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R. Arita, K. Itoh, S. Maeda, K. Maeda, A. Furuta, S. Fukuoka, S. Amano; Noncontact Meibography Reduces Disparities in Diagnosing Obstructive Meibomian Gland Dysfunction. Invest. Ophthalmol. Vis. Sci. 2009;50(13):531.
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To examine the morphologic change of meibomian glands using a non-contact meibography we have developed and assess their relation with slit-lamp findings regarding eyelids and tear film function between patients with obstructive meibomian gland dysfunction (oMGD) and normal control.
Fifty three eyes in fifty three patients (18 men, 35women; mean ± standard deviation of age, 71.4 ± 10.0 years) who were diagnosed as oMGD using our criteria. Sixty eyes in sixty healthy volunteers (22 men, 38 women; 71.0 ± 9.3 years) were recruited as the control. Written informed consent was obtained from all subjects before examination. This study was approved by the institutional review board of Itoh clinic and adhered to the tenets of the Declaration of Helsinki.The subjective symptoms were questioned and lid margin and ocular surface disorders were observed with a slit lamp. The upper and lower eyelids were turned over and the meibomian glands were observed with the non-contact meibography. Partial or complete loss of meibomian glands was scored (meibo-score) for each eyelid from grade 0 (no loss of meibomian glands) through grade 3 (the lost area was over 2/3 of total area of meibomian glands). The break-up time of the tear film with fluorescein (BUT) was measured. Meibum was graded and tear film production was evaluated by Schirmer’s test.
In oMGD patients, meibo-score was significantly higher than that in the controls (P < 0.0001). Lid margin abnormality score was significantly higher in oMGD patients than that in the controls (P < 0.0001). SPK was significantly more (P < 0.0001) and BUT was significantly shorter in the oMGD patients than that in the controls (P < 0.0001, respectively). The grading of meibum was significantly higher in the oMGD patients than that in the controls. Meiboscore had significantly positive correlation with the grade of meibum (R=0.534, P<0.001). There was no significant difference in Schirmer value (P = 0.174).
In oMGD, the morphologic changes of meibomian glands were increased compared with the control and were correlated with the function of meibomian glands. The non-contact meibography is a useful method to obtain information on the structure of meibomian glands and likely to reduce disparities in diagnosing oMGD.
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