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. 2023 Apr 11;23(1):154.
doi: 10.1186/s12886-023-02878-5.

Differential characteristics among asymptomatic and symptomatic meibomian gland dysfunction and those with dry eye

Yi-Ran Chiou  1 , Pei-Yu Lin  1   2 , Yu-Bai Chou  1   2 , Po-Wei Huang  3 , Nai-Wen Fan  4   5
Affiliations

Differential characteristics among asymptomatic and symptomatic meibomian gland dysfunction and those with dry eye

Yi-Ran Chiou et al. BMC Ophthalmol. .

Abstract

Purpose: To identify the characteristics of asymptomatic meibomian gland dysfunction (MGD), symptomatic MGD, and MGD coexisting with dry eye disease (DED).

Methods: This cross sectional study enrolled a total of 153 eyes of 87 MGD patients. Participants filled in ocular surface disease index (OSDI) questionnaires. Age, gender, Schirmer's test, meibomian gland (MG) related parameters, lipid layer thickness (LLT) and blinking were compared among patients with asymptomatic MGD, symptomatic MGD, and MGD with DED. Multivariate regression was used to analyze the significant factor of DED in MGD. Spearman's rank correlation analysis was used to evaluate the association between the significant factors and MG function.

Results: There was no difference in age, Schirmer's test, lid changes, MG secretion, and MG morphology among three groups. The OSDI of asymptomatic MGD, symptomatic MGD and MGD coexisting with DED were 8.5 ± 2.9, 28.5 ± 12.8 and 27.9 ± 10.5, respectively. Patients with MGD coexisting with DED exhibited more frequent eye blinking than that of patients with asymptomatic MGD (8.1 ± 4.1 vs. 6.1 ± 3.5 blinks/20 sec, P = 0.022), and reduced LLT than that of patients with asymptomatic MGD (68.6 ± 17.2 vs. 77.6 ± 14.5 nm, P = 0.010) and symptomatic MGD (78.0 ± 17.1 nm, P = 0.015). Multivariate analysis identified LLT (per nm, OR = 0.96, 95% CI = 0.93-0.99, P = 0.002) as a significant factor associated with DED development in MGD. The number of expressible MG was positively correlated with LLT (Spearman's correlation coefficient = 0.299, P = 0.016) but negatively correlated with the number of blinking (Spearman's correlation coefficient = -0.298, P = 0.016) in MGD patients with DED, and these findings were not identified in those without DED.

Conclusions: Asymptomatic MGD, symptomatic MGD, and MGD coexisting with DED share similar characteristics, including meibum secretion and morphology, but MGD patients coexisting with DED exhibited significantly reduced LLT.

Keywords: Dry eye disease; Interferometry; Lipid layer thickness; Meibomian gland dysfunction; Ocular surface parameters.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Box-and-whisker graphs showing clinical examinations (mean is presented as a cross symbol within the box, the 10th and 90th percentile value is presented as whiskers) of (A) lipid layer thickness and (B) total blinking in the three groups
Fig. 2
Fig. 2
The receiver operating characteristics (ROC) curve for lipid layer thickness of the eyes with coexistence of meibomian gland dysfunction and dry eye disease. AUC, area under the curve
Fig. 3
Fig. 3
Correlations between (A) meibum expressibility and lipid layer thickness or (B) meibum expressibility and complete blinking in the eyes with coexistence of meibomian gland dysfunction and dry eye disease
See this image and copyright information in PMC

References

    1. Sledge SM, Khimji H, Borchman D, Oliver AL, Michael H, Dennis EK, et al. Evaporation and hydrocarbon chain conformation of Surface lipid Films. Ocul Surf. 2016;14(4):447–59. doi: 10.1016/j.jtos.2016.06.002. - DOI - PMC - PubMed
    1. Alghamdi YA, Mercado C, McClellan AL, Batawi H, Karp CL, Galor A. Epidemiology of Meibomian Gland Dysfunction in an Elderly Population. Cornea. 2016;35(6):731–5. doi: 10.1097/ICO.0000000000000815. - DOI - PMC - PubMed
    1. Tsubota K, Yokoi N, Watanabe H, Dogru M, Kojima T, Yamada M, et al. A New Perspective on Dry Eye classification: proposal by the Asia Dry Eye Society. Eye Contact Lens. 2020;46(Suppl 1):2–s13. doi: 10.1097/ICL.0000000000000643. - DOI - PMC - PubMed
    1. Arita R, Mizoguchi T, Kawashima M, Fukuoka S, Koh S, Shirakawa R, et al. Meibomian gland dysfunction and Dry Eye are similar but different based on a Population-Based study: the Hirado-Takushima Study in Japan. Am J Ophthalmol. 2019;207:410–8. doi: 10.1016/j.ajo.2019.02.024. - DOI - PubMed
    1. Viso E, Rodríguez-Ares MT, Abelenda D, Oubiña B, Gude F. Prevalence of asymptomatic and symptomatic meibomian gland dysfunction in the general population of Spain. Invest Ophthalmol Vis Sci. 2012;53(6):2601–6. doi: 10.1167/iovs.11-9228. - DOI - PubMed

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