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Fabrizio Magnani, Veronica Canton, Elena Garoli, Francesco Viola, Edoardo Villani, Roberto Ratiglia; The Eyelid Margin in Dry Eye: An In Vivo Confocal Study. Invest. Ophthalmol. Vis. Sci. 2012;53(14):595.
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To evaluate by in vivo laser scan confocal microscopy (LSCM) the morphological changes of the eyelid margin in patients with aqueous-deficient (ADDE) and evaporative (EDE) dry eye.
Fifteen patients with ADDE, 15 with EDE, and 15 age- and gender-matched control subjects were consecutively enrolled. Each partecipant completed an Ocular Surface Disease Index questionnaire and underwent a full eye exam (including BUT, fluorescein and lissamine green staining, Schirmer test and meibomian glands examination) and a LSCM examination of the inferior eyelid margin (to study epidermal superficial and basal epithelial density, meibomian glands - MGs - orifices diameter and distance from mucocutaneous junction - MCJ, tarsal cunjunctival superficial and basal epithelial density).
All the clinical parameters showed statistical significant differences among the groups (P<0.001, ANOVA or Kruskal Wallis test). No differences among the groups were found in epidermal density. MGs orifices diameter was increased in EDE compared to both ADDE and controls (P<0.01, Mann-Whitney U test). The distance between MGs orifices and MCJ was increased in both ADDE (figure 1B) and EDE (figure 1C) compared to controls (figure 1A) (P<0.001, LSD post hoc test). Tarsal superficial and basal epithelial densities were reduced in both ADDE and EDE compared to controls (P<0.05, LSD post hoc test).
LSCM allows to perform an in vivo, non-invasive, high-resolution evaluation of the eyelid margin, showing several changes in dry eye patients. The chance to study the different epithelia and the MCJ localization in relation to the MGs orifices provide important information to better understand the eyelid margin involvement in dry eye pathogenetic mechanisms.
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