Meibomian Gland Disease

Chhadva, Priyanka; Goldhardt, Raquel; Galor, Anat

doi:10.1016/j.ophtha.2017.05.031

Cited by 262 publications

(176 citation statements)

References 61 publications

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“…Their primary function is to produce meibum, a compositionally complex lipid secretion that promotes tear film stability and prevents evaporation. 4 Meibomian gland dysfunction (MGD), characterized by impaired meibum delivery due to obstruction, inflammation, gland dropout, and so on, is believed to be one of the most common disorders encountered in ophthalmic practice and the leading cause of DED. 5 , 6 Thus, a better understanding of MGD pathology may reveal pathogenic mechanisms and, ultimately, lead to better treatment paradigms for patients with evaporative dry eye.…”

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confidence: 99%

Wide-Field In Vivo Confocal Microscopy of Meibomian Gland Acini and Rete Ridges in the Eyelid Margin

Zhou

Robertson

2018

Invest. Ophthalmol. Vis. Sci.

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PurposeIn vivo confocal microscopy (IVCM) has been widely used to evaluate changes in the meibomian glands (MGs) in response to age and disease. This study examined the structures described as MGs using wide-field IVCM and laser scanning confocal microscopy (LSCM) in situ and characterized their spatial distribution and localization relevant to the eyelid margin.MethodsIVCM was performed on 30 subjects aged 18 to 38 to visualize structures in the eyelid margin. Size, shape, and distribution characteristics were measured, and individual frames were montaged into wide-field images. Structures observed on IVCM were then visualized using LSCM of whole-mount and cryosectioned cadaver eyelids stained with Nile red, mucin-1 (MUC1), laminin-5, and 4′,6-diamidine-2′-phenylindole dihydrochloride.ResultsThe size, distribution, and staining patterns of the reflective structures seen on IVCM did not correspond to the MGs in cadaver eyelids. Instead, staining profiles indicated that these structures corresponded to the rete ridges present at the dermal–epidermal junction. Wide-field imaging showed a densely populated field of rete ridges with distinct size and shape characteristics depending on their location relative to the meibomian orifices. A distal shift of the mucocutaneous junction (MCJ) was evident in some eyelids.ConclusionsIVCM is unable to visualize MGs in the human eyelid margin due to light attenuation at that tissue depth. LSCM confirms that these structures are rete ridges located at the dermal–epidermal junction. Alterations in the structure of the dermal–epidermal junction within the eyelid margin indicate a shifting of the MCJ and may impact tear film dynamics.

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confidence: 99%

Wide-Field In Vivo Confocal Microscopy of Meibomian Gland Acini and Rete Ridges in the Eyelid Margin

Zhou

Robertson

2018

Invest. Ophthalmol. Vis. Sci.

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“…Meibomian gland dysfunction is the leading cause of evaporative dry eye and is also the most common pathology underlying cases of aqueous-deficient dry eye [ 1 , 14 ]. The meibomian glands are recognized as large sebaceous glands vertically aligned in the eyelids, but research into their morphology related to their openings is limited.…”

Section: Discussionmentioning

confidence: 99%

“…Meibomian gland dysfunction (MGD) is characterized by functional abnormalities of the meibomian glands [ 1 ]. MGD is likely the primary cause of evaporative dry eye and may occur in conjunction with aqueous-deficient dry eye [ 2 , 3 ].…”

Section: Introductionmentioning

confidence: 99%

Comparison of the Meibomian Gland Openings by Optical Coherence Tomography in Obstructive Meibomian Gland Dysfunction and Normal Patients

Cui

Zhai

et al. 2020

JCM

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Purpose: The aim of this study was to use swept-source anterior segment optical coherence tomography (OCT) to explore imaging the meibomian gland openings and to identify their in vivo characteristics in patients with obstructive meibomian gland dysfunction (MGD) and healthy participants. Methods: We enrolled 49 patients with MGD and 54 health controls in this case-control study. Each participant underwent slit-lamp examination, meibography, and OCT scanning. Sixteen patients with MGD underwent a repeat OCT examination after eyelid massage. The outcome measures included determinations of meibomian gland openings (orifices and terminal ducts) from OCT images and comparisons of the meibomian openings between patients with MGD and normal controls before and after meibomian gland massage. Results: Using the same OCT scanning model, the number of visible orifices of the meibomian glands was similar between eyes with MGD and normal eyes (9.2 ± 2.3 vs. 9.7 ± 2.4). The mean diameter of the terminal ducts in patients with MGD was larger (120.22 ± 27.92 µm vs. 100.96 ± 20.30 µm) than in the normal controls, and had a larger coefficient of variation. Significant differences were observed in the mean diameter of the terminal ducts of patients with MGD before and after meibum gland massage (133.73 ± 27.81 μm vs. 102.26 ± 24.30 μm, p < 0.001). Conclusions: Patients with MGD have more diversified orifices and larger meibomian gland terminal duct diameters than normal subjects. In addition, meibomian gland terminal duct diameters seem to decrease in patients with MGD after meibum gland massage.

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“…MGD is characterized by chronic abnormalities of the meibomian glands, resulting in altered meibum delivery to the tear film, which can result in poor tear film stability or poor breakup times, a type of dry eye classified as evaporative dry eye. On the other hand, dry eye may also be due to aqueous tear deficiency [ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Strip Meniscometry and Association with Clinical and Demographic Variables in a Community Eye Study (in Bangladesh)

Rashid¹,

Thia

Teo

et al. 2020

JCM

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Strip meniscometry (SM) is a relatively new technique for evaluating inferior tear meniscus. We described SM in an epidemiology study and its potential associations with clinical and tear parameters. This cross-sectional study involved 1050 factory garment workers in Gazipur, Bangladesh. The Ocular Surface Disease Index (OSDI) questionnaire and a standard examination for dry eye and meibomian gland dysfunction (MGD), including the five-second SM, were performed by a single ophthalmologist. The participants’ ages were 35.56 ± 12.12 years (range 18–59), with 53.8% women. The overall SM was 7.7 ± 3.6 mm, with skewness of 0.126 and kurtosis of 1.84 in frequency distribution. SM values were significantly lower in men than women, and significantly correlated with schirmers (r = 0.71) and tear break up time (TBUT) (r = 0.89). A lower SM value was associated with higher OSDI, lower Schirmer test, increased MG severity and lower TBUT. In multivariable analysis, when adjusted by age, SM values remained associated with schirmers and TBUT, and inversely associated with OSDI. In a separate regression model, higher SM was associated with increasing age, reduced severity of MGD grading, and increased TBUT. To conclude, SM is a rapid clinical test associated with dry eye symptoms and signs, with findings affected by both tear secretion and tear stability.

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Meibomian Gland Disease

Cited by 262 publications

References 61 publications

Wide-Field In Vivo Confocal Microscopy of Meibomian Gland Acini and Rete Ridges in the Eyelid Margin

Wide-Field In Vivo Confocal Microscopy of Meibomian Gland Acini and Rete Ridges in the Eyelid Margin

Comparison of the Meibomian Gland Openings by Optical Coherence Tomography in Obstructive Meibomian Gland Dysfunction and Normal Patients

Evaluation of Strip Meniscometry and Association with Clinical and Demographic Variables in a Community Eye Study (in Bangladesh)

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