The significance of meibomian gland changes in asymptomatic children

Zhao, Yue; Chen, Siping; Shang-rong, Wang; Chen, Yan; Li, Junhua; Fu, Yana; Dai, Qi; Lin, Xiaolei; Wu, Yue; Zhao, Ying‐Zheng

doi:10.1016/j.jtos.2018.03.006

Cited by 35 publications

(47 citation statements)

References 30 publications

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“…The study by Pult et al 7 reported that the bent degree of the most bent MG in the upper eyelid was correlated with the NIBUT; however, this method measures only the bent degree of a single MG, which does not represent the tortuosity of all of the MGs. In addition, the studies by Zhao et al 8 and Arita et al 9 divided MG tortuosity into three and five grades, a process that was semi-quantitative and subjective. New software was used in this study that can calculate the tortuosity of all MGs quantitatively and objectively.…”

Section: Introductionmentioning

confidence: 99%

A Novel Quantitative Index of Meibomian Gland Dysfunction, the Meibomian Gland Tortuosity

Lin

et al. 2020

Trans. Vis. Sci. Tech.

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To quantitatively measure meibomian gland (MG) tortuosity in meibomian gland dysfunction (MGD) patients and normal controls and to observe the efficacy of evaluating MG tortuosity for the diagnosis of MGD. Methods: This cross-sectional study enrolled 32 obstructive MGD patients and 28 normal volunteers. Clinical assessments were performed, including symptom questionnaires, tear meniscus height, tear break-up time (TBUT), corneal fluorescein staining, lid margin abnormality, MG expressibility, and meibography. The meibomian gland tortuosity and meibomian gland density were measured by VIA software. Results: The mean age of the patients in the MGD group was 33.28 ± 9.28 years, and that of the normal controls was 25.25 ± 11.19 years. The average tortuosity of all MGs in the MGD patients was significantly larger than in the normal controls (P < 0.05). We further stratified the MGD patients into symptomatic MGD and asymptomatic groups. The average tortuosity of all MGs and of the central eight MGs was significantly higher in the symptomatic MGD patients than in the asymptomatic MGD patients (P < 0.05). Significant linear correlations were found between MG tortuosity and the lid margin score, meiboscore, meibum expressibility score, and TBUT (P < 0.05). When the diagnosis of obstructive MGD was based on the tortuosity of the central eight MGs of both eyelids, the sensitivity and specificity were 100% and 100%, respectively. Conclusions: MG tortuosity is an effective index to delineate MG morphology and to diagnose MGD, especially for the diagnosis of early-stage MGD. Translation Relevance: Calculating tortuosity quantitatively may play an important role in the diagnosis of MGD.

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Section: Introductionmentioning

confidence: 99%

A Novel Quantitative Index of Meibomian Gland Dysfunction, the Meibomian Gland Tortuosity

Lin

et al. 2020

Trans. Vis. Sci. Tech.

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“…There was no difference in MG distortion between children with BKC and healthy volunteers (Zhao et al. ) (Table ).…”

Section: Resultsmentioning

confidence: 96%

“…; Gupta et al. , Zhao et al., ). Our study compared with age‐matched children with and without ocular surface inflammation and therefore allows the conclusion that the level of MG dropout we observe in children with BKC is indeed significantly higher than expected for their age.…”

Section: Discussionmentioning

confidence: 99%

“…). However, MG distortion can also be observed in children who do not have any sign of ocular surface or lid inflammation (Zhao et al., ). This is consistent with our finding of a similar prevalence of distorted MGs in children with BKC and in healthy volunteers.…”

Section: Discussionmentioning

confidence: 99%

“…). Meibomian gland distortion is a potential marker of structural MG change and is graded from 0 to 5 (Zhao et al. ).…”

Section: Methodsmentioning

confidence: 99%

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Meibography and corneal volume optical coherence tomography to quantify damage to ocular structures in children with blepharokeratoconjunctivitis

