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Caroline A Blackie, Ekoue Folly, Jill Ruppenkamp, Chantal Holy; Prevalence of Meibomian Gland dysfunction – a systematic review and analysis of published evidence. Invest. Ophthalmol. Vis. Sci. 2019;60(9):2736.
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© ARVO (1962-2015); The Authors (2016-present)
Meibomian Gland Dysfunction (MGD), known to significantly compromise ocular surface health, is reported in a multitude of clinical populations. Prevalence counts vary greatly due to differences in disease definition, diagnostic criteria and target populations. This research estimates most current and accurate MGD prevalence rates based on published evidence from prospective clinical trials.
A systematic review was conducted in Embase and Medline. The search strategy was defined to include all prospective clinical studies reporting primary data related to prevalence of MGD. Two independent researchers reviewed all identified manuscripts and extracted prevalence rates, target populations and diagnostic methods. When multiple data points existed for similar subpopulations, pooled estimates were calculated using a random-effect analyses.
The initial search strategy yielded 670 manuscripts. Based on a title and abstract review, full-text review of 82 papers was performed, yielding a final count of 37 papers to be included in the study, spanning 16 countries (US: 10 manuscripts, Asia: 12 manuscripts) and 26,063 patients. Five papers included pediatric patients and 6 papers focused exclusively on elderly patients. Subpopulations with highest rates of MGD included patients with Sjögren’s disease (〉90%), sulfur mustard gas survivors (96%), epidermolysis bullosa (88%), glaucoma medication use (82%), rosacea (85%), perimenopausal women taking hormone replacement therapy (87%) and chronic blepharitis (74%). In the overall dry eye population (with no other comorbidities), 9 data points were available, providing a random-effect estimate of 70.4% (95%CI: 61.6%-77.9%). Significant variability (I2=93.7%) was observed, a reflection of differences in diagnostic measures and geography across studies. In patients with no ocular symptoms (13 data points), the prevalence of MGD reached 41.7% across all ages (95%CI: 33.6%-50.21%), 47.8% (95%CI: 40.2%-55.4%) in the elderly and 35.76% (95%CI: 32.28%-39.41%) in pediatric/young adult populations.
Despite variability in diagnostic criteria, strikingly high prevalence of MGD is reported, including in pediatric and young adult patients with no diagnoses of dry eye or other ocular conditions. Comorbidities with extremely high prevalence of MGD include patients with dry eye disease, glaucoma medication use and Sjögren’s disease.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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