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T. Suzuki, N. Yokoi, A. Komuro, S. Kinoshita; The Cyclic Change of Meibomian Gland Physiology During the Menstrual Cycle. Invest. Ophthalmol. Vis. Sci. 2007;48(13):434.
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Since pilosebaceous gland is known to show changes during the menstrual cycle, we hypothesize that meibomian gland, which is a large sebaceous gland as well as a hormone target organ, changes during the menstrual cycle. Thus, the objective of our study is to assess the cyclic change of meibomian gland physiology during the menstrual cycle.
Six female in the twenties with regular 28-day menstrual cycle were enrolled in this study, with informed consent. The diameter of meibomian gland orifice (MGO) using slit-lamp photography with high-magnification and serum concentration of sex steroid hormones and basal body temperature were evaluated every three days for 5 consecutive weeks. The cyclic changes were also evaluated with regards to the volume of meibum by meibometry, fluorescein tear-film breakup time (F-BUT) and meibomian gland morphology by meibography during the menstrual cycle.
The menstrual cycle was divided into 6 phases- 2 days before menstruation (phase VI) and the first 2 days of menstruation (phase I), and the remaining time was divided into four 6-day periods (phase II-V). The diameter of central MGO was significantly smaller at phase IV (after the ovulation, 0.228±0.004, p<0.005) than that at phase I (the first 2 days after menstruation, 0.257±0.005), and the smallest at phase V (0.212±0.03, p=0.002). There was no significant difference in the MGO size among phase I, II, III and VI. The cyclic changes were also seen in the volume of meibum, F-BUT and meibomian gland morphology during the menstrual cycle.
The meibomian gland physiology during the menstrual cycle, especially at post-ovulation, may influence on tear film instability, resulting in the evaporative type of dry eye. Serum levels of sex steroid hormones should be considered as causative factors for meibomian gland physiology.
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