Comparison of the meibomian gland dysfunction in patients with chronic ocular graft-versus-host disease and Sjögren’s syndrome

Choi, Won Suk; Ha, Jun Young; Li, Ying; Choi, Ji‐Young; Ji, Yong Sok; Yoon, Kyung Chul

doi:10.18240/ijo.2019.03.07

Cited by 13 publications

(10 citation statements)

References 23 publications

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“…A previous study on MGD in patients with pSS reported that changes in the meibomian gland induced an increase of tear evaporation and subsequent worsening of the ocular surface desiccation [ 38 ]. Furthermore, in another study, morphological and functional features of the meibomian gland correlated with other ocular surface parameters and disease severity in ADDE, such as pSS and graft-versus-host disease [ 39 ]. According to this result, more attention is needed in pSS patients with low FBUT and severe MGD, which could cause more ocular surface epithelial damage.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with ocular surface epithelial damage in patients with primary Sjögren’s syndrome

Kim

Chin

et al. 2021

BMC Ophthalmol

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Background The aim of this study was to evaluate the effects of systemic parameters, laboratory findings, oral parameters, and other ocular surface parameters on ocular surface epithelial damage in patients with primary Sjögren’s syndrome (pSS). Methods A total of 82 dry eye disease (DED) patients with pSS were enrolled in this study. Ocular surface epithelial damage was measured by ocular staining score (OSS). Systemic parameters, laboratory findings including serologic markers, oral parameters, and other ocular surface parameters were collected. Other ocular surface parameter assessments such as the Schirmer’s test, fluorescein tear breakup time, meibomian gland examinations, noninvasive keratographic tear film break-up time measurements using the Keratograph® 5 M were performed, and the Ocular Surface Disease Index was determined. Results In a multivariate analysis, decreased age and increased duration of pSS were significantly related to increased logarithm-transformed OSS (β = -0.011, P = 0.043 and β = 0.003, P = 0.008). Among the ocular surface parameters, decreased fluorescein tear breakup time and increased MGD grade were significantly associated with increased logarithm-transformed OSS (β = -0.183, P < 0.001 and β = 0.192, P = 0.049). Conclusions Ocular surface epithelial damage in patients with pSS was associated with young age, long duration of disease, unstable tear film, and decreased meibomian gland function.

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Section: Discussionmentioning

confidence: 99%

Factors associated with ocular surface epithelial damage in patients with primary Sjögren’s syndrome

Kim

Chin

et al. 2021

BMC Ophthalmol

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“…[ 54 55 ] The MG loss and damage in oGVHD are often more severe than those seen in other DED such as Sjogren’s syndrome. [ 56 ] Early detection and aggressive management can perhaps help in minimizing damage in oGVHD as few studies have shown some reversibility of MG damage in the initial stages. [ 52 57 58 ] Meibography revealed a loss of about 80% MG function in oGVHD patients evaluated over 1 year with over 25% being refractory to treatment.…”

Section: Clinical Featuresmentioning

confidence: 99%

“…Meibography is a technique of in vivo observation of MGs[ 48 56 57 58 61 76 77 ]. Meibography in oGVHD shows complete or partial MG loss/atrophy, structural alteration such as distortion, or dilation of ducts.…”

Section: Newer Diagnostic Modalitiesmentioning

confidence: 99%

“…Meibography in oGVHD shows complete or partial MG loss/atrophy, structural alteration such as distortion, or dilation of ducts. [ 52 56 58 ] Occasional finding of slender MG either pre- and early-post-HSCT has been attributed to long-term immunosuppression causing sebaceous hyperplasia which results in obstruction MGD and can be reversed in some cases. [ 57 ] As MG loss seen prior to the allo-HSCT can progress rapidly following oGVHD onset, noninvasive meibography for routine evaluation of hematological malignancies patients before and at regular follow-up posttransplant has been recommended.…”

Section: Newer Diagnostic Modalitiesmentioning

confidence: 99%

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Update on ocular graft-versus-host disease

Nair

Vanathi

Mukhija

et al. 2021

Indian Journal of Ophthalmology

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Ocular graft-versus-host disease (oGVHD) occurs as a complication following hematopoietic stem cell transplantation and is associated with significant ocular morbidity resulting in a marked reduction in the quality of life. With no current consensus on treatment protocols, management becomes challenging as recurrent oGVHD often refractory to conventional treatment. Most authors now diagnose and grade the disease based on criteria provided by the National Institutes of Health Consensus Conference (NIH CC) or the International Chronic oGVHD (ICCGVHD) consensus group. This article will provide an insight into the diagnostic criteria of oGVHD, its classification, and clinical severity grading scales. The inflammatory process in oGVHD can involve the entire ocular surface including the eyelids, meibomian gland, corneal, conjunctiva, and lacrimal system. The varied clinical presentations and treatment strategies employed to manage them have been discussed in the present study. The recent advances in ocular surface imaging in oGVHD patients such as the use of meibography and in vivo confocal microscopy may help in early diagnosis and prognostication of the disease. Researching tear proteomics and identification of novel potential tear biomarkers in oGVHD patients is an exciting field as they may help in objectively diagnosing the disease and monitoring the response to treatment.

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“…It was stated that in patients with Sjögren syndrome Meibomian glands have increased number of occluded orifices, metaplasia and reduced quality of Meibomian gland secretions. Thus it is important to consider infestation with Demodex mites in patients who are non-responsive to Meibomian gland disease treatment [ 2 , 17 ]. Reducing the number of mites is the main and more possible to achieve the goal of treating demodicosis.…”

mentioning

confidence: 99%

Massive Demodicosis of the Eyes in a Patient with Sjögren Syndrome: A Case Report

et al. 2020

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Purpose Demodex mites infestation, typically asymptomatic, is a problem for patients with weakened immune systems because it often takes the form of symptomatic, massive infection. The Demodex mites play an important role in the occurrence of a range of eye surface diseases such as Demodex blepharitis, Meibomian gland dysfunctions, conjunctivitis and corneal changes. The ocular infection is closely related to the systemic invasion. Our goal was to minimize infestation and alleviate the symptoms of massive demodicosis so as to prevent further damage to the cornea. Methods Our research note involves a 61-year old woman diagnosed with secondary Sjögren syndrome due to rheumatoid arthritis. On the background of the autoimmune disease, corneal perforation of the left eye occurred that was cured by surgery. Then during the follow-up visit the patient was found (microscopically) massively infected with Demodex mites and the developed symptoms were particularly severe. Results Adequate dry eye syndrome and massive demodicosis therapy significantly reduced the number of Demodex mites and improved the patient’s condition. Conclusion We would like to draw the attention of the physicians of different specialties that special care should be taken with respect to the therapy of dry eye syndrome and ocular demodicosis in patients with immunological disorders to achieve therapeutic success and avoid particularly dangerous consequences of these diseases.

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Comparison of the meibomian gland dysfunction in patients with chronic ocular graft-versus-host disease and Sjögren’s syndrome

Cited by 13 publications

References 23 publications

Factors associated with ocular surface epithelial damage in patients with primary Sjögren’s syndrome

Factors associated with ocular surface epithelial damage in patients with primary Sjögren’s syndrome

Update on ocular graft-versus-host disease

Massive Demodicosis of the Eyes in a Patient with Sjögren Syndrome: A Case Report

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