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Rika Shirakawa, Reiko Arita, Shima Fukuoka, Satoshi Yamamoto, Kaori Yonehara, Tsuyoshi Haraguchi, Shiro Amano; Double rows of meibomian gland orifices observed by non-invasive infrared meibography. Invest. Ophthalmol. Vis. Sci. 2013;54(15):956.
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© ARVO (1962-2015); The Authors (2016-present)
Multiple rows of meibomian gland orifices (MGOs), which were first reported in 1992 by Hykin and Bron, exist mainly in the upper eyelids of young people. Little is known about the morphology of the meibomian glands and their influences on the ocular surface. We observed lid margins and meibomian glands in healthy young adults to explore the incidence, morphology and function of double rows of MGOs.
Subjects were consecutive cases of healthy male volunteers under 36 years of age. After obtaining written consent, we measured the width of the eyelid, counted the number of MGOs in the upper and lower eyelids, obtained a fluorescein staining score, tear break-up time (BUT), meibum expressibility grade, tear meniscus height under the slit-lamp microscopy, and performed a Schirmer tear production test. We also recorded images of meibomian glands by non-invasive infrared meibography, which were later reviewed to count the number of meibomian glands in each lid. We scored a meiboscore (grade 0-3) according to the ratio of the area of missing glands. “Double rows” were defined where more than 4 orifices were aligned in a second row distinctly separate from the primary row. This study was approved by the institutional review board of University of Tokyo School of Medicine, and adhered to the tenets of the Declaration of Helsinki.
We examined 35 eyes of 35 people (all male, average age 28.9±2.8). We observed double rows of MGOs in the upper eyelids of 10 eyes (28.5%), whereas none (0%) were observed in the lower eyelids. Comparing between the double rows group (n=10) and the single row group (n=25), the number of the orifices and number of the meibomian glands in the upper eyelids are significantly higher in the double rows group (48.0±5.7 vs 36.3±4.9, p<0.0001 and 29.4±3.4 vs 34.3±7.5, p=0.03, respectively). BUT were significantly longer in the double rows group (7.4±3.3 sec vs.5.1±2.4 sec, p=0.03). Other measurements were not significantly different. In 8 out of 10 eyes with double rows, meibomian glands branched into two narrower glands just before the lid margin. The other 2 eyes had narrow and compact meibomian glands.
Double rows of MGOs exist in 28.5% of upper eyelids of healthy young adult males. BUT is higher in the double rows group compared with the single row group. There are two types of morphology for double row MGOs; the dichotomous branching type and the dense type.
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