Abstract
Purpose :
To correlate the relationship between lid margin rete ridges (RR) differentiating into the meibomian gland (MG) distal duct basement membrane (BM) (ARVO 2022) with lid margin fluorescein staining and infrared meibography results.
Methods :
Confocal microscopy (CFM) images of MG at the upper lid margin (avg 4 glands/lid) of 494 lids from 247 patients diagnosed with MGD were reviewed to determine the presence of orifice-overlying RR and given a grade A, B, C, or D based on if/how they differentiate into the MG distal duct BM (grade A: healthy RR form BM, grade B: unhealthy RR form BM, grade C: enlarged and inactive RR with no clear BM, grade D: Absence of RR with well demarcated BM). Lids with a uniform grade were deemed as “pure lids”. 37 pure lids from 28 patients (52.02 ±15.70 y/o, OD:OS=16:21, M:F=18:19) had meibography exams to evaluate gland area (%GA) and fluorescein staining to identify the location of the MCJ at the lid margin. IBM SPSS version 25 software was used to run descriptive and statistical analysis for significance (p≤ 0.05).
Results :
Statistical analysis showed a significant relationship between the presence and health of orifice-overlying rete ridges (OORR) and the location of the MCJ (p=0.002) where all lids with posterior staining demonstrated OORR (grade A, B, or C), all lids with anterior staining showed no OORR (grade D), and lids with midline staining varied in the presence of OORR on CFM. Furthermore, the location of the MCJ was correlated with %GA on meibography (p=0.035) where lids with posterior staining had an average %GA of 36.03%, midline staining had an average of 28.75%, and anterior staining had an average of 17.28%. The %GA was also significantly correlated with Grades A-D (p=0.002) where %GA was equal to 39.98%, 29.95%, 25.68%, and 19.43%, respectively.
Conclusions :
This study of rete ridge differentiation using volume CFM further emphasizes the role of these structures in the formation and maintenance of the MG external duct wall and basal epithelium as well as strongly suggests stem cell activity to support MG health.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.