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

Abstract Background Meibomian gland dysfunction (MGD) is one of the possible conditions underlying ocular surface disorders (OSD). Prevalence of MGD in dogs affected by OSD has not yet been reported. We aimed to evaluate the prevalence of MGD among OSD canine patients, which had been assessed by non-contact infrared meibography and interferometry, and to identify MGD associated factors that might guide its diagnosis. Medical records of canine patients examined for OSD between 2016 and 2019 were reviewed. The frequency of MGD was evaluated within different categories (skull conformation, gender, eye and STT-1). The putative MGD risk factors and frequency of MGD within grades of interferometry were evaluated in a regression analysis model and reported as odd ratios (ORs). Results One hundred fifty eyes from 81 dogs with OSD were included with median age 75 months (range 3–192) and female representation with 52%. MGD was present in 70% of the examined eyes. MGD risk was higher in males ORadj = 3.015 (95% CI: 1.395–6.514) (P = 0.005) and older patients ORadj = 1.207 (95% CI: 1.081–1.348) (P = 0.001). No significant differences were found between left and right eyes (P = 0.66) or between the two types of skull conformation (P = 0.477) and MGD presence. MGD was associated to the lowest lipid layer (LL) thickness, as assessed by interferometry (grade 0) OR = 16.00 (95% CI: 2.104–121.68) (P < 0.001). STT values were not significantly associated with the presence of MGD (P > 0.05). Conclusions MGD is a common underlying pathology in OSD. Being male and higher age are risk factors for MGD. An interferometry grade 0 may guide OSD diagnosis towards MGD.

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A novel noninvasive ocular surface analyzer for the assessment of dry eye with Meibomian gland dysfunction

Experimental and Therapeutic Medicine ◽

10.3892/etm.2017.4364 ◽

2017 ◽

Vol 13 (6) ◽

pp. 2983-2988 ◽

Cited By ~ 9

Author(s):

Yuanyuan Qi ◽

Chen Zhang ◽

Shaozhen Zhao ◽

Yue Huang ◽

Ruibo Yang

Keyword(s):

Dry Eye ◽

Ocular Surface ◽

Meibomian Gland ◽

Meibomian Gland Dysfunction

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Ocular surface changes and meibomian gland dysfunction evaluation in patients with Stevens–Johnson syndrome

European Eye Research ◽

10.14744/eer.2021.39974 ◽

2021 ◽

Author(s):

Irmak Karaca

Keyword(s):

Ocular Surface ◽

Meibomian Gland ◽

Meibomian Gland Dysfunction ◽

Stevens Johnson Syndrome ◽

Johnson Syndrome ◽

Surface Changes

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Effects of intense pulsed light treatment on tear cytokines and clinical outcomes in meibomian gland dysfunction

PLoS ONE ◽

10.1371/journal.pone.0256533 ◽

2021 ◽

Vol 16 (8) ◽

pp. e0256533

Author(s):

Qian Li ◽

Junxiu Liu ◽

Cheng Liu ◽

Junfeng Piao ◽

Wei Yang ◽

...

Keyword(s):

Inflammatory Cytokines ◽

Ocular Surface ◽

Signs And Symptoms ◽

Meibomian Gland ◽

Intense Pulsed Light ◽

Tissue Inhibitor Of Metalloproteinase ◽

Meibomian Gland Dysfunction ◽

Pulsed Light ◽

Tnf Α ◽

Ifn Γ

Meibomian gland dysfunction (MGD) has become a prevalent ocular surface disorder. Its pathogenesis is regarded as a self-perpetuating inflammatory vicious circle. Intense Pulsed Light (IPL) treatment was recently applied to improve the meibomian gland function and reduce symptoms of MGD. However, studies investigating the change of specific inflammatory cytokines during IPL treatment remained sparse. To further figure out how IPL treatment modulates the inflammatory cytokines in tears of MGD, we therefore performed a cross-sectional study and enrolled 32 patients from March 2019 to December 2020. The patients received 3 sessions of IPL treatment (10 to 16 J/cm2) at 4-week interval. The signs and symptoms of MGD were evaluated by ocular surface disease index (OSDI), tear film breakup time (TBUT), and meibomian gland yield secretion score (MGYSS). The clinical evaluators and tear samples were analyzed at baseline and at each IPL treatment session. Concentrations of (chemokine ligand) CXCL1, (C-C motif chemokine) CCL11, (tumor necrosis factor) TNF-α, (interferon) IFN-γ, (interleukin) IL-2, IL-6 and (tissue inhibitor of metalloproteinase) TIMP-1were measured by Quantibody Human Dry Eye Disease Array1. OSDI significantly decreased after IPL treatment compared with baseline. TBUT and MGYSS increased consecutively during treatment. CXCL1, CCL11, TNF-α, IFN-γ, IL-2, IL-6 presented significantly decrease and TIMP-1 showed significantly increase from the pretreatment baseline. The changed concentrations of TNF-α, IFN-γ, IL-2, TIMP-1 correlated with TBUT, the changed values of CXCL1, TNF-α, IFN-γ, CCL11, IL-2, IL-6, TIMP-1 correlated with MGYSS, and the changed concentrations of CXCL1, IFN-γ, CCL11, IL-2, IL-6 correlated with TIMP-1. The data supported IPL treatment could significantly relieve both signs and symptoms of MGD. The therapeutic effect of IPL treatment may originate from regulation of inflammatory cytokines including CXCL1, TNF-α, IFN-γ, CCL11, IL-2, IL-6, and TIMP-1.

