Evaluation of Dry Eye and Meibomian Gland Dysfunction With Meibography in Patients With Rosacea

Palamar, Melis; Değirmenci, Cumali; Ertam, İlgen; Yağcı, Ayşe

doi:10.1097/ico.0000000000000393

Cited by 60 publications

(34 citation statements)

References 18 publications

(29 reference statements)

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“…The meiboscore of individuals with ocular rosacea was found to be significantly higher than that of control subjects, [56][57][58] suggesting that rosacea, a condition with which MGD is often associated, affects the morphology of meibomian glands.…”

Section: Rosaceamentioning

confidence: 91%

Meibography: A Japanese Perspective

Arita

2018

Invest. Ophthalmol. Vis. Sci.

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Meibography allows observation of meibomian glands in an objective and repeatable manner. Original meibography systems were invasive and not readily adopted by ophthalmology clinics. The development of noncontact infrared meibography allowed the rapid and noninvasive observation of meibomian glands, and such systems have now been widely adopted for standard examinations in dry eye clinics. Noncontact meibography has also spurred research into meibomian glands and has been applied to evaluation of their structure and status in various ocular surface diseases. Although the images obtained by meibography are objective and repeatable, the interpretation of these images is subjective, with the relationship between image features and actual gland structure and composition remaining unclear. Additional clinical and basic research with regard to the interpretation of meibography images is thus necessary. Future improvements to meibography will likely provide new insights into the pathophysiology of meibomian gland diseases as well as enhance its contribution to the diagnosis and evaluation of treatments for such diseases.

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Section: Rosaceamentioning

confidence: 91%

Meibography: A Japanese Perspective

Arita

2018

Invest. Ophthalmol. Vis. Sci.

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“…123 MG dysfunction (MGD), defined by the International Workshop on MGD as a “chronic, diffuse abnormality of the MGs, commonly characterized by terminal duct obstruction and/or qualitative/quantitative changes in the glandular secretion,” is a leading cause of evaporative DED. 1,123–125 Recently, imaging of the MGs under infrared illumination has become easier to perform and can be included in clinical trial testing, 126–129 but may not be sufficient for diagnosis of MGD or DED. Some studies suggest MG dropout, using direct- or transillumination of the lid, shows a strong relationship between MGD and DED.…”

Section: Point Of Care Biomarkersmentioning

confidence: 99%

The Growing Need for Validated Biomarkers and Endpoints for Dry Eye Clinical Research

Roy

Wei

Kuklinski

et al. 2017

Invest. Ophthalmol. Vis. Sci.

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PurposeBiomarkers with minimally invasive and reproducible objective metrics provide the key to future paradigm shifts in understanding of the underlying causes of dry eye disease (DED) and approaches to treatment of DED. We review biomarkers and their validity in providing objective metrics for DED clinical research and patient care.MethodsThe English-language literature in PubMed primarily over the last decade was surveyed for studies related to identification of biomarkers of DED: (1) inflammation, (2) point-of-care, (3) ocular imaging, and (4) genetics. Relevant studies in each group were individually evaluated for (1) methodological and analytical details, (2) data and concordance with other similar studies, and (3) potential to serve as validated biomarkers with objective metrics.ResultsSignificant work has been done to identify biomarkers for DED clinical trials and for patient care. Interstudy variation among studies dealing with the same biomarker type was high. This could be attributed to biologic variations and/or differences in processing, and data analysis. Correlation with other signs and symptoms of DED was not always clear or present.ConclusionsMany of the biomarkers reviewed show the potential to serve as validated and objective metrics for clinical research and patient care in DED. Interstudy variation for a given biomarker emphasizes the need for detailed reporting of study methodology, including information on subject characteristics, quality control, processing, and analysis methods to optimize development of nonsubjective metrics. Biomarker development offers a rich opportunity to significantly move forward clinical research and patient care in DED.OverviewDED is an unmet medical need — a chronic pain syndrome associated with variable vision that affects quality of life, is common with advancing age, interferes with the comfortable use of contact lenses, and can diminish results of eye surgeries, such as cataract extraction, LASIK, and glaucoma procedures. It is a worldwide medical challenge with a prevalence rate ranging from 8% to 50%. Many clinicians and researchers across the globe are searching for better answers to understand the mechanisms related to the development and chronicity of DED. Though there have been many clinical trials for DED, few new treatments have emerged over the last decade. Biomarkers may provide the needed breakthrough to propel our understanding of DED to the next level and the potential to realize our goal of truly personalized medicine based on scientific evidence. Clinical trials and research on DED have suffered from the lack of validated biomarkers and less than objective and reproducible endpoints. Current work on biomarkers has provided the groundwork to move forward. This review highlights primarily ocular biomarkers that have been investigated for use in DED, discusses the methodologic outcomes in providing objective metrics for clinical research, and suggests recommendations for further work.

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“…It was reported that rosacea is accompanied with significant loss of meibomian glands highly associated with eyelid margin inflammation. (Palamar et al, 2015; Machalińska et al, 2016; Liang et al, 2016). Two Demodex species ( folliculorum and brevis ) have been identified as causative mites of rosacea.…”

Section: Dermatological Disorders and Meibomian Gland Pathologymentioning

confidence: 99%

Ocular surface inflammation impairs structure and function of meibomian gland

Mizoguchi

Iwanishi

Arita

et al. 2017

Experimental Eye Research

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Dysfunction of the meibomian glands alters secreted meibum quantitatively and qualitatively that can lead to damage to the ocular surface epithelium. In response to an unstable tear film cause by meibomian gland dysfunction, ocular surface epithelium is damaged and expresses inflammatory cytokines leading to secondary ocular inflammation. In turn, inflammatory disorders of the palpebral conjunctiva and lid margin may affect the structure and function of meibomian gland. The disorders include allergic conjunctivitis, long-term usage of contact lenses, dermatological diseases that affect conjunctival homeostasis, Stevens-Johnson’s syndrome or chemical burning of the ocular surface and lid margin.

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Evaluation of Dry Eye and Meibomian Gland Dysfunction With Meibography in Patients With Rosacea

Abstract: Ocular rosacea causes dry eye and significant meibomian gland loss that can objectively be demonstrated with meibography. The infrared camera of OCT-that is widely found in many ophthalmology departments-might be used to evaluate meibomian gland dysfunction in these individuals.

Cited by 60 publications

References 18 publications

Meibography: A Japanese Perspective

Meibography: A Japanese Perspective

The Growing Need for Validated Biomarkers and Endpoints for Dry Eye Clinical Research

Ocular surface inflammation impairs structure and function of meibomian gland

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