The International Workshop on Meibomian Gland Dysfunction: Report of the Subcommittee on the Epidemiology of, and Associated Risk Factors for, MGD

Schaumberg, Debra A.; Nichols, Jason J.; Papas, Eric; Tong, Louis; Uchino, Makoto; Nichols, Kelly K.

doi:10.1167/iovs.10-6997e

Cited by 481 publications

(465 citation statements)

References 104 publications

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“…17,18 NonYSjögren syndrome dry eye subjects were allowed to participate because this common condition could potentially result from meibomian gland atrophy. 19 …”

Section: Inclusion and Exclusion Criteriamentioning

confidence: 99%

Associations with Meibomian Gland Atrophy in Daily Contact Lens Wearers

2016

Optometry and Vision Science

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Purpose. To determine associations for contact lenses (CLs) and meibomian gland atrophy in a matched-pair study. Methods. Contact lens wearers (case) and age-and sex-matched nonYcontact lens (NCL) wearers with no history of CL use (control) were recruited for a multicenter study. All subjects were administered the Ocular Surface Disease Index questionnaire and a comprehensive battery of clinical tests (e.g., tear breakup time, bulbar and limbal redness, meibography, etc.) were performed. Upper and lower eyelid meibomian gland atrophy were graded with both digital meibography (percent gland atrophy) and visual meiboscore methods. Conditional logistic regression analyses were then used to determine relationships among CL use, meibomian gland atrophy, and ocular surface signs and symptoms. Results. A total of 70 matched pairs were analyzed. The mean (TSD) age of the CL group was 30.6 (T12.4) years, and that of the NCL group was 30.1 (T12.2) years. The subjects were 63% female. The association between CL wear and meiboscore was not significant univariately, but the best-fitting multivariate regression model showed that higher meiboscores were associated with being a CL wearer (odds ratio [OR], 2.45) in a model that included eyelid margin erythema (OR, 0.25) and lissamine green staining (OR, 1.25). Percent gland atrophy was not associated with CL wear in regression analysis (p = 0.31).Conclusions. This study determined inconclusive associations with CLs and meibomian gland atrophy. This study also provided a comprehensive assessment of differences between CL and NCL wearers. (Optom Vis Sci 2015;92:e206Ye213)

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“…17,18 NonYSjögren syndrome dry eye subjects were allowed to participate because this common condition could potentially result from meibomian gland atrophy. 19 …”

Section: Inclusion and Exclusion Criteriamentioning

confidence: 99%

Associations with Meibomian Gland Atrophy in Daily Contact Lens Wearers

2016

Optometry and Vision Science

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“…[1][2][3] Population-based studies have revealed that the prevalence of MGD is reported to be nearly 20% among Caucasians and 60% on average in Asian populations. 4,5 Treatments for MGD typically combine a number of approaches ranging from lubrication, oral omega-3 fatty acids, and targeting clinically apparent inflammation with steroids and antibacterial therapy. 6 Further, intraglandular obstruction, central to the pathogenesis of MGD, 7 may be reduced through self-administered heat compresses and lid massage, 6 meibomian gland expression in the clinic, or through newer advanced techniques such as thermal pulsation procedures, intraductal meibomian gland probing, and intense pulse light therapy performed in the outpatient setting.…”

Section: Introductionmentioning

confidence: 99%

In vivo detection of clinically non-apparent ocular surface inflammation in patients with meibomian gland dysfunction-associated refractory dry eye symptoms: a pilot study

Qazi

Kheirkhah

Blackie

et al. 2015

Eye

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Purpose The utility of in vivo confocal microscopy (IVCM) in the investigation of palpebral conjunctival and corneal inflammation in patients with meibomian gland dysfunction (MGD)-associated refractory dry eye symptoms following gland expression, despite objective clinical improvement. Methods A retrospective, observational pilot study was conducted evaluating five patients with MGD-associated refractory dry eye symptoms and three control groups: symptomatic untreated MGD patients (n = 3), treatment-responsive MGD patients with improved symptoms (n = 3) and asymptomatic healthy normals (n = 11). Ocular surface disease index (OSDI) scores, tear break-up time (TBUT), the number of meibomian glands yielding liquid secretion (MGYLS), palpebral conjunctival epithelial and substantia propria immune cell (EIC, SIC), and corneal dendritic cell (DC) densities were measured. Results Despite clinical improvement (TBUT: 6.4 ± 1.2 s to 10.1 ± 2.1 s, P = 0.03; MGYLS: 3.5 ± 0.8 glands to 7.0 ± 1.1 glands, P = 0.13) and a normal clinical examination post treatment, MGD patients remained symptomatic. IVCM revealed increased immune cells in the palpebral conjunctiva (refractory MGD EIC = 592.6 ± 110.1 cells/ mm 2 ; untreated MGD EIC = 522.6 ± 104.7 cells/mm 2 , P = 0.69; responsive MGD EIC = 194.9 ± 119.4 cells/mm 2 , Po0.01; normals EIC = 123.7 ± 19.2 cells/mm 2 , Po 0.001), but not the cornea (refractory MGD DC = 60.9 ± 28.3 cells/mm 2 ; normals DC = 25.9 ± 6.3 cells/mm 2 ; P = 0.43). EIC did not correlate with TBUT (R s = − 0.26, P = 0.33). OSDI scores correlated with both EIC (R s = 0.76, Po0.001) and TBUT (R s = − 0.69, Po0.01) but not SIC. Intraglandular immune cells were also seen. Conclusion MGD-associated refractory symptoms and the symptom-sign disparity may be explained by clinically non-apparent, active inflammation of the palpebral conjunctiva as detected by IVCM. These patients may benefit from anti-inflammatory therapy.

