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G. N. Foulks, D. Borchman, M. Yappert; Modification of Meibomian Gland Lipids by Topical Azithromycin. Invest. Ophthalmol. Vis. Sci. 2009;50(13):2676.
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To determine abnormalities of the Meibomian gland lipids in lid margin disease and measure the effects of topical azithromycin on lipid function.
Mechanical expression of the Meibomian glands of subjects with Meibomian gland dysfunction (MGD) before and after therapy with topical azithromycin provided samples of secretions that were analyzed by Fourier transform infrared (FTIR), MALDI-TOF, and nuclear magnetic resonance spectroscopies. Measurement of lipid structure and function was determined for each subject.
All MGD subjects were found to have abnormal lipid structure and function prior to therapy with evidence of increased lipid ordering (49% versus 34% trans rotamer) and higher phase transition temperature (32.8oC versus 28oC) than normals. Fifteen subjects were treated with topical azithromycin solution with reduction of the abnormal lipid behavior measured at 2 and 4 weeks of treatment. Azithromycin was identifiable in the lipid samples at 2 and 4 weeks.
The structure and behavior of lipids of the Meibomian glands is altered in subjects with MGD with evidence of increased phase transition temperature that correlates with a more ordered (greater % trans rotamer) lipid structure. This pattern correlates with clinical features of thickened and turbid Meibomian gland secretions. Therapy with daily topical azithromycin solution for one month reduces the phase transition temperature and % trans rotamer pattern of the lipids to that of normal secretions.
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