Noncontact Meibography in Patients with Keratoconus

Mostafa, Engy Mohamed; Abdellah, Marwa Mahmoud; Elhawary, Ashraf Mostafa; Mounir, Amr

doi:10.1155/2019/2965872

Cited by 19 publications

(20 citation statements)

References 32 publications

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“…Keratoconus is a multifactorial disease with genetic, environmental, in ammatory, hormonal risk factors and eye rubbing playing role in etiopathogenesis [17]. In the literature, few studies reported on increased dry eye symptoms [7,18], tear lm instability [6,19], ocular surface staining [6, 7] and conjunctival metaplasia with goblet cell loss in keratoconus patients [5][6][7]. indicating involvement of whole ocular surface epithelium and tear lm in the disease process in these eyes.…”

Section: Discussionmentioning

confidence: 99%

Morphological and Functional Assessment of Meibomian Glands in Keratoconus

Uçakhan

Özcan

2021

Preprint

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Purpose: To evaluate the morphology and function of the meibomian glands (MG) in keratoconus patients.Methods: One hundred eyes of 100 keratoconus patients and 100 eyes of 100 age-matched healthy subjects were included into this study. Ocular Surface Disease Index (OSDI) scores, non-invasive break up time (NIBUT), meibography findings, fluorescein staining of the ocular surface, tear film break-up time (TBUT), and Schirmer I test were recorded in all patient eyes and were compared with controls.Results: The mean TBUT and NIBUT were significantly lower, corneal staining and OSDI scores were statistically higher in the keratoconus group (p<0.05). The mean meiboscore, partial gland, gland dropout and gland thickening scores of the upper and lower eyelids were significantly higher in keratoconus patients compared to controls (p<0.05). The NIBUT measurements significantly correlated with MG loss in both upper and lower eyelids (p<0.05). The severity of keratoconus seemed to correlate with meiboscore, partial gland, gland thickening scores in both upper and lower eyelids. Conclusion: Our data suggest that corneal ectasia in keratoconus is associated with alterations in ocular surface, tear film function and MG morphology. Early screening and treatment of MG dysfunction may improve ocular surface quality and allow better disease management in keratoconus patients.

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Section: Discussionmentioning

confidence: 99%

Morphological and Functional Assessment of Meibomian Glands in Keratoconus

Uçakhan

Özcan

2021

Preprint

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“…Some studies have found that subjects with irregular corneas are more likely to suffer from DED and MGD [42][43][44]. Moreover, McMonnies [61] and Lema et al [62] also suggested that a possible inflammatory role might be involved in the pathogenesis of keratoconus since inflammatory molecules were overexpressed in the tears of subjects with keratoconus.…”

Section: Effect Of Scleral Lens Wear In Ocular Surface Symptoms Gland Drop-out and Gland Visibilitymentioning

confidence: 99%

“…The sample of this study represented irregular corneas, except for four of them. Since scleral lenses are usually fitted in subjects with irregular corneas, who are more likely to suffer from DED [42][43][44], assessing the effect of these lenses on meibomian glands is vital. Thus, a recent review confirmed that there is a need for prospective evaluation of meibomian gland appearance and function during scleral lens wear [11].…”

Section: Effect Of Scleral Lens Wear In Ocular Surface Symptoms Gland Drop-out and Gland Visibilitymentioning

confidence: 99%

“…Moreover, it has been recognized the need for assessing meibomian glands in subjects fitted with these lenses [41]. Since scleral lenses are usually fitted in subjects with irregular corneas, namely patients with keratoconus who are more likely to suffer from DED and MGD [42][43][44], understanding their effect on meibomian glands is clinically relevant. The present study has two main aims: The first one is to validate a previously developed algorithm based on the visibility of meibomian glands with a commercial fundus camera, which might help to further validate this algorithm, suggesting that it is not instrumentspecific.…”

Section: Introductionmentioning

confidence: 99%

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Assessment of meibomian gland drop-out and visibility through a new quantitative method in scleral lens wearers: A one-year follow-up study

