scholarly journals Comparative of Meibomian Gland Morphology in Patients With Evaporative Dry Eye Versus Non-Dry Eye

2021 ◽  
Author(s):  
Ricaurte Ramiro Crespo-Treviño ◽  
Anna Karen Salinas-Sánchez ◽  
Francisco Amparo ◽  
Manuel Garza-Leon
Keyword(s):  
Dry Eye ◽  
Healthy Subjects ◽  
Morphological Changes ◽  
Tear Film ◽  
Retrospective Chart Review ◽  
Meibomian Gland ◽  
Ocular Surface Disease Index ◽  
Non Invasive ◽  
Evaporative Dry Eye ◽  
The Impact

Abstract Many recent studies have demonstrated that morphological changes are one of the key signs of Meibomian gland disease (MGD) . These changes can be seen even before symptom onset, potentially underestimating the prevalence of MGD; however, Until now, there is no conclusive information about the impact of MG morphology in tear film physiology and disease. This study aimed to investigate the prevalence of anatomical and morphological MG alterations between patients with evapo-rative DED and healthy controls. Retrospective chart review of Seventy-five patients with evaporative dry eye and healthy individuals who had dry eye assesments included Ocular Surface Disease Index questionnaire, Meibum quality, meibum expressibility, lid margin abnormality, ocular staining, non-invasive tear film break-up time, and Meibography. We did not find significant differences in MG alterations in the upper lid between healthy and dry-eye subjects. Patients with evaporative dry eye presented MG alterations in the lower lid more frequently than healthy subjects (54.8 vs 30.3%; p=0.03). The presence of shortened glands was the only MG alteration that was more prevalent in the lower lid in dry-eye patients than in healthy subjects (p <0.05). Subjects with evaporative dry eye presented more alterations in the lower lid than healthy subjects.

scholarly journals Comparative of meibomian gland morphology in patients with evaporative dry eye disease versus non-dry eye disease

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ricaurte Ramiro Crespo-Treviño ◽  
Anna Karen Salinas-Sánchez ◽  
Francisco Amparo ◽  
Manuel Garza-Leon
Keyword(s):  
Dry Eye ◽  
Healthy Subjects ◽  
Morphological Changes ◽  
Tear Film ◽  
Meibomian Gland ◽  
Dry Eye Disease ◽  
Eye Disease ◽  
Ocular Surface Disease Index ◽  
Evaporative Dry Eye ◽  
The Impact

AbstractMany recent studies have showed that morphological changes are one of the key signs of meibomian gland disease (MGD). These changes can be seen even before symptom onset, potentially underestimating the prevalence of MGD; however, until now, there is no conclusive information about the impact of meibomian gland (MG) morphology in tear film physiology and disease. This study aimed to investigate the prevalence of anatomical and morphological MG alterations between patients with evaporative dry eye disease (DED) and healthy controls. Retrospective chart review of seventy-five patients with evaporative DED and healthy individuals who had dry eye assessments included Ocular Surface Disease Index questionnaire, meibum quality, meibum expressibility, lid margin abnormality, ocular staining, non-invasive tear film break-up time, and meibography. We did not find significant differences in MG alterations in the upper lid between healthy and DED subjects. Patients with evaporative DED presented MG alterations in the lower lid more frequently than healthy subjects (54.8 vs. 30.3%; p = 0.03). The presence of shortened glands was the only MG alteration that was more prevalent in the lower lid in dry-eye patients than in healthy subjects (p < 0.05). Subjects with evaporative DED presented more alterations in the lower lid than healthy subjects.

scholarly journals Pellevé™ vs Lipiflow™ MGD-Related Dry Eye Treatment Study: The ThermaLid™ Procedure

2018 ◽  
Vol 1 (1) ◽  
pp. e11-e21
Author(s):  
Edward Hall Jaccoma ◽  
Craig Litherland ◽  
Andrew Jaccoma ◽  
Aseef Ahmed
Keyword(s):  
Dry Eye ◽  
Randomized Study ◽  
Meibomian Gland ◽  
Treatment Modalities ◽  
Ocular Surface Disease Index ◽  
Non Invasive ◽  
Standard Patient ◽  
Significant Difference ◽  
Surface Staining ◽  
Time Point

