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Mehmet Cem Mocan, Enes Uzunosmanoglu, Sibel Kocabeyoglu, Murat T Irkec; The impact of meibomian gland dysfunction on the ocular surface parameters of glaucoma patients on long-term topical hypotensive medications.. Invest. Ophthalmol. Vis. Sci. 2016;57(12):3876. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
Meibomian gland dysfunction (MGD) is a prevalent inflammatory eyelid condition that adversely affects tear stability and may potentially exacerbate ocular surface inflammation in patients on chronic topical glaucoma medications. The purpose of this cross-sectional, observational study was to evaluate the impact of MGD on the ocular surface parameters of medically treated glaucoma patients.
Seventy eyes of 70 glaucoma subjects with a mean age of 65.0±9.9 years (range=46-86 years) who were on long-term (>12 months) topical hypotensive medication were prospectively recruited. Patients with a history of ocular or periocular surgery, cicatrizing conjunctivitis and contact lens use were excluded. MGD was defined as the presence of signs consistent with meibomian gland terminal duct obstruction with or without accompanying resistance to meibomium expressibility. MGD was categorized between grades 1-5 according to clinical severity. Ocular surface disease index (OSDI) questionnaire was completed at the time of enrollment. Ocular surface tests consisting of tear break-up time (BUT), ocular surface staining with lissamine green (LG) and Schirmer test with anesthesia were employed. Student’s t test, chi-square test and Mann-Whitney U test were used in statistical comparisons. Forty-five healthy control subjects with no ocular disease were also included.
The mean duration of glaucoma was 12.0±9.0 years (range=1-35 years). Patients were on average 1.7±0.8 classes of glaucoma medication. MGD was detected in 56 (80.0%) glaucoma subjects. Of these 47 (83.9%) had signs consistent with mild to moderate MGD. The ocular surface test results of both glaucoma patients with MGD and those without MGD fared significantly worse (p<0.001) for all investigated parameters compared to those of healthy controls. However there were no significant differences between OSDI scores (p=0.912), BUT (p=0.635), LG staining scores (p=0.248), Schirmer test values (p=0.991), between glaucoma patients MGD versus those without MGD.
Mild to moderate MGD is frequently encountered in medically treated glaucoma patients. However the presence of MGD does not appear to have an additional detrimental effect on the ocular surface to that already induced by chronic topical medication use.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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