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The association between demodex infestation and ocular surface manifestations in meibomian gland dysfunction

International Journal of Ophthalmology ◽

10.18240/ijo.2018.04.08 ◽

2018 ◽

Cited By ~ 1

Keyword(s):

Ocular Surface ◽

Meibomian Gland ◽

Meibomian Gland Dysfunction ◽

Demodex Infestation

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Analysis of tear inflammatory molecules and clinical correlations in evaporative dry eye disease caused by meibomian gland dysfunction

International Ophthalmology ◽

10.1007/s10792-020-01489-z ◽

2020 ◽

Vol 40 (11) ◽

pp. 3049-3058

Author(s):

Xingdi Wu ◽

Xiang Chen ◽

Yajuan Ma ◽

Xueqi Lin ◽

Xuewen Yu ◽

...

Keyword(s):

Dry Eye ◽

Ocular Surface ◽

Healthy Subjects ◽

Meibomian Gland ◽

Meibomian Gland Dysfunction ◽

Surface Parameters ◽

Tnf Α ◽

Evaporative Dry Eye ◽

Ifn Γ ◽

Inflammatory Molecules

Abstract Purpose To compare the levels of inflammatory molecules in tear samples between patients with meibomian gland dysfunction (MGD)-related evaporative dry eye (EDE) and healthy subjects and to analyze the correlations between the levels of tear inflammatory molecules and ocular surface parameters. Methods A total of 30 MGD-related EDE patients (48 eyes) and ten healthy volunteers (15 eyes) were enrolled. Dry eye-related examinations and questionnaires were obtained from all participants. The levels of nine inflammatory molecules were determined through multiplex bead analysis. Results Inflammatory molecules including ICAM-1, IFN-γ, CXCL8/IL-8, IL-6, TNF-α and IL-12p70 were detected in 100% of the patients, while IL-1α, IL-1β and IL-10 were detected in 56.25%, 13.60% and 45.83% of the patients, respectively. Moreover, ICAM-1, IL-8, IL-6, TNF-α, IL-12p70 and IFN-γ were detected in 86.67–100% of the healthy subjects, and the detection rates of IL-10, IL-1α and IL-1β were below 50%. The levels of IL-8, IL-6, IFN-γ and ICAM-1 were significantly higher in the patient group compared with the control group. In addition, IL-8 and IL-6 were negatively correlated with Schirmer I test. Besides, IFN-γ was negatively correlated with tear film breakup time. Furthermore, ICAM-1 and IL-6 were positively correlated with meibography score. Conclusions Collectively, patients with MGD-related EDE had higher levels of inflammatory molecules in their tears, and some molecules were correlated with ocular surface parameters. These findings suggested that inflammation played an important role in MGD-related EDE, and several inflammatory molecules could be used in the diagnosis and the treatment of MGD-related EDE.

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A study to assess the efficacy of topical cyclosporine A 0.05% in the management of dry eye with meibomiam gland dysfunction

Indian Journal of Clinical and Experimental Ophthalmology ◽

10.18231/j.ijceo.2021.134 ◽

2022 ◽

Vol 7 (4) ◽

pp. 667-671

Author(s):

Prajwalli Reddy ◽

Wajeeha Umam

Keyword(s):

Dry Eye ◽

Cyclosporine A ◽

Ocular Surface ◽

Tear Film ◽

Meibomian Gland ◽

Meibomian Gland Dysfunction ◽

Control Group ◽

Dry Eyes ◽

Group A ◽

Group B

: Dry eye is a multifactorial disease of the tears and ocular surface that results in symptoms of discomfort, visual disturbance, and tear film instability with potential damage to the ocular surface. It is accompanied by increased osmolarity of the tear film and inflammation of the ocular surface. Meibomian Gland Dysfunction (MGD) is an abnormality of the meibomian gland that blocks the secretion of lipids. Without sufficient lipid production, tears evaporate quickly causing Dry Eye.MGD is associated with multiple pathological mechanisms including inflammation, microbial factors and lipid deficiencies. Topical Cyclosporine A (CsA) 0.05% is a calcineurin inhibitor that reduces inflammation by specifically inhibiting T‑cell activity, which reduces ocular surface inflammation and improves tear film dynamics. This was a prospective observational study done on 100 patients at the Department of Ophthalmology Basaveshwar teaching and general hospital, on patients of dry eyes due to meibomian gland dysfunction. Patients who were diagnosed with dry eyes due to meibomian gland dysfunction were invited to take part in the study. Patients were divided randomly into two groups of 50 patients each. This study, was explained in detail to them. An informed consent was obtained. Patients fulfilling the inclusion criteria were listed.All OSDI scores (symptom intensity, frequency and aggravation) revealed decreasing patterns throughout the observation period in both the groups. In single analysis, the cyclosporine A 0.05% group showed a significant improvement for each score at 3 months (p < 0.01, p = 0.01, p = 0.02, respectively). The mean TBUT after treatment in the group A (cyclosporine A group) increased to 12.36± 3.58(p<0.001) seconds, and in the group B (Control group) the TBUT score increased to 11.01±3.06 seconds. After 3 Months, there was statistically significant improvement in the mean Schirmer’s scores in both the treatment groups, however improvement was significantly greater in Cyclosporine A group. Prior to the treatment in group A (Cyclosporine A) mean Lissamine staining score was 2.73±0.15 and post treatment it reduced to 1.32±0.15 which was statistically significant (P<0.001). In group B (Control group) score before treatment was 2.46±0.15 and after treatment it reduced to 2.39±0.27 (p=0.11), not much difference was seen. : Findings from our study showed that there were significant improvements in the dry eye conditions due to defect in meibomian gland by treatment of topical Cyclosporine A 0.05% and sodium hyaluronate 0.1%.

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