Abstract
Purpose :
Marx's line (ML) indicates the transition from the epidermis of the dry lid to the conjunctiva. Age and pathological changes are linked to a shift in the line's position. The position and path of the Marx line in test subjects with healthy eyes were examined in this exploratory study.
Methods :
The images of ML stained with lissamine green of the upper and lower eyelids from 25 healthy participants (20 female, 5 male) aged 25 ± 4 years were analyzed. ML was measured in three different areas: nasally, centrally, temporally and additinally depending on the position it had to the Meibomian gland orifices. The evaluation included the visibility of the meibomian gland orifices on the lid's edge, the assignment of a 3-point score (grade 1-3) to the Marx shift in line and the staining behaviour at the tear ducts and any other abnormalities that seemed pertinent.
Results :
In every subject, the meibomian gland orifices were visible. In any case, ML did not cross grade 2 in relation to the gland's orifices which is located on the meibomian gland openings. The evaluation of the upper eyelid showed grade 1 in 72% (18/25), and grade 2 in 28% (7/25). On the lower eyelid grade 1 was 48% (12/25) and grade 2 was 52% (13/25). ML was primarily visible behind the meibomian gland openings on the upper eyelid, nasal, temporal, and central regions. The course was nasally, temporally, centrally, mostly on the meibomian gland orifices on the lower eyelid. ML became thicker at the tear points. 13 subjects had lid-wiper epitheliopathies.
Conclusions :
The ML does not always run behind the meibomian gland orifices in subjects with healthy eyes, contrary to what has been reported in the literature. In 52% of the lower eyelids, there is a contact between the Marx line and the meibomian gland orifices. It is necessary to conduct additional research to ascertain whether the shift in ML’s position in relation to the meibomian gland orifices can function as a marker of pathological alterations in the eye, e.g. Dry Eye.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.