Abstract
Abstract: :
Purpose: To evaluate relationship between lid margin abnormalities and gland dropout of the meibomian gland. Methods: Eighty–six eyes from 43 patients [24 eyes from 12 males; 62 eyes from 31 females; aged 63.5 ± 14.6 yrs. (mean ± SD)] were enrolled in this study. Using slit–lamp biomicroscope, lid margin abnormalities including vascularity (V) and irregularity of lid margin (I), plugging (P) of meibomian orifices and irregularity of mucocutaneous junction (MCJ), and the abnormality of expressed meibomian oil (high viscosity of expressed oil and over and under expression were regarded as abnormal) by the moderate digital pressure to the lid (DP)] were evaluated by one ophthalmologist with respect to their prominence. Using video–meibography, gland dropout of meibomian glands was evaluated by the other ophthalmologist based on the previously reported grades (G: 0, 1, and 2, higher grades for greater severity; Shimazaki, et al. Ophthalmology 1998). In a total of 516 portions (upper and lower lids, and nasal, central and temporal portions of individual lids), relationship between prominent abnormalities of the lid margin, and gland dropout of the meibomian gland were evaluated. Results: The ratio (%) of gland dropout with more than G1 to prominent abnormalities of the lid margin was: V: 40.6 /57.6 (upper/ lower lids); I: 66.7/100; P: 45.0/87.5; DP: 52.9/83.3; MCJ: 39.4/53.2. In both lower and upper lid, the portion of lid where either DP, V or P was prominent, the grades for gland dropout was significantly greater than the portion without prominent abnormality (p<0.001 for each abnormality in the lower lid; p<0.001 for DP or V and p = 0.03 for P in the upper lid). Furthermore, the portion where DP, V or P was prominent, the dropout was significantly greater in the lower lid than in the upper lid (p = 0.01 for DP or V; p<0.01 for P). Conclusions: This study suggests that DP, V and P were useful as the index for gland dropout of the meibomian gland and the dropout is greater in the lower lid than the dropout in the upper lid.