Abstract
Purpose :
Meibomian gland dysfunction (MGD) comprises a group of conditions that involve functional and structural abnormalities of the Meibomian glands (MG). Various clinical findings are lumped under this diagnosis including eyelid telangiectasias, MG plugging, MG dropout, and abnormal meibum quality. However, it is not clear if the various signs of MGD are driven by similar underlying contributors.
Methods :
Prospective study of 39 United States veterans. All individuals were screened for signs of MGD and provided tear samples via Schirmer strip from the right eye. Tears were stored at -80oC until protein extraction. A multiplex assay system was custom designed from ThermoFisher and run with the reagents, standards, and protocols supplied by the vendor to quantify 23 inflammatory proteins. Pearson correlations examined associations between clinical markers of MGD and inflammatory proteins.
Results :
The mean age of the population was 61±13 years, 95% identified as male, 31% as White, and 15% as Hispanic. Of all MGD signs, eyelid vascularity was most closely correlated with various inflammatory proteins including C-X-C motif chemokine ligand (CXCL) 11, interferon (IFN)-γ, interleukin (IL)-4, IL-17A, matrix metalloproteinase (MMP)-2, C-C motif chemokine ligand (CCL) 5, and tumor necrosis factor (TNF)-α (r range from 0.37 to 0.49, p<0.05 for all). MG dropout and meibum quality were less strongly correlated with inflammatory markers, with notable associations including CCL2 and meibum quality (r = -0.38) and CXCL11 and MG dropout (r = 0.33), p<0.05 for both. Some dry eye (DE) parameters also correlated with inflammatory proteins, most notably corneal staining and IL-1α, IL-8, macrophage inflammatory protein (MIP)-1α, MMP-9, and CCL5 (r range from 0.38 to 0.52, p<0.05 for all).
Conclusions :
Of all MGD signs, eyelid vascularity was most closely associated with inflammation. These findings suggest that inflammation may variably contribute to signs of MGD and that different treatment algorithms may be indicated for different MGD-subtypes.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.