Purchase this article with an account.
Srihari Narayanan, Narges Kasraie, Charles G Connor, William Miller; Increased Meibomian gland dropout and MMP-9 expression in an untreated millennial population who did not self-report for MGD treatment. Invest. Ophthalmol. Vis. Sci. 2018;59(9):929. doi: https://doi.org/.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Meibomian gland dysfunction (MGD), the leading cause of evaporative dry eye is commonly under diagnosed. We examined a millennial population who were asymptomatic and did not self-report for MGD treatment, to study signs of evolving MG problems using meibography and MMP-9 testing.
Thirty-seven subjects (average age 24.61 yrs; 18 female and 19 males) consented to participate in this study. The subjects did not have any known past therapeutic management for MGD. The following measurements were taken: OSDI scores, NITBUT, Schirmer-I test, Phenol red thread test (PRT), MMP-9 expression using the InflammaDry test and meibography of the upper and lower lid (UL, LL) using the Pult grading scheme. Investigators were blind to OSDI scores prior to obtaining clinical measures. Descriptive statistical measures were calculated.
The mean OSDI score was 12.89+/- 5.21 with 14 subjects scoring over 12. The NITBUT averaged 8.97+/-3.09 with 19 subjects having a NITBUT lower than 10 seconds. Schirmer-I score was 17.4 mm+/- 9.33 with 8 subjects less than 10mm wetting. Phenol red thread had a mean of 22.41+/- 6.58 with no subjects < 10 mm. Twenty one subjects showed positive MMP-9 expression. The mean UL meibography score was 1.72 +/- 1.00, while the LL was 2 +/- 1.10. Only 3 subjects had no gland dropout in any eyelid.
Our results show that 38% of subjects have mild dry eye based on the OSDI, while 51% had reduced tear break-up time. Tear production was decreased in 21% of the subjects. Most strikingly, a large number (57%) of our subjects had positive MMP-9 expression (over 40 ng/mL) in the tear fluid, while a greater percentage (92%) showed measurable Meibomian gland loss. A lack of self-reporting for MGD or dry eye in this millennial population did not correlate with a healthy ocular surface. The results of our study strongly suggest a need for routine evaluation of ocular surface inflammatory markers as well as Meibomian gland status in young, healthy patient populations. It is conceivable that these subjects would become symptomatic in the future and could benefit now from interventional therapeutic management of their asymptomatic MGD. Thus, it is prudent to examine and identify “at-risk” millennial MGD patients before the ocular surface worsens.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
This PDF is available to Subscribers Only