Al-Hayouti

Daniel

Hingorani

et al. 2019

Acta Ophthalmologica

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Purpose To evaluate non‐contact infrared meibography and anterior segment optical coherence tomography (AS‐OCT) to detect meibomian gland (MG) and corneal changes in children with blepharokeratoconjunctivitis (BKC). Methods We acquired infrared meibography images of upper and lower lids and AS‐OCT corneal scans. One masked observer graded meiboscore, full/partial MG dropout, and measured total corneal volume and differential corneal volume per quadrant and central corneal thickness (CCT). Results We enrolled 63 children, 31 with BKC and 32 without ocular surface inflammation; median (interquartile range) age BKC 10.6 (7.2‐13.9) years, healthy volunteers (HV) 11.4 (9.5‐13.8) years. Likert scale scores for meibography and OCT indicate no to low discomfort. Meiboscores for upper and lower lids as well as the total meiboscore were significantly higher in children with BKC than in HV. Subscores for full and partial MG dropout were also significantly higher in children with BKC than in healthy volunteers. There was no statistically significant difference between upper and lower lid for meiboscore nor full/partial MG dropout scores. The corneal volume in the superior quadrant was significantly higher in children with BKC than in HV, whereas the corneal volume in the nasal and inferior quadrants was significantly lower. Conclusions Non‐contact imaging technologies objectively demonstrate damage to meibomian glands and changes in corneal volume secondary to BKC. The tests are well tolerated by children with mild/moderate ocular surface inflammation and can detect changes without the requirement for routine eversion of the upper lid. These parameters may be useful both for clinical follow‐up and clinical trials.

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Quantitative evaluation of lipid layer thickness and blinking in children with allergic conjunctivitis

Yang

Wen

et al. 2021

Graefes Arch Clin Exp Ophthalmol

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Purpose To quantitatively evaluate the lipid layer thickness (LLT) and blinking in children with or without allergic conjunctivitis (AC), and to compare those between the different types of AC. Methods For this case-control study, 81 children with symptomatic AC with an average age of 9.62 ± 2.67 years were enrolled and subdivided according to the subtypes of AC, including seasonal/perennial allergic conjunctivitis group and vernal keratoconjunctivitis (VKC)/atopic keratoconjunctivitis (AKC) group. Another 82 age-matched healthy children were enrolled as control group. All subjects underwent routine eye examination and measurements of LLT, the number of incomplete or total blinking, partial blinking rate by the LipiView interferometer over a 10-s period. Other ocular surface assessment included fluorescein tear breakup time (TBUT), lower tear meniscus height, meibomian gland loss (MGL), meibum expressibility and quality. Results Pediatric patients with AC had significant thinner LLT, shorter TBUT, decreased total blinking but increased partial blinking rate, especially in those with VKC/AKC (all P < 0.05). A significant deterioration of meibomian gland parameters was observed in AC group when compared with control subjects, demonstrated by severe upper and lower MGL, lid margin abnormalities, decreased meibum expressibility, and abnormal meibum quality, all of which were worse in the severe type of AC (all P < 0.05). Thinner LLT was significantly correlated with decreased TBUT (β = 3.666, P < 0.001) and severity of upper MGL (β = − 7.701, P = 0.002). Conclusion Decreased LLT and blinking disorders in pediatric patients with AC may contribute to lipid layer deficiency in the long run, which should be considered and appropriately diagnosed for a more precise treatment.

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The significance of meibomian gland changes in asymptomatic children

Cited by 35 publications

References 30 publications

A Novel Quantitative Index of Meibomian Gland Dysfunction, the Meibomian Gland Tortuosity

A Novel Quantitative Index of Meibomian Gland Dysfunction, the Meibomian Gland Tortuosity

Meibography and corneal volume optical coherence tomography to quantify damage to ocular structures in children with blepharokeratoconjunctivitis

Quantitative evaluation of lipid layer thickness and blinking in children with allergic conjunctivitis

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