Objective: To assess the safety and efficacy of the Pellevé Wrinkle Treatment System as compared to LipiFlow, for treatment of dry eye syndrome due to meibomian gland dysfunction (MGD). Materials and Methods: In this split face, randomized study, ten patients who met specific criteria for inclusion were followed after treatment with the Pellevé Wrinkle Reduction System (what the authors have dubbed the "thermaLid Procedure") and a standard LipiFlow procedure performed the same day, with 1 and 3 months follow-up. Pre- and post- treatment MGD was assessed using a variety of subjective and objective measurements.   Results: The function of the meibomian glands improved significantly from baseline to 3 months for both thermaLid and Lipiflow treated eyes, with no significant difference between them, as measured by MGE grading, wax plug scoring, Standard Patient Evaluation of Eye Dryness (SPEED) and Ocular Surface Disease Index (OSDI) scoring. A significant change in conjunctival staining was found after both treatments at the 1-month time point but not the 3-month time point. thermaLid but not Lipiflow treatment, significantly decreased MARX line measurements at 3-months. Lipiview, Non-Invasive Tear Breakup Time (NITBUT), corneal surface staining, Tear Osmolarity, and anesthetic Schirmer's testing did not show statistically significant improvement, nor differences between treatment modalities. Conclusions: thermaLid treatment of the eyelids appears to show efficacy similar to Lipiflow treatment in reducing symptoms, reducing wax plugging and improving the number of functioning MGs as well as reducing conjunctival staining in MGD related dry eye disease.

scholarly journals Noncontact Meibography in Patients with Keratoconus

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Engy Mohamed Mostafa ◽  
Marwa Mahmoud Abdellah ◽  
Ashraf Mostafa Elhawary ◽  
Amr Mounir
Keyword(s):  
Morphological Changes ◽  
Tear Film ◽  
Cost Effective ◽  
Lower Eyelid ◽  
Meibomian Gland ◽  
Control Group ◽  
Schirmer Test ◽  
Ocular Surface Disease Index ◽  
Meibomian Glands ◽  
Grade 3

Purpose. To examine the morphological changes in the meibomian glands of patients with keratoconus as well as to study the relationship between these changes in the morphology and several tear film parameters. Methods. Examination of the meibomian gland (MG) of 300 keratoconus patients presenting to the center using infrared noncontact meibography system (Sirius, CSO, Italy) between January 2017—January 2019. 100 eyes of healthy individuals were also enrolled as a control group. Tear breakup time (TBUT) test and Schirmer test II were evaluated. Subjective symptoms were also assessed using Ocular Surface Disease Index (OSDI). Results. Mean age of keratoconus patients was 19 ± 12 years and 21 ± 14 years in control group. Average TBUT was 4.9 ± 2.1 sec. and average Schirmer test was 5.3 ± 2.2 mm which was significantly lower than control group (p=0.05). Meibomian gland dropout in the lower eyelid of the keratoconus group was as follows: grade 0 (no loss of meibomian glands): 100 eyes; grade 1 (gland dropout area <1/3 of the total meibomian glands): 85 eyes; grade 2 (gland dropout area 1/3 to 2/3): 68 eyes; and grade 3 (gland dropout >2/3): 47 eyes. Conclusion. Keratoconus shows significant meibomian gland dropout and distortion that can be recorded by noncontact meibography. Sirius meibography is a simple, cost-effective method of evaluating meibomian gland dropout as a part of the routine refractive examination.

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

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.

A Systematic Approach to Dry Eye using LipiFlow Treatment

2014 ◽  
Vol 07 (02) ◽  
pp. 104 ◽  
Author(s):  
Mitchell A Jackson ◽  
Keyword(s):  
Dry Eye ◽  
Ocular Surface ◽  
Inflammatory Markers ◽  
Systematic Approach ◽  
Tear Film ◽  
Meibomian Gland ◽  
Diagnostic Methods ◽  
Therapeutic Options ◽  
Eye Disease ◽  
Evaporative Dry Eye

The complex strategy to understanding dry eye syndrome has led to a widespread change in approaching this condition as an ocular surface disease, stratified as evaporative dry eye, aqueous deficient dry eye, and ocular allergy. The diagnostic armamentarium has vastly expanded to include tear osmolarity and inflammatory markers as redefined by the new International Dry Eye WorkShop (DEWS) in 2007. The Tear Film & Ocular Surface Society (TFOS) panel on meibomian gland dysfunction (MGD) further expanded the interpretation of evaporative dry eye and its therapeutic options, including the newest US Food and Drug Administration (FDA)-approved device known as LipiFlow Thermal Pulsation System. This paper will give an overview on understanding dry eye disease, its etiology, diagnostic methods, and current therapeutic options.

