Development of Definitive and Reliable Grading Scales for Meibomian Gland Dysfunction

Arita, Reiko; Minoura, Izumi; Morishige, Naoyuki; Shirakawa, Rika; Fukuoka, Shima; Asai, Kei; Goto, Tateki; Imanaka, Tadayuki; Nakamura, Masatsugu

doi:10.1016/j.ajo.2016.06.025

Cited by 136 publications

(150 citation statements)

References 24 publications

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“…Subscores for full and partial MG dropout were also significantly higher in children with BKC than in healthy volunteers (Arita et al. ) (Table ). There was no statistically significant difference between upper and lower lid full/partial MG dropout scores in either group.…”

Section: Resultsmentioning

confidence: 98%

“…Chronic MG inflammation is associated with MG dropout or loss, and meibography has high sensitivity and specificity in the diagnosis of MG dysfunction (Pult & Nichols ; Arita ; Pult & Riede‐Pult ; Arita et al. , ; Yin & Gong ). In adults with BKC, considered a severe form of MG dysfunction in this population, (Tong ) MG morphology may show distinctive changes, characterized by a lesser degree of partial and full MG dropout (Yin & Gong ).…”

Section: Discussionmentioning

confidence: 99%

“…). the updated meiboscore system distinguishes between ‘full’ and ‘partial’ MG loss or dropout (Arita et al. ). Full MG loss is graded from 0 to 2, partial MG loss is graded from 0 to 3 (Arita et al.…”

Section: Methodsmentioning

confidence: 99%

“…Full MG loss is graded from 0 to 2, partial MG loss is graded from 0 to 3 (Arita et al. ). Meibomian gland distortion is a potential marker of structural MG change and is graded from 0 to 5 (Zhao et al. ).…”

Section: Methodsmentioning

confidence: 99%

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Meibography and corneal volume optical coherence tomography to quantify damage to ocular structures in children with blepharokeratoconjunctivitis

Al-Hayouti

Daniel

Hingorani

et al. 2019

Acta Ophthalmologica

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Purpose To evaluate non‐contact infrared meibography and anterior segment optical coherence tomography (AS‐OCT) to detect meibomian gland (MG) and corneal changes in children with blepharokeratoconjunctivitis (BKC). Methods We acquired infrared meibography images of upper and lower lids and AS‐OCT corneal scans. One masked observer graded meiboscore, full/partial MG dropout, and measured total corneal volume and differential corneal volume per quadrant and central corneal thickness (CCT). Results We enrolled 63 children, 31 with BKC and 32 without ocular surface inflammation; median (interquartile range) age BKC 10.6 (7.2‐13.9) years, healthy volunteers (HV) 11.4 (9.5‐13.8) years. Likert scale scores for meibography and OCT indicate no to low discomfort. Meiboscores for upper and lower lids as well as the total meiboscore were significantly higher in children with BKC than in HV. Subscores for full and partial MG dropout were also significantly higher in children with BKC than in healthy volunteers. There was no statistically significant difference between upper and lower lid for meiboscore nor full/partial MG dropout scores. The corneal volume in the superior quadrant was significantly higher in children with BKC than in HV, whereas the corneal volume in the nasal and inferior quadrants was significantly lower. Conclusions Non‐contact imaging technologies objectively demonstrate damage to meibomian glands and changes in corneal volume secondary to BKC. The tests are well tolerated by children with mild/moderate ocular surface inflammation and can detect changes without the requirement for routine eversion of the upper lid. These parameters may be useful both for clinical follow‐up and clinical trials.

