Abstract
Purpose :
In meibomian gland dysfunction (MGD), a number of risk factors for meibomian gland (MG) loss have been identified. However, little is known regarding the characteristics of patients with severe MG loss. We performed a retrospective chart review to investigate the relationships between severe MG loss, tear film properties, symptoms, and systemic disease.
Methods :
A retrospective chart review was performed of dry eye patients who underwent meibography imaging between September 2015 and November 2018 using the LipiView II Ocular Surface Interferometer. Subjects included adult dry eye patients with the presence of severe MG dropout (>75% on Meiboscale) in at least one eye. Lipid layer thickness (LLT), partial blink rate, Ocular Surface Disease Index (OSDI) score, tear osmolarity, demographic data, and medical history were recorded. Age- and sex-matched dry eye patients with no MG dropout in at least one eye were used as controls. LLT, partial blink rate, and tear osmolarity were compared as the mean of both eyes.
Results :
Preliminary results show that the LLT was significantly thinner in the severe MG loss group (n = 35; 60.7 nm) than in the control group (n = 35; 74.9 nm; p<0.05). However, the severe MG loss group did not differ significantly from controls in OSDI score (severe: 31.1 versus control: 36.0; p = 0.214), partial blink rate (p=0.738), or tear osmolarity (p=0.184). When examining systemic disease and risk factors, 17.1% of severe MG loss patients were found to have graft-versus-host-disease, compared to none of the patients in the control group (p < 0.05). Additionally, there was a significantly lower percent of Sjogren’s syndrome in the severe MG loss group (p < 0.001). Thyroid dysfunction, hyperlipidemia, acne rosacea, allergic conjunctivitis, diabetes, contact lens wear, post-refractive surgery, history of smoking, and hormone replacement therapy did not differ significantly between groups (all p>0.10).
Conclusions :
Dry eye patients with severe MG loss had significantly thinner LLT, but similar symptoms to dry eye patients without MG loss. These results suggest that, due to the multifactorial nature of dry eye, the presence of severe MG loss and a thinner LLT does not necessarily correlate with more severe ocular symptoms. Our data also confirms previous reports of the relationship between severe MGD and GVHD, warranting further investigation into the pathophysiology of MG loss in GVHD.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.