Correlation of non‐contact Meibography to dry eye symptoms and signs in Sjögren`s syndrome and graft‐versus‐host disease

Abstract

Purpose Severe dry eye is often observed in patients suffering from Sjögren’s syndrome (SS) or chronic graft‐versus‐host‐disease (cGVHD). Although the underlying pathomechanisms differ, deficient tear production, as well as meibomian gland dysfunction (MGD) are present in both. Non‐contact Meibography can achieve a non‐invasive investigation of the meibomian glands inside the tarsal plates of the eyelids. The purpose of this study was to evaluate the correlation of non‐contact Meibography to dry eye symptoms in patients suffering from SS or cGVHD. Methods We examined 37 patients suffering from SS and 11 patients with cGVHD of our dry eye unit. Subjective dry eye symptoms were evaluated with a visual analogue scale and the Ocular Surface Disease Index© (OSDI). Clinical signs of MGD were graded from 0 to 3 according to the Report of the TFOS Workshop on MGD. Non‐contact Meibography was performed by a Heidelberg Retina Angiograph 1, featuring two infrared diode lasers. Partial or complete loss of the meibomian glands was scored according to the meiboscore of Arita and colleagues. Results The mean age of the study population was 55.3 ± 13.4 years and 91.7% were women. The Meiboscore correlated significantly with the subjective symptoms assessed by visual analogue scale. The grading of the lid margins correlated significantly with the Meiboscore. Conclusion Non‐contact Meibography is a valuable tool in the diagnosis of MGD. Standard ophthalmic angiography cameras equipped with infrared diodes can easily perform it. The meiboscore correlates with the intensity of subjective symptoms and lid margin changes in patients suffering from SS or cGVHD.

Nicht invasive Diagnostik der okulären Graft-versus-Host-Erkrankung

“…Ebenso wie mit der konfokalen Mikroskopie kann mithilfe der Infrarot-Meibografie nicht nur der generelle Status der Meibom-Drüsen erhoben, sondern auch eine Abnahme mittels standardisierter Scores verfolgt werden [34]. Eine Studie an wenigen Patienten zeigte eine deutliche Reduktion der Meibom-Drüsen bei Patienten mit chronischer okulärer GvHD gegenüber Normalpatienten [31].…”