Meibomian Gland Dysfunction Correlates to the Tear Film Instability and Ocular Discomfort in Patients with Pterygium

Wu, Huping; Zhong, Lin; Yang, Fan; Fang, Xie; Dong, Ning; Luo, Shuyi; Shang, Xumin; Li, Wei; Liu, Zuguo

doi:10.1038/srep45115

Cited by 23 publications

(37 citation statements)

References 18 publications

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“…This study reported NIBUT, meibomian gland dropout and meibum score alterations in pterygium patients. [9] However, besides these findings, by evaluating each patient meibography picture, an association of the dropout area related to the topography of the pterygium was observed in a considered number of cases, to our knowledge, no association with pterygium localization was described before. [23]…”

Section: Discussionmentioning

confidence: 87%

“…Some studies have pointed to tear film and ocular surface varying changes related to pterygium, but consistent correlations remain unknown. [6–9] Although numerous theories have been listed in the pathogenesis of the pterygium (e.g. exposure to ultraviolet radiation, viral infection, oxidative stress, genetic problems, inflammatory mediators, extracellular matrix modulators) the mechanism responsible development remains controversial.…”

Section: Introductionmentioning

confidence: 99%

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Impact of pterygium on the ocular surface and meibomian glands

et al. 2019

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PurposeTo analyze how ocular surface parameters correlate to presence of pterygium and investigate the possible impact of pterygia on tear film findings and meibomian glands findings.MethodsWe investigated objective parameters of the ocular surface such as conjunctival hyperemia, tear film stability and volume, meibomian gland dysfunction, dry eye disease, corneal topography comparing healthy individuals and correlating with the pterygium clinical presentation.ResultsA total of 83 patients were included. Corneal astigmatism induction was 2.65 ± 2.52 D (0.4–11.8). The impact of pterygium on the ocular surface parameters compared to matched controls was seen in: conjunctival hyperemia (control 1.55±0.39/pterygium 2.14±0.69; p = 0.0001), tear meniscus height (control 0.24±0.05 mm/pterygium 0.36±0.14mm; p 0.0002), meiboscore lower eyelid (control 0.29±0.64/pterygium 1.38±0.95; p 0.0001) and meiboscore upper eyelid (control 0.53±0.62/pterygium 0.98±0.75; p = 0.0083). We found a high number of pterygium patients (88%) presented meibomian gland alterations. Interestingly, meibomian gland loss was coincident to the localization of the pterygium in 54% of the upper and 77% lower lids.ConclusionPterygium greatly impacts on ocular surface by inducing direct alterations in the pattern of meibomian glands besides corneal irregularities, conjunctival hyperemia and lacrimal film alterations, inducing significant symptoms and potential signs of dysfunction.

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Section: Discussionmentioning

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Impact of pterygium on the ocular surface and meibomian glands

et al. 2019

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“…Some studies have pointed tear film and ocular surface changes related to pterygium, but consistent correlations remain unknown. [6–9] Although numerous theories have been implicated in pterygium pathogenesis, including ultraviolet radiation exposure, viral infection, oxidative stress, genetic issues, inflammatory mediators, extracellular matrix modulators, it remains controversial as well as its impact on ocular surface homeostasis and function. [10] And a better understanding of the pathophysiological mechanisms associated with pterygium, the morphological alterations on the ocular surface and functional impact may contribute to specific approaches and more effective therapeutic proposals for this common ocular condition.…”

