Relationship between eyelid margin irregularity and meibomian gland dropout

Ha, Minji; Hong, Seo-Yeon; Chang, Dong Jin; Whang, Woong-Joo; Na, Kyung‐Sun; Kim, Eun Chul; Kim, Hyun Seung; Hwang, Ho Sik

doi:10.1016/j.jtos.2020.11.007

Cited by 15 publications

(12 citation statements)

References 21 publications

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“…The upper eyelid could be relaxed to a larger extent to compensate for the damage induced by OOK (43)(44)(45). It may be that the lower eyelid is more irregular (46), and so predisposed to greater meibomian gland dropout. Considering that the upper eyelid usually shows a larger area lens than the lower eyelid during sleep, its deformation might be less affected by wearing OOK lenses, which results in a more regular lid margin and lower meiboscore.…”

Section: Discussionmentioning

confidence: 99%

Orthokeratology Lens Wear for 2 Years in Children Did Not Alter Tear Film Lipid Thickness by Non-Invasive Interferometry

Yuan

et al. 2022

Front. Med.

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PurposePrevious studies suggest that overnight orthokeratology (OOK) may be detrimental to tear function. We aimed to investigate the effect of OOK on lipid layer thickness (LLT), blink pattern, and meibomian gland and elucidate the relationship of these variables.MethodsThirty-seven participants who wore OOK lenses every night for at least 2 years and twenty-four healthy non-contact lens wearers (controls) were enrolled in this retrospective study. LipiView interferometry, blink pattern analysis, the ocular surface status, and morphology and function of the meibomian gland were determined.ResultsThe OOK group and healthy controls had similar LLT, blink patterns, ocular surface status, and the function of the meibomian gland. OOK participants demonstrated higher meiboscore in the lower eyelids (p < 0.05) but not in the upper eyelids. Within the OOK group, LLT was significantly impacted by the partial blink rate (p < 0.05) and the total score of the upper meibomian gland (p = 0.10).ConclusionsWearing OOK for 2 or more years increased lower eyelid meibomian gland dropout but did not have a reduction of LLT.

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Section: Discussionmentioning

confidence: 99%

Orthokeratology Lens Wear for 2 Years in Children Did Not Alter Tear Film Lipid Thickness by Non-Invasive Interferometry

Yuan

et al. 2022

Front. Med.

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“…Previous studies described similar inconsistencies and weak intergrading correlation in meibography. [9,16,45] On the other hand, the DL-based meiboscore prediction achieved an accuracy of 73.01% on images annotated by MGD Expert 1,2 and 59.17% on images annoted by MGD Experts of different test center.…”

Section: Discussionmentioning

confidence: 99%

AI-based automated Meibomian gland segmentation, classification and reflection correction in infrared Meibography

Saha¹,

Chowdhury²,

Na³

et al. 2022

Preprint

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Purpose: Develop a deep learning-based automated method to segment meibomian glands (MG) and eyelids, quantitatively analyze the MG area and MG ratio, estimate the meiboscore, and remove specular reflections from infrared images. Methods: A total of 1600 meibography images were captured in a clinical setting. 1000 images were precisely annotated with multiple revisions by investigators and graded 6 times by meibomian gland dysfunction (MGD) experts. Two deep learning (DL) models were trained separately to segment areas of the MG and eyelid. Those segmentation were used to estimate MG ratio and meiboscores using a classification-based DL model. A generative adversarial network was implemented to remove specular reflections from original images. Results: The mean ratio of MG calculated by investigator annotation and DL segmentation was consistent 26.23% vs 25.12% in the upper eyelids and 32.34% vs. 32.29% in the lower eyelids, respectively. Our DL model achieved 73.01% accuracy for meiboscore classification on validation set and 59.17% accuracy when tested on images from independent center, compared to 53.44% validation accuracy by MGD experts. The DL-based approach successfully removes reflection from the original MG images without affecting meiboscore grading. Conclusions: DL with infrared meibography provides a fully automated, fast quantitative evaluation of MG morphology (MG Segmentation, MG area, MG ratio, and meiboscore) which are sufficiently accurate for diagnosing dry eye disease. Also, the DL removes specular reflection from images to be used by ophthalmologists for distraction-free assessment.

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“…Environmental dryness or humidity may be an important reason for the difference in eyelid margins between patients living in the north and south. Although morphological changes of the eyelid margin can reflect the condition of the meibomian gland [ 25 ], patients with MGD may not have eyelid margin abnormalities, and a comprehensive assessment is needed to evaluate the presence and severity of MGD.…”

Section: Discussionmentioning

confidence: 99%

The lack of correlation between symptoms and signs in patients with meibomian gland dysfunction: a secondary analysis of the multicenter, randomized controlled trial

et al. 2022

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Background This study was performed to investigate the association between symptoms and signs in patients with meibomian gland dysfunction (MGD). Methods Data were obtained from 122 MGD patients who were recruited for intense pulsed light therapy from November 2017 to April 2018 and the severity of their symptoms and signs at baseline were observed and recorded. Spearman correlation analyses were performed to analyze the relationships between SPEED score and signs. Subjects were divided into different subgroups based on possible influencing factors, and the differences in symptoms and signs were compared between different subgroups. Then influencing factors were controlled by regression analysis to explore the relationship between symptoms and signs and the strong factors affecting symptoms and signs. Results Analysis of baseline data showed that SPEED scores were not correlated with TBUT, CFSS, MGYSS or any index of eyelid margin abnormality (p > 0.05). In addition, abnormalities of lid margins, including hyperemia, thickening, rounding, hyperkeratinization, and telangiectasia around orifices, were more likely to occur in older patients, menopausal patients, and patients living in northern China. Multiple linear regression analysis indicated that there was still no correlation between symptoms and signs (p > 0.05) after adjusting for influencing factors. Further analysis suggested that each influencing factor has different effects on symptoms and signs, among which menopause affects the SPEED score (R = -4.112, p = 0.025), and age and region have significant effects on eyelid margin abnormalities. Conclusions In conclusion, the results demonstrated a poor correlation between symptoms and signs in MGD patients. Age, hormone, and a dry environment may influence the disease, which suggests that the severity of the disease needs to be comprehensively assessed.

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Relationship between eyelid margin irregularity and meibomian gland dropout

Cited by 15 publications

References 21 publications

Orthokeratology Lens Wear for 2 Years in Children Did Not Alter Tear Film Lipid Thickness by Non-Invasive Interferometry

Orthokeratology Lens Wear for 2 Years in Children Did Not Alter Tear Film Lipid Thickness by Non-Invasive Interferometry

AI-based automated Meibomian gland segmentation, classification and reflection correction in infrared Meibography

The lack of correlation between symptoms and signs in patients with meibomian gland dysfunction: a secondary analysis of the multicenter, randomized controlled trial

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