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Section: Resultsmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Meibography and corneal volume optical coherence tomography to quantify damage to ocular structures in children with blepharokeratoconjunctivitis

Al-Hayouti

Daniel

Hingorani

et al. 2019

Acta Ophthalmologica

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“…Several grading scales for meibomian gland dysfunction have been proposed and adopted in clinical practice [44]. These scales are based on findings for the lid margin or meibomian glands, although their utility for ocular GVHD has not been well validated.…”

Section: Meibomian Scorementioning

confidence: 99%

Ocular Graft-versus-Host Disease after Hematopoietic Cell Transplantation: Expert Review from the Late Effects and Quality of Life Working Committee of the Center for International Blood and Marrow Transplant Research and Transplant Complications Working Party of the European Society of Blood and Marrow Transplantation

Inamoto¹,

Valdés-Sanz

Ogawa

et al. 2019

Biology of Blood and Marrow Transplantation

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A B S T R A C T Ocular graft-versus-host disease (GVHD) occurs in more than one-half of patients who develop chronic GVHD after allogeneic hematopoietic cell transplantation (HCT), causing prolonged morbidity that affects activities of daily living and quality of life. Here we provide an expert review of ocular GVHD in a collaboration between transplantation physicians and ophthalmologists through the Late Effects and Quality of Life Working Committee of the Center for International Blood and Marrow Transplant Research and the Transplant Complications Working Party of the European Society of Blood and Marrow Transplantation. Recent updates in ocular GVHD regarding pathophysiology, preclinical models, risk factors, prevention, screening, diagnosis, response criteria, evaluation measures, and treatment are discussed. Ocular GVHD involves at least 3 biological processes: lacrimal gland dysfunction, meibomian gland dysfunction, and corneoconjunctival inflammation. Preclinical models have identified several novel pathogenic mechanisms, including the renin angiotensin system and endoplasmic reticulum stress signaling, which can be targeted by therapeutic agents. Numerous studies have identified reliable tests for establishing diagnosis and response assessment of ocular GVHD. The efficacy of systemic and topical treatment for ocular GVHD is summarized. It is important that all health professionals caring for HCT recipients have adequate knowledge of ocular GVHD to provide optimal care.

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Evaluation of ocular surface parameters in dogs with and without meibomian gland dysfunction

et al. 2022

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Background: Interest in meibomian gland dysfunction (MGD) is growing in veterinary medicine. However, research on MGD in dogs is lacking. The aims of this study were to compare the interferometry grades, tear meniscus height (TMH) and non-invasive tear break-up time (NIBUT) grades between dogs with and without MGD. Methods: Routine ophthalmic examination, interferometry, NIBUT assessment, TMH measurement and meibography were performed. Age and Schirmer tear test-1 (STT-1) results were compared between the control and MGD groups using Student's t-test. Interferometry grades, NIBUT grades and TMH were compared between the two groups using Mann-Whitney U-test. Results: There was no significant difference in age between the two groups (p = 0.279). STT-1 (p = 0.024), interferometry (p = 0.004) and NIBUT grades (p = 0.012) were significantly lower in the MGD group than in the control group. No significant difference in TMH values (p = 0.587) was observed between the two groups. While the control group included 18 and seven eyes in meiboscore 0 and 1, in MGD group, 12, eight, five and three eyes were included in meiboscore 0, 1, 2 and 3, respectively. Conclusions: Low interferometry and NIBUT grades were associated with MGD, suggesting decreased meibum and disrupted tear film quality. TMH did not differ between the two groups. Meibography could aid in the diagnosis of MGD in severe cases, although it could not detect early MGD in the dogs in this study.

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Development of Definitive and Reliable Grading Scales for Meibomian Gland Dysfunction

Abstract: New grading scales for MGD signs were developed and found to have appropriate inter- and intrarater reliabilities for grading MGD. These grading scales are suitable for MGD diagnosis and application to multicenter trials.

Cited by 136 publications

References 24 publications

Meibography and corneal volume optical coherence tomography to quantify damage to ocular structures in children with blepharokeratoconjunctivitis

Meibography and corneal volume optical coherence tomography to quantify damage to ocular structures in children with blepharokeratoconjunctivitis

Evaluation of ocular surface parameters in dogs with and without meibomian gland dysfunction

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