Meibomian Gland Dysfunction and Ocular Surface Findings in Rosacea Patients

Abstract

Purpose : Rosacea is a chronic inflammatory cutaneous disorder that frequently causes eyelid and ocular surface inflammation and dry eye. Ocular rosacea symptoms and clinicals features can be subtle, potentially impacting on quality of life and vision, being critical ophthalmologic examination early. There are gaps in the understanding of the magnitude of this condition on the ocular surface and, above all, on meibomian glands. This study aimsto evaluate in detail ocular surface, tear film and meibography and to understand its correlations with different stages of rosacea.

Methods : Thirty-nine participants were included in this cross-sectional study and compared to fifty-three controls. Ocular evaluation consisted of ocular surface disease index (OSDI) questionnaire, a non-invasive objective assessment of the ocular surface and photographic documentation (Keratograph 5M) which included tear meniscus height, non-invasive tear film breakup time, conjunctival redness and meibography; along with ocular surface staining with fluorescein and lissamine green and Schirmer test.

Results : Rosacea patients were mostly women (69.23%), mean age of 47.34±12.62. There were no statistically significant difference in the results between rosacea and control group regarding visual acuity (p=0.987), tear meniscus (p=0.338), Non Invasive Breakup Time (NITBUT) (p=0.228), conjunctival redness (p=0.106), fluorescein staining (p=0.489), Invasive Breakup Time (TBUT) (p=0.471) and Schirmer Test (p=0.244). Significant associations were found in meiboscore (p=0.026), lisamine green staining (p=0.015) and OSDI (p<0.0001). Rosacea patients also presented more glandular obstruction (p<0.001), alterations in glandular expression (p<0.001) and eyelid telangiectasia (p<0.001) than control group, regardless to systemic disease stage.

Conclusions : Rosacea can profoundly impact on meibomian gland morphology and function. Indeed, despite mild finding on tear film tests patients presented high ocular surface symptoms scores.

This is a 2020 ARVO Annual Meeting abstract.