Ocular Surface Workup in Patients with Meibomian Gland Dysfunction Treated with Intense Regulated Pulsed Light

Vigo, Luca; Taroni, Leonardo; Bernabei, Federico; Pellegrini, Marco; Sebastiani, Stefano; Mercanti, Andrea; Stefano, Nicola Di; Scorcia, Vincenzo; Carones, Francesco; Giannaccare, Giuseppe

doi:10.3390/diagnostics9040147

Cited by 21 publications

(22 citation statements)

References 45 publications

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“… 22 Additionally, LLL is the only treatment that was applied directly to the upper lid ( Table 1 ). The improvement in lipid layer thickness was frequently described in IPL without LLL treatment, 8 , 13 , 15 , 17 , 18 , 23 but other studies are showing no effect. 19 , 24 …”

Section: Discussionmentioning

confidence: 91%

“…This can be explained by the higher increment on the lipid layer (solute) compared to the increment on the aqueous layer (solvent). In IPL without LLL studies, the tear osmolarity has been reported as lowered 23 , 24 or unchanged. 8 , 13 , 14 , 19 According to important studies, 25–27 it was expected that DED symptoms and OSDI score would worsen with increasing osmolarity, but this wasn´t the case.…”

Section: Discussionmentioning

confidence: 98%

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Intense Pulsed Plus Low-Level Light Therapy in Meibomian Gland Dysfunction

Marta¹,

Baptista²,

Marques³

et al. 2021

OPTH

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Purpose To analyse the clinical outcome in patients with meibomian gland dysfunction (MGD) who underwent intense pulsed light (IPL) plus low-level light therapy (LLL). Materials and Methods The prospective non-comparative study included identified by MGD patients with altered interferometry and lower loss area of the meibomian glands (LAMG), who underwent IPL plus LLL, between July 2020 and August 2020. A multimodal assessment was performed before, 2–3 weeks, and 6 months after treatment. The main outcome was lipid layer thickness (LLT) and the secondary outcomes were the ocular surface disease index (OSDI) score, presence of corneal fluorescein staining (CFS), blink rate (BR), Schirmer test (ST), tear meniscus height (TMH), tear osmolarity (OSM), non-invasive break-up time (NIBUT) and LAMG. Results This study included 62 eyes of 31 patients, 61.3% female, with a mean age of 66.94±9.08 years at the time of IPL plus LLL treatment. LLT (<0.001) grades improved 6 months after treatment. The mean OSDI score improved (p<0.001) from 45.02±21.17 (severe symptoms) to 22.35±17.68 (moderate symptoms) at 2–3 weeks and 8.24±17.9.91 (normal) at 6 months after treatment. CFS was identified in 51.6% (32/62) before and in 45.2% (28/62) 6 months (p=0.293) after treatment. ST (p=0.014) grades improved; OSM grades mild worsened (p<0.001); TMH, NIBUT and LAMG grades did not modify 6 months after treatment. No patient suffered any adverse effects. Conclusion IPL combined with LLL was effective and safe, improving the lipid layer thickness in MGD and decreasing the level of symptoms.

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 98%

Intense Pulsed Plus Low-Level Light Therapy in Meibomian Gland Dysfunction

Marta¹,

Baptista²,

Marques³

et al. 2021

OPTH

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show abstract

“…However, no differences were found between days 75 and 45, suggesting that two sessions were enough to reduce the signs and symptoms of MGD. Vigo et al [ 74 ] (III) also performed follow-up visits on day 1, 15, and 45. They found an improvement in NIBUT, LLT, and osmolarity and suggested that patients with lower BUT responded better to the treatment.…”

Section: Light-based Devicesmentioning

confidence: 99%

“…There is a lack of agreement in the IPL treatment protocol. The number of sessions varies among three [ 74 , 76 ], four [ 73 , 77 , 78 ], and eight [ 79 ], and the period between sessions can fluctuate between 15 [ 73 , 74 , 77 ], 21 [ 78 , 79 ] and 30 [ 76 , 77 ] days. Finally, the number of flashes is not standardized, 4–5 being the most frequent [ 73 – 75 , 80 ], although other authors double the flashes or apply even more [ 78 , 79 ].…”

Section: Light-based Devicesmentioning

confidence: 99%

Therapeutic Instruments Targeting Meibomian Gland Dysfunction

et al. 2020

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The most prevalent type of meibomian gland dysfunction (MGD), which is obstructive, is the main cause of evaporative dry eye and is characterized by changes in the meibum composition and duct obstruction. Eyelid hygiene has usually been the most common clinical approach. However, alternative therapies for MGD are emerging on the market. Some warming and humidity devices have led to an improvement in the signs and symptoms in MGD patients. Likewise, eyelid massaging and cleaning devices are also beneficial for ocular signs and symptoms; however, patients usually need more than one session to maintain the therapeutic effect. Thermal pulsation has been reported to be more efficient than other strategies, and the effects can last up to 12 months. Moreover, intense pulsed light therapy has been demonstrated to improve ocular signs and symptoms alone and in combination with other therapies. Proper counseling of clinicians considering MGD status and patient compliance will help patients to undergo the adequate technique that best suits their condition.

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“…The severity of bulbar redness can be objectively quantified via an automated and standardized image grading system. Moreover, meibography and ocular surface staining are two critical assessment for identifying evaporative dry eye [ 13 , 14 ] and ocular surface disease severity of dry eye [ 15 , 16 ], respectively.…”

Section: Introductionmentioning

confidence: 99%

Tear Proteomics Study of Dry Eye Disease: Which Eye Do You Adopt as the Representative Eye for the Study?

Kuo

Fang

Kuo

et al. 2021

IJMS

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Most studies about dry eye disease (DED) chose unilateral eye for investigation and drew conclusions based on monocular results, whereas most studies involving tear proteomics were based on the results of pooling tears from a group of DED patients. Patients with DED were consecutively enrolled for binocular clinical tests, tear biochemical markers of DED, and tear proteome. We found that bilateral eyes of DED patients may have similar but different ocular surface performance and tear proteome. Most ocular surface homeostatic markers and tear biomarkers were not significantly different in the bilateral eyes of DED subjects, and most clinical parameters and tear biomarkers were correlated significantly between bilateral eyes. However, discrepant binocular presentation in the markers of ocular surface homeostasis and the associations with tear proteins suggested that one eye’s performance cannot represent that of the other eye or both eyes. Therefore, in studies for elucidating tear film homeostasis of DED, we may lose some important messages hidden in the fellow eye if we collected clinical and proteomic data only from a unilateral eye. For mechanistic studies, it is recommended that researchers collect tear samples from the eye with more severe DED under sensitive criteria for identifying the more severe eye and evaluating the tear biochemical and proteomic markers with binocular concordance drawn in prior binocular studies.

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Ocular Surface Workup in Patients with Meibomian Gland Dysfunction Treated with Intense Regulated Pulsed Light

Cited by 21 publications

References 45 publications

Intense Pulsed Plus Low-Level Light Therapy in Meibomian Gland Dysfunction

Intense Pulsed Plus Low-Level Light Therapy in Meibomian Gland Dysfunction

Therapeutic Instruments Targeting Meibomian Gland Dysfunction

Tear Proteomics Study of Dry Eye Disease: Which Eye Do You Adopt as the Representative Eye for the Study?

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