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Sruthi Srinivasan, Kara Menzies, Lyndon Jones; INFRA-RED IMAGING OF MEIBOMIAN GLANDS & EVALUATION OF THE LIPID LAYER IN SJOGREN’S SYNDROME PATIENTS. Invest. Ophthalmol. Vis. Sci. 2013;54(15):6012.
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The purpose of this study was to evaluate meibomian gland (MG) drop-out and lipid layer thickness in patients with and without Sjogren’s syndrome (SS).
Eleven participants with SS (1 male and 10 females; mean age = 56.0±9.1yrs) and 10 non dry eye (NDE) controls (3 males and 7 females; mean age=58.5±4.7yrs) were recruited. Ocular and oral dryness symptoms were assessed using the American-European Consensus Criteria for Sjögren’s Syndrome (AECC) in the SS group. All participants completed the Ocular Surface Disease Index (OSDI) questionnaire to assess dryness symptoms. Lipid layer thickness (LLT) was assessed using the Tearscope Plus (Keeler) based on the appearance of the lipid layer. Non-invasive tear break up time (NITBUT) was assessed. The lower lid (LL) and upper lid (UL) of all subjects were everted and the MGs imaged using the infra-red (IR) camera of the Keratograph 4 (OCULUS). A MG drop-out score (MGDS) due to complete or partial gland loss of both lids was obtained via digital analysis of the images using ImageJ software.
100% of the SS participants reported ocular and oral dryness symptoms in the AECC questionnaire. The SS group recorded a higher OSDI score (40.0±21.0 vs 1.7±1.7; p<0.001), lower LLT (20±14nm vs 64±5nm; p<0.05) and lower NITBUT (3.6±1.7 vs 11.6±7.6sec; p<0.001), compared to the NDE controls. Digital MGDS (% drop out) was significantly higher for the SS group for the UL (OD: 22% vs 3%; p<0.005; OS: 22% vs 6%; p<0.02), and LL (OD: 31% vs 12%; p>0.05; OS: 31% vs 8%; p<0.05). MGDS were negatively correlated with NITBUT (r=-0.71, p<0.05). There was a positive correlation between LLT and NITBUT for both OD (r= 0.44; p<0.05) and OS (r= 0.72; p<0.05).
Patients with SS showed higher MGDS and reduced LLT and NITBUT which likely contribute to the severe dry eye symptoms reported by SS subjects.
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