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Joo Hyun Kim, Hyun Sun Jeon, Won Ryang Wee, Joon-Young Hyon; Correlation of change in meibomian gland structure with tear film lipid layer thickness. Invest. Ophthalmol. Vis. Sci. 2017;58(8):4397.
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© ARVO (1962-2015); The Authors (2016-present)
Meibomian gland dysfunction (MGD) is characterized by inadequate meibomian gland (MG) secretion attributable to chronic, diffuse abnormality of the MG, and relationships between MGD and dry eye symptoms have been well established. This study is to evaluate the correlation of structural change in MG with tear film lipid layer thickness.
This retrospective cross-sectional study included 156 eyes of 78 patients who presented MGD on slit lamp examination. Patients were subclassified into Young (Y) group (35 subjects, age under 65) and Old (O) group (43 subjects, age 65 and older). Average, maximum, and minimum LLT and incomplete/total blinking were measured using the Lipiview 2. Meibography was taken with Lipiview 2 and evaluated using meiboscore for lower lid. Partial or complete loss of the meibomian glands was graded by meiboscore; grade 0 (no loss of meibomian glands), grade 1 (loss of 1/3 of the total area of meibomian glands), grade 2 (area loss between 1/3 and 2/3), and grade 3 (area loss ≥2/3). The correlation between meiboscore and several parameters were evaluated using Spearman’s correlation analysis. The differences in parameters between two groups were evaluated using the Independent T test.
The average age was 62.2 ± 13.3. Male and female subjects were 14/78 (17.9%) and 64/78 (82.1%), respectively. Average LLT in the O group (89.6 ± 16.8 nm) was significantly thicker than that of the Y group (70.8 ± 21.9 nm) (p = 0.000). The O group showed severe meiboscore (1.4 ± 0.9) when compared with the Y group (1.0 ± 0.9, p = 0.018). However, there was no significant difference in ratio of incomplete blinking between two groups. In the Y group, Meiboscore showed a significant negative correlation with average LLT (r = -0.445, p = 0.000). In contrast, Meiboscore in the O group showed a positive correlation with average LLT (r = 0.215, p = 0.047). In the O group, ratio of incomplete blinking showed significant positive correlation with average LLT (r = 0.324, p = 0.002). But, this correlation was not found in the Y group.
Young MGD patients had thin LLT according to MG dropout. But, in older patients, LLT was positively correlated with MG losses, suggesting that hypersecretory MGD is predominant in older patients.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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