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Carolina Kunnen, Percy Lazon De La Jara, Brien A Holden, Eric B Papas; Meibomian Gland Morphology and Function in Groups with Different Levels of Severity of Ocular Symptoms . Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):331.
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© ARVO (1962-2015); The Authors (2016-present)
To determine if meibomian gland morphology and function differs between groups of individuals who have different levels of severity of ocular symptoms.
80 participants aged between 18 and 40 had their ocular symptoms assessed using the Ocular Comfort Index (OCI). Novel meibography image analysis software was applied to extract the following variables describing the characteristics of meibomian glands (MG) from images of the upper tarsal conjunctiva: proportional coverage (MGPC), maximum gland width (Max MG width), minimum gland width (Min MG width), median gland width (Median MG width), mean gland width (Mean MG width), number of glands (Number MG), and most frequent gland width (Most freq MG width). Meibomian gland function variables assessed were meibum quality (0-4) after expression with the Korb MG evaluator, and tears and meibum lipid profiles using nano-electrospray mass spectrometry to identify and quantify the major classes of component lipids. Subjects were divided into three symptom-based groups on their OCI score; none/mild <24, moderate 24 to 35, and severe >35. Comparisons between groups were made using the Kruskal-Wallis test or ANOVA for non-parametric and parametric data respectively. Statistical significance was set at p < 0.05 and main effects were compared after Bonferroni correction.
Significantly more meibomian gland loss was observed for the severe symptoms group compared to the moderate symptom group (39.9% ± 5.1 vs 43.5% ± 4.5, p = 0.009). Meibum quality was significantly higher for the severe symptom group compared to either none/mild or moderate groups (1.00 ± 1.00 vs 0.00 ± 1.00 and 0.50 ± 1.00, p = 0.045). Significantly smaller amounts of (O-acyl)-omega-hydroxy fatty acid (OAHFA) were found in tears from severely symptomatic subjects (1.27% ± 0.62 vs 1.90% ± 0.80, p = 0.004).
Individuals with the most severe symptoms (>35 OCI score) show meibomian gland morphological changes that appear to have consequences in terms of the nature of the secreted meibum and its characteristics as a component of the tear film. OAHFAs may be an important lipid class for the maintenance of normal tear film function.
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