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David Murakami, Caroline A Blackie, Heiko Pult, Donald R Korb; Meibomian Gland Function Cannot Be Predicted By Meibography In Patients Symptomatic For Dry Eye.. Invest. Ophthalmol. Vis. Sci. 2014;55(13):27.
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The purpose of this study was to determine if meibography could predict meibomian gland (MG) function with regard to number of functional MGs and/or estimation of functional MG volume in patients symptomatic for dry eye.
Patients (n=23) symptomatic for dry eye who met the inclusion criteria for the study were fully consented and enrolled. Inclusion criteria: willingness to participate in the study, over the age of 18, no lid abnormalities, no current ocular inflammation/disease, no ocular surgery within the last 6 months, no history of lid surgery. Symptoms were scored using the SPEED questionnaire. MG function and estimation of functional MG volume were performed with the Korb meibomian gland evaluator. Meibography was performed using the Modi Topographer and analyzed using the Phoenix software provided. Lower lids were examined in three equal sections: nasal (N), central (C) and temporal (T) for the number of functional MGs and their functional volume (volume was as 1 for minimal, 2 for moderate and 3 for copious), and for MG dropout. MG dropout was categorized according to the Pult Meiboscale.
Only data for right eyes are presented. The mean age and symptom score of the patients was 48.0±12.1 years (5 males; 18 females) and 8.9±5.0 respectively. The average number of functional glands per lid section was: N=2.7±1.7, C=2.2±2.0, T=0.2±0.5. The estimated functional gland volume per lid section was: N=5.0±3.9, C=3.2±3.2, T=0.3±1.1. The N and C lid sections had significantly more functional MGs and higher functional gland volume relative to the T section (p < 0.005). Conversely the amount of gland loss as determined by gland atrophy was significantly highest in the nasal section of the lid (p<0.0001) and drop out showed no apparent correlation with MG function or functional volume.
There appears to be no relationship between the level of apparent drop out and the number of functional MGs and/or functional MG volume. These counterintuitive results strongly indicate that standard noncontact infrared meibography cannot be used to predict MG function in terms of number of functional glands and/or functional gland volume except in the case of total gland dropout, when the glands are completely absent.
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