García‐Marqués

Macedo-de-Araújo

Cerviño

et al. 2023

Contact Lens and Anterior Eye

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To validate a previously developed algorithm based on the visibility of meibomian gland images obtained with Cobra fundus camera and to assess the changes in meibomian glands in scleral lens wearers over one year of lens wear. Methods: Infrared meibography was obtained from the upper eyelid using the Cobra fundus camera in forty-three volunteers (34.2 ± 10.1 years). Meibographies were classified into 3 groups: Group 1 = good subjective gland visibility and gland drop-out < 1/3 of the total area; Group 2 = low visibility and gland drop-out < 1/3; and Group 3 = low visibility and gland drop-out > 1/3. Meibomian gland visibility metrics were then calculated using the developed algorithm from the pixel intensity values of meibographies. Repeatability of new metrics and their correlations with gland drop-out were assessed. Meibographies and ocular symptoms were also assessed after 1 year of scleral lens wear in 29 subjects. Results: Gland drop-out percentage was not statistically different between groups 1 and 2 (p = 0.464). Nevertheless, group 1 showed higher grey pixel intensity values than the other groups. Statistically significant correlations were found between gland visibility metrics and gland drop-out percentage. Repeatability was acceptable for all metrics, coefficient of variation achieving values between 0.52 and 3.18. While ocular symptoms decreased with scleral lens wear (p < 0.001), no statistically significant differences were found in gland drop-out percentage (p = 0.157) and gland visibility metrics (p > 0.217). Conclusions: The proposed method can assess meibomian gland visibility in an objective and repeatable way. Scleral lens wear appears to not adversely affect meibomian gland drop-out and visibility while might improve dry eye symptoms after one year of lens wear. These preliminary results should be confirmed with a control group.

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“…11–13 Evaluating dry eye parameters in KC patients revealed low tear break-up time (TBUT) and marked corneal staining, increased the Ocular Surface Disease Index© (OSDI) scores, dropout, and distortion in MGs. 8,14–16…”

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confidence: 99%

Evaluation of Corneal Parameters and Meibomian Gland Alterations After Corneal Cross-Linking in Patients With Progressive Keratoconus

Balıkçı

Ulutaş

2022

Eye &Amp; Contact Lens: Science &Amp; Clinical Practice

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The aim of the study was to evaluate the changes in corneal parameters and meibomian gland alterations after corneal cross-linking (CXL) for progressive keratoconus. Methods: Thirty nine eyes of 39 keratoconus patients were treated with CXL. Corneal topography, specular microscopy, the Ocular Surface Disease IndexÓ (OSDI), noninvasive tear break-up time (NITBUT), and meibography indices were evaluated preoperatively and at the first, third, and sixth months after CXL. Results: The flattest keratometry (K1) (P¼0.003), steepest keratometry (K2) (P,0.001), apex, central, and thinnest corneal thicknesses (P,0.001) showed significant differences after cross-linking, whereas the changes in the maximum keratometry (Kmax) were not significant (P¼0.140). The endothelial cell density, coefficient of variation, and hexagonality were unchanged. The NITBUT values decreased after crosslinking; however, there was no significant change in OSDI index (P¼0.313), meiboscore (P¼0.392), and meibomian gland loss degrees (P¼0.300). No change was detected in the morphology of the meibomian glands after CXL. Conclusion:In eyes with keratoconus, a flattening in keratometry readings and thinning in corneal thickness were observed after CXL. The corneal endothelium is protected by dextran-free riboflavin. Cross-linking procedure causes dry eye by changing the corneal structure without affecting the morphology of the meibomian glands.

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Noncontact Meibography in Patients with Keratoconus

Cited by 19 publications

References 32 publications

Morphological and Functional Assessment of Meibomian Glands in Keratoconus

Morphological and Functional Assessment of Meibomian Glands in Keratoconus

Assessment of meibomian gland drop-out and visibility through a new quantitative method in scleral lens wearers: A one-year follow-up study

Evaluation of Corneal Parameters and Meibomian Gland Alterations After Corneal Cross-Linking in Patients With Progressive Keratoconus

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