June 2020
Volume 61, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2020
Association of Meibomian Gland Morphology with the Severity of Symptoms and Signs of Dry Eye Disease in the Dry Eye Assessment and Management (DREAM) Study
Author Affiliations & Notes
  • Ebenezer Daniel
    Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania, United States
  • Maxwell Pistilli
    Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania, United States
  • Penny A Asbell
    Hamilton Eye Institute, University of Tennessee Health Science Center (UTHSC), TN, USA, Memphis, Tennessee, United States
  • Vatinee Y Bunya
    Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania, United States
  • Giacomina M Massaro-Giordano
    Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania, United States
  • Gui-Shuang Ying
    Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania, United States
  • Maureen Maguire
    Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania, United States
  • Footnotes
    Commercial Relationships   Ebenezer Daniel, None; Maxwell Pistilli, None; Penny Asbell, Alcon (C), Allakon (C), CLAO (C), Dompe (C), Kala (C), Medscape (C), Novaliq (C), Regeneron (C), Santen (C), Senju (C), Shire (C), Sun Pharma (C); Vatinee Bunya, Bausch & Lomb (F), Celularity (C), Verily (C); Giacomina M Massaro-Giordano, Celularity (C), GSK (C), PRN (C); Gui-Shuang Ying, None; Maureen Maguire, None
  • Footnotes
    Support  Grants U10EY022881, U10EY022879 and R01 EY026972 from the National Eye Institute; Supplemental funding from the Office of Dietary Supplements, National Institutes of Health; Prevention of blindness
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 344. doi:
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      Ebenezer Daniel, Maxwell Pistilli, Penny A Asbell, Vatinee Y Bunya, Giacomina M Massaro-Giordano, Gui-Shuang Ying, Maureen Maguire; Association of Meibomian Gland Morphology with the Severity of Symptoms and Signs of Dry Eye Disease in the Dry Eye Assessment and Management (DREAM) Study. Invest. Ophthalmol. Vis. Sci. 2020;61(7):344.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To determine if morphological features of meibomian glands (MGs) are associated with the severity of symptoms and signs of dry eye disease (DED)

Methods : Cross-sectional study of a subset of patients (N=277) with moderate-to-severe DED who were enrolled in the Dry Eye Assessment and Management (DREAM) Study from centers with an Oculus Keratograph 5M. Patients completed Ocular Surface Disease Index (OSDI) and underwent ocular surface examination. Meibography images were obtained from both lids. Masked graders assessed baseline images for MG morphological features that included distorted, tortuous, hooked, short, thick, thin, ghost, fluffy areas, abnormal gap between glands and dropout glands. The mean number of glands with the presence of morphological features in the middle third of each lid was compared across severity levels of DED signs and symptoms. Adjustments were made for age and sex, and inter-eye correlations were accounted for using generalized estimating equations

Results : After excluding images with poor image quality, 468 (84%) lower lids (LL) and 394 (67%) upper lids (UL) were available for analysis. The mean number of glands was 9; distorted and short glands were more common (means of 4 and 3), respectively than other features (means < 1; Table 1). None of the MG features were associated with OSDI scores (all p>0.1). Having tortuous MGs in the UL was associated with less severe corneal staining (p=0.02), less severe conjunctival staining, and longer tear break-up times (p=0.01). UL hooked glands were associated with decreased corneal staining scores (p=0.02). Tortuous glands in the LL, were associated with less corneal staining scores (p=0.04). DED patients with Sjogren's syndrome compared with those without Sjogren syndrome, had less distorted MGs (mean 3.4 vs 4.3, p=0.03), more thickened MGs (mean 0.18 vs 0.0, p=<0.001) and more ghost glands (mean 0.89 vs 0.33, p=0.006) in the UL (Table 2). Other morphologic features were either not associated or inconsistently associated with signs.

Conclusions : Within DREAM study patients, most morphologic features of meibomian glands were not associated with the severity of DED symptoms or signs. However, tortuous and hooked glands were associated with less severe signs of DED. Some MG features were different in patients with and without Sjogren syndrome

This is a 2020 ARVO Annual Meeting abstract.

 

 

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