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Donald R Korb, William Joseph Benjamin, Amy Nau; Meibomian gland structure is correlated to meibomian gland function. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4857. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To retrospectively investigate the potential correlation between loss of meibomian gland structure and meibomian gland function.
Inclusion criteria: age 25-45, purpose of visit dry eye evaluation, willingness to cooperate with examination procedures. Exclusion criteria: eyelid surgery, ocular surgery within the past 2 years, active infectious disease, presence of autoimmune disease. The de-identified data from the records of 40 consecutively consented patients (30 females, 10 males) from a single dry eye clinic in Boston, MA meeting the above criteria were categorized into 4 groups of 10 patients based on percentage of meibomian gland structural loss in the right lower eyelid (MGSRL): Group 1 = ≤ 5%, Group 2 = 20-30%, Group 3 = 40-60%, and Group 4 = 70-100% loss. MGSRL was assessed by dynamic meibomian imaging (DMI), meibomian gland function by number of glands yielding liquid secretion (MGYLS) using the Korb Meibomian Gland Evaluator (MGE), and symptoms with the Standardized Patient Evaluation of Eye Dryness (SPEED) questionnaire. The latter tests are performed on all patients reporting for dry eye evaluation.
MGSRL was correlated to number of MGYLS and SPEED score, and MGYLS and SPEED score to each other when data were best fit with 3rd-order polynomial (R2 = −0.592), linear (R2 = +0.403), and quadratic (R2 = −0.616) equations, respectively (n = 40). Analyses of Variance (ANOVAs) for MGSRL, number of MGYLS, and SPEED score showed statistical differences between the means of the 4 severity groups (p ≤ 0.0001). Bonferroni correction for multiple comparisons to T-tests between groups involving unequal variances (do = 18) revealed 6 of 6 comparisons were statistically significant for MGSRL, 4 of 6 for number of MGYLS, and 3 of 6 for SPEED score (p ≤ 0.01). There was little correlation of age with MGSRL, number of MGYLS, or SPEED score, and an ANOVA lacked statistical significance between severity groups in terms of age (p ≤ 0.890).
This is the first study to correlate meibomian gland structure to meibomian gland function and patient symptomatology utilizing standardized metrics. These findings establish a high probability that, as meibomian gland structure is lost, the number of functional meibomian glands decrease and symptoms of dry eye increase; thus supporting the concept of treatment to prevent loss of structure and disease progression.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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