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“…[6] Blefarit, kontakt lens kullanımı, Demodex folliculorum ve kuru göz gibi oftalmik faktörler ile androjen eksikliği, menopoz, yaş-lanma, Sjögren sendromu, atopi, rozasea gibi sistemik faktörler etiyolojik nedenler arasındadır. [7] Meibomius bezi disfonksiyonu tanısı semptomların anketler yardımı ile sorgulanması, kapak morfolojisinin ve oküler yüzeyin biyomikroskopik muayenesi, gözyaşı ozmolaritesinin ölçülmesi, gözyaşı sekresyonun ölçülmesi, oküler yüzeyin boyanması ve gözyaşı film stabilitesinin gözyaşı kırılma zamanı ile belirlenmesi gibi yöntemler ile konur. [8] Meibomius bezi disfonksiyonu olan hastalarda, alt kapak kenarında köpüklü gözyaşı göllenmesi, gözyaşı kırılma zamanında kısalma, tarsal ve bulber konjoktivada kızarıklık, tarsta papiller reaksiyon, göz kapağı kenarında düzensizlik, telanjiektazik damar oluşumu ve meibomian bezlerinin ağzında tıkanıklık görülebilir.…”

Section: Introductionunclassified

Tear function test results in patients with meibomian gland dysfunction

Muslubaş¹,

Kahya²,

Özertürk³

2014

J Kartal TR

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ÖzetAmaç: Meibomius bezi disfonksiyonu (MBD) olan hastalarla kontrol grubu hastaların Oküler Yüzey Hasar İndeksi (OSDI, Allergan Inc., [Irvine, Calif ]) anketi, Schirmer testi ve gözyaşı kırılma zamanı (GKZ) sonuçlarını karşılaştırmak.Gereç ve Yöntem: MBD olan 16 hastanın 32 gözü (Grup A) ve kontrol grubu olarak 16 hastanın 32 gözü (Grup B) çalışma-ya alındı. Tüm hastaların görme keskinliği muayenesi ve ayrıntılı oftalmolojik incelemesi yapıldıktan sonra OSDI anketi ile semptomları sorgulandı. Kuru göz tanısı için anestezisiz Schirmer testi ve GKZ testleri uygulandı. Bulgular:Grup A'da yaş ortalaması 26.9±4.9 (10 kadın, 6 erkek) iken, B grubunda yaş ortalaması 27.3±5.1 yaş (9 kadın, 7 erkek) idi. İki grup arasında yaş ve cinsiyet açısından anlamlı olarak fark yoktu (p=0.65; p=0.78). Tüm hastaların en iyi düzeltilmiş görme keskinliği Snellen eşeli ile 10/10 idi. OSDI skoru ortalaması Grup A'da 45.5±15.1 iken, B grubunda 9.4±3.7 idi ve iki grup arasında ileri derecede anlamlı fark bulundu (p<0.001). Schirmer testi ortalaması her iki grupta da normal sınırlardaydı (Grup A; 19.1±5.7 mm, Grup B; 17.3±4.4 mm) ve iki grup arasında anlamlı fark yoktu (p=0.72). GKZ ortalaması ise Grup A'da 4.5±1.1 sn iken Grup B'de 14.3±2.2 bulundu ve iki grup arasındaki istatiksel fark yine ileri derecede anlamlıydı (p<0.001).Sonuç: MBD olan hastalarda buharlaşma artışına bağlı kuru göz sendromu oluşabilmektedir. Schirmer test ölçümleri azalmadan OSDI anketinde skor yüksek ve GKZ kısa olarak ölçülmektedir. Bu nedenle bu tür olgularda kuru göz varlığını saptamak için GKZ ve OSDI anketi yapılması uygun olacaktır.

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The International Workshop on Meibomian Gland Dysfunction: Report of the Subcommittee on the Epidemiology of, and Associated Risk Factors for, MGD

Cited by 481 publications

References 104 publications

Associations with Meibomian Gland Atrophy in Daily Contact Lens Wearers

Associations with Meibomian Gland Atrophy in Daily Contact Lens Wearers

In vivo detection of clinically non-apparent ocular surface inflammation in patients with meibomian gland dysfunction-associated refractory dry eye symptoms: a pilot study

Tear function test results in patients with meibomian gland dysfunction

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