Section: Introductionmentioning

confidence: 99%

Impact of pterygium on the ocular surface and meibomian glands

Wanzeler

Barbosa

Duarte

et al. 2019

Preprint

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2627 Purpose: To analyze how ocular surface parameters correlate to pterygium and investigate the 28 possible impact on tear film and meibomian glands. Methods: we investigated objective parameters 29 of the ocular surface such as conjunctival hyperemia, tear film stability and volume, meibomian gland 30 dysfunction, dry eye disease, corneal topography comparing healthy individuals and correlating with 31 the pterygium clinical presentation. Results: A total of 83 patients were included. Corneal 32 astigmatism induction was 2. 65 ± 2.52 D (0.4-11.8). The impact of pterygium on the ocular surface 33 parameters compared to matched controls was seen in: conjunctival hyperemia (control 34 1.55±0.39/pterygium 2.14±0.69; p=0.0001), tear meniscus height (control 0.24±0.05 mm/pterygium 35 0.36±0.14mm; p 0.0002), meiboscore lower eyelid (control 0.29±0.64/pterygium 1.38±0.95; p 36 0.0001) and meiboscore upper eyelid (control 0.53±0.62/pterygium 0.98±0.75; p=0.0083). We found 37 a high number of pterygium patients (88%) presented meibomian gland alterations. Interestingly, 38 meibomian gland loss was coincident to the localization of the pterygium in 54% of the upper and 39 77% lower lids. Conclusion: Pterygium greatly impacts on ocular surface by inducing direct 40 alterations in the pattern of meibomian glands besides corneal irregularities, conjunctival hyperemia 41 and lacrimal film alterations, inducing significant symptoms and potential signs of dysfunction. 3 42 Introduction 43 Pterygium is a degenerative fibrovascular disease of the ocular surface that can cause 44 symptoms of discomfort, corneal irregularities, aesthetics issues thus compromising visual acuity and 45 patients` quality of life. [1-3] The prevalence of pterygium varies worldwide. Global prevalence was 46 estimated in 10.2% to 12%, reaching higher numbers in tropical regions. Several risk factors have 47 been associated with pterygia, such as geographical latitude, residence in rural areas, old age, race, 48 sex, sun exposure, chronic irritation and inflammation. [4,5] 49 Some studies have pointed tear film and ocular surface changes related to pterygium, but 50 consistent correlations remain unknown. [6-9] Although numerous theories have been implicated in 51 pterygium pathogenesis, including ultraviolet radiation exposure, viral infection, oxidative stress, 52 genetic issues, inflammatory mediators, extracellular matrix modulators, it remains controversial as 53 well as its impact on ocular surface homeostasis and function.[10] And a better understanding of the 54 pathophysiological mechanisms associated with pterygium, the morphological alterations on the 55 ocular surface and functional impact may contribute to specific approaches and more effective 56 therapeutic proposals for this common ocular condition. 57 This study aimed to evaluate how ocular surface parameters correlate with pterygium clinical 58 presentation and its impact on ocular surface structures and homeostasis. 4 59 Materials and Methods 60 The present study had a transversal, obs...

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“…1. Meibomian gland expression (MG expressibility) was scored according to the secretion seen in all 5 meibomian glands [20] : 0, all glands; 1 (3–4 glands); 2 (1–2 glands); and 3 (no glands). Meibum quality (Meibum score) was graded as follows [21] : 0 (clear); 1 (cloudy); 2 (cloudy with debris); 3 (inspissated, toothpaste-like).…”

Section: Methodsmentioning

confidence: 99%

Evaluation of ocular surface impairment in meibomian gland dysfunction of varying severity using a comprehensive grading scale

Chou

Hao

et al. 2019

Medicine

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This study aimed to propose a comprehensive grading scale to evaluate different clinical manifestations in patients with varying severity of meibomian gland dysfunction (MGD) and analyze the correlations between the parameters of ocular surface impairment in MGD. A total of 63 patients with MGD were enrolled. Ten specific symptoms were evaluated each with a subjective score and total score was applied to grade the severity of MGD. Thirty-seven patients were diagnosed with mild, 19 with moderate, and 7 with severe MGD. Slit-lamp and keratography were used to assess the signs of ocular surface and meibomian gland (MG). In vivo confocal microscopy (IVCM) was performed to evaluate the corneal nerves and dendritic cells. The differences and correlations between symptoms, signs, and IVCM parameters were analyzed. Dryness, foreign body sensation, asthenopia, and photophobia were the most common and severe symptoms in our patients. The severe MGD group showed worse MG expressibility, Meibum score, Meiboscore, MG score, and higher nerve reflectivity ( P < .05). The mild MGD group showed higher nerve density ( P < .05). Total symptom score was negatively correlated with nerve density ( r = –0.374, P < .05), while positively correlated with nerve reflectivity and dendritic cell density ( r = 0.332 and 0.288, respectively, P < .05). MG score was correlated with nerve reflectivity ( r = 0.265, P < .05). The comprehensive grading scale was suitable for evaluating clinical manifestations in MGD of varying severity. The relationship between the specific symptoms, signs, and IVCM results concerning whole ocular surface impairment could help elucidate MGD pathophysiology and benefit evaluation or treatment in the future.

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Meibomian Gland Dysfunction Correlates to the Tear Film Instability and Ocular Discomfort in Patients with Pterygium

Cited by 23 publications

References 18 publications

Impact of pterygium on the ocular surface and meibomian glands

Impact of pterygium on the ocular surface and meibomian glands

Impact of pterygium on the ocular surface and meibomian glands

Evaluation of ocular surface impairment in meibomian gland dysfunction of varying severity using a comprehensive grading scale

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