Possibilities of ultrasound examination for assessing biometric characteristics of the lacrimal gland in normal individuals of different ages

The purpose was to determine the biometric characteristics of the palpebral and orbital parts of the lacrimal gland (LG) in normal individuals of different ages. Material and methods. A total of 120 healthy individuals (240 eyes) were examined, including 60 children (group 1) and 60 adults (group 2). Depending on their age, the subjects were divided into subgroups: 1A — 20 children aged 1 to 7 years, 1B — 20 children aged 7 to 13 years, 1B — 20 children aged 13 to 17 years, 2A — 20 adults aged 18 to 40 years, 2B — 20 adults aged 40 to 60 years and 2B — 20 adults aged 60 to 90 years. Ultrasound examination (US) of the LG was performed on a multifunctional device using a linear 11–18 MHz sensor in the B-scan mode at medium-low values of the signal gain (GAIN). Results. Analysis of biometric parameters of the LG showed that the sizes of the palpebral and orbital parts of the LG depend on age. The minimum sizes of the LG were noted in children in subgroup 1A. The diameter and thickness of the palpebral part were 6.49±0.50 mm and 2.20 ± 0.13 mm, respectively, while the size of the orbital part was 9.50 ± 0.44 mm. In adults, the lowest values of biometric parameters of the LG were established in subgroup 2A, amounting to 8.48 ± 0.50 mm and 2.2 ± 0.1 mm for the palpebral part and 13.47 ± 0.48 mm for the orbital part, respectively. In the older age subgroup, the highest values of the parameters of the LG orbital part were noted, the average size of which was 16.02 ± 0.15 mm. Conclusion. The normative parameters of LG sizes differ significantly in adults and children, which must be taken into account when examining patients of different ages with suspected pathological changes in the LG. The biometric characteristics of the LG revealed by ultrasound in healthy individuals can be used as echographic criteria for diagnosing LG diseases.

1. Garg A, Zhang X. Lacrimal gland development: From signaling interactions to regenerative medicine. Dev Dyn. 2017; 246 (12): 970–80. doi: 10.1002/dvdy.24551

2. Andreoli MT, Aakalu V, Setabutr P. Epidemiological trends in malignant lacrimal gland tumors. Otolaryngol Head Neck Surg. 2015; 152 (2): 279–83.

3. Nawaz S, Lal S, Butt R, et al. Computed tomography evaluation of normal lacrimal gland dimensions in the adult Pakistani population. Cureus. 2020; 24 (123): 7393. doi: 10.7759/cureus.7393

4. Neroev B.B., Kiselevа T.N., eds. Ultrasound in Ophthalmology: A Guide for Physicians. Moscow: IKAR. 2019: 110–250 (In Russ.).

5. Dartt D.A. Neural regulation of lacrimal gland secretory processes: relevance in dry eye diseases. Prog Retin Eye Res. 2009; 28 (3): 155–77. doi:10.1016/j.preteyeres.2009.04.003

6. Andreoli MT, Aakalu V, Setabutr P. Epidemiological trends in malignant lacrimal gland tumors. Otolaryngol Head Neck Surg. 2015 Feb; 152 (2): 279–83. doi: 10.1177/0194599814556624

7. Brovkina A.F. Ophthalmooncology. A guide for physicians. Publisher: Medicine; 2002: 177–204 (In Russ.).

8. Kopaeva V.G. Eye diseases. Fundamentals of ophthalmology: textbook Moscow: Medicine; 2012: 53–78 (In Russ.).

9. Lyubavska V., Beldovskaya N.Yu., Novikov S.A. et al. Radiation methods for diagnosing the pathology of the lacrimal ducts. Ophthalmological Bulletins. 2017; 10: 3: 35–45 (In Russ.). doi: 10.17816/OV10335-45

10. Kharlap S.I., Nasnikova I.Yu., Markosyan A.G., et al. Structural features of the lacrimal gland in normal and pathological conditions according to the results of spatial ultrasound digital examination. Vestnik oftal’mologii. 2011; 127: 4: 16–24 (In Russ.).

11. Eksarenko O.V., Kharlap S.I., Safonova T.N., et al. Changes in the lacrimal gland in sarcoidosis according to the results of spatial ultrasound digital examination. Vestnik oftal’mologii. 2013; 129: 1: 10–5 (In Russ.).

12. Karakozov A.N., Belyamova A.F. Some features of lacrimal gland changes in patients with dry eye syndrome in ultrasonic diagnostics. Russian medical journal. 2017; 18 (3): 141–5 (In Russ.).

13. Askerova S.M., Smyslenova M.V., Aslanov S.D. Clinical and echographic diagnostics of the lacrimal system in pathology of the lacrimal ducts. Ophthalmosurgery. 2017; (1): 34–9 (In Russ.).

14. Zapuskalov I.V., Krivosheina O.I., Fetisov A.A. Pathology of the appendage apparatus of the eyeball: textbook. Publisher: Tomsk, SibGMU; 2013 (In Russ.).

15. Kiseleva T.N., Lugovkina K.V., Zaitsev M.S. The method of ultrasound examination of the lacrimal gland. Patent RF # 2759385. 2021 (In Russ.).

16. Ossoinig K. Die Ultraschalldiagnostik in der Augenheikunde. Wien Med Wochenschr. 1968; 118 (16): 362–7.

17. Byrne S.F. Standardized echography of the eye and orbit. Neuroradiology. 1986; 28: 5–6: 618–40. doi: 10.1007/BF00344110

18. Giovagnorio F, Pace F, Giorgi A. Sonography of lacrimal glands in Sj gren syndrome. J Ultrasound Med. 2000; 19: 8: 505–9. doi: 10.7863/jum.2000.19.8.505

19. Rana K, Juniat V, Patel S. Normative lacrimal gland dimensions by magnetic resonance imaging in an Australian cohort. Orbit. 2023; 42 (2): 157–60. https://doi.org/10.1080/01676830.2022.2055085

20. Dalvi VN, Ambhore A, Dhok AP, et al. Normal dimensions of the lacrimal gland on magnetic resonance imaging in Indian adult population: a retrospective study. Pan Afr Med J. 2023; 31 (45): 71. doi: 10.11604/pamj.2023.45.71.38213

21. Tamboli DA, Harris MA, Hogg JP, et al. Computed tomography dimensions of the lacrimal gland in normal Caucasian orbits. Ophthalmic Plast Reconstr Surg. 2011; 27 (6): 453–6. doi: 10.1097/IOP.0b013e31821e9f5d

22. Hat K, Ka telan S, Planini A et al. Pathohistological features of the aging human lacrimal gland. Croat Med J. 2023; 64 (5): 307–19. doi: 10.3325/cmj.2023.64.307