 23.81 ±14.67 months; range, 12 to 72 months) were studied retrospectively. Of these, 37 of 88 children with tearing were bilateral cases, and 51 were unilateral cases. None of the patients had a history of craniofacial disorder or trauma. The chief complaint of tearing with or without eye discharge and delivery mode, past history of neonatal conjunctivitis, syringing, or probing were collected from parents, grandparents, or previous hospital data. The drainage pattern of the nasolacrimal duct was analyzed, and the clearance rate of 50 microCi 99m technetium pertechnetate was measured by dacryoscintigraphy.
RESULTS
According to the dacryoscintigraphy results, 98 of 125 eyes (78.4%) with tearing showed nasolacrimal obstruction and 29 of 51 eyes (56.9%) without tearing showed patency. There was a significant difference between tearing eyes and normal eyes (p = 0.001). The clearance rate difference after 3 and 30 minutes was 16.41 ± 15.37% in tearing eyes and 23.57 ±14.15% in normal eyes. There was a significant difference between epiphoric eyes and normal eyes (p = 0.05). Based on the dacryoscintigraphic findings, nasolacrimal-duct obstruction was treated with probing or silicone-tube intubation. The majority of patients showed symptom improvement (75.2%) during the two months of follow-up.
CONCLUSIONS
Dacryoscintigraphy is a non-invasive method of qualitatively and quantitatively diagnosing nasolacrimal duct obstruction in children with tearing.

Keyword

Dacryoscintigraphy; Nasolacrimal duct; Obstruction; Tearing

MeSH Terms

Child, Preschool
*Diagnostic Techniques, Ophthalmological
Female
Follow-Up Studies
Humans
Infant
Lacrimal Apparatus/*radionuclide imaging/secretion
Lacrimal Apparatus Diseases/metabolism/*radionuclide imaging
Male
Retrospective Studies
Tears/*secretion

Figure

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  Fig. 1 Patency pattern of dacryoscintigraphic findings.

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  Fig. 2 (A) Clearance rate measured in the nasal cavity area after 3, 5, 7, 10, 15, 20, and 30 minutes. (B) Time activity curve.

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  Fig. 3 Tear clearance rate 3 minutes and 30 minutes after instillation according to dacryoscinitigraphy. *p = 0.05.

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  Fig. 4 Flow-sheet for the management in children of tearing in children older than one year. *30 min - 3 min.

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