scholarly journals Dry Eye in Systemic Sclerosis Patients: Novel Methods to Monitor Disease Activity

Diagnostics ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. 404
Author(s):  
Caterina Gagliano ◽  
Elisa Visalli ◽  
Mario Damiano Toro ◽  
Roberta Amato ◽  
Giovanni Panta ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
Dry Eye ◽  
Tear Film ◽  
Symptom Assessment ◽  
Meibomian Gland ◽  
Schirmer Test ◽  
Skin Score ◽  
Non Invasive ◽  
Modified Rodnan Skin Score ◽  
Severity Of The Disease

Background: In systemic sclerosis (SSc) patients, dry eye syndrome (DES) is the most frequent ocular feature. The aim of this study was to investigate ocular DES-related SSc patients and to establish any correlation with the severity of the disease. Methods: Retrospectively, data from 60 patients with SSc underwent ophthalmic examination, where non-invasive film tear break-up time (NIF-TBUT), tear film lipid layer thickness (LLT), anesthetic-free Schirmer test I, tear osmolarity measurement (TearLab System), and modified Rodnan skin score (mRSS) data were collected. The visual analog scale (VAS) and Symptom Assessment in Dry Eye (SANDE) methods were utilized. The results were correlated with mRSS and the duration of SSc. Results: Severe DES occurred in 84% of cases, and was more severe in women. The eyelids were involved in 86.6%, secondary to meibomian gland disease (MGD). A direct correlation was found between the tear osmolarity (mean 328.51 ± 23.8 SD) and skin score (mRSS) (r = 0.79; p < 0.01). Significantly reduced NIF-TBUT, LLT, and Schirmer test I values were observed in the case of severe skin involvement. Conclusions: SSc patients show lipid tear dysfunction related to the severity and duration of the disease due to inflammation and the subsequent atrophy of the meibomian glands.

scholarly journals Tear Film Break-Up Time and Dry Eye Disease Severity in a Large Norwegian Cohort

2021 ◽  
Vol 10 (4) ◽  
pp. 884
Author(s):  
Mazyar Yazdani ◽  
Jørgen Fiskådal ◽  
Xiangjun Chen ◽  
Øygunn A. Utheim ◽  
Sten Ræder ◽  
...  
Keyword(s):  
Dry Eye ◽  
Ocular Surface ◽  
Characteristic Curve ◽  
Tear Film ◽  
Correlation Coefficients ◽  
Meibomian Gland ◽  
Discriminative Power ◽  
Ocular Surface Disease Index ◽  
Significant Difference ◽  
Break Up

This study evaluated to what extent tear film break-up time (TFBUT) could discriminate pathological scores for other clinical tests and explore the associations between them. Dry eye patients (n = 2094) were examined for ocular surface disease index (OSDI), tear film osmolarity (Osm), TFBUT, blink interval, ocular protection index (OPI), ocular surface staining (OSS), Schirmer I test, meibomian expressibility, meibomian quality, and meibomian gland dysfunction. The results were grouped into eight levels of break-up time (≤2, ≥3, ≤5, ≥6, ≤10, ≥11, ≤15, and ≥16) with or without sex stratification. Receiver-operating characteristic curve (ROC) analysis and Pearson’s correlation coefficients were used to study TFBUT’s discriminative power and the associations among the tests, respectively. Above and below each TFBUT’s cut-off, all of the parameters indicated significant difference between groups, except OSDI (cut-off 15 s) and Osm (cut-offs 5 s–15 s). At TFBUT cut-off of 2 s, sex difference could be detected for OSDI, Osm, and OSS. OPI presented the strongest discriminative power and association with TFBUT in sharp contrast to Osm, holding the poorest discriminative power with no significant correlation. The remaining parameters were within the poor to very poor categories, both with regard to discrimination and correlation. In conclusion, patients with lower TFBUT presented with more severe DED parameters at all four defined cut-off values.

scholarly journals The impact of pseudoexfoliation and arteficial tear application on tear film stability in a pseudophakic eye

2018 ◽  
Vol 146 (7-8) ◽  
pp. 422-427
Author(s):  
Dusan Todorovic ◽  
Tatjana Sarenac-Vulovic ◽  
Svetlana Jovanovic ◽  
Mirjana Janicijevic-Petrovic ◽  
Nenad Petrovic ◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Dry Eye ◽  
Statistical Significance ◽  
Tear Film ◽  
Ocular Surface Disease Index ◽  
Film Stability ◽  
Group Iii ◽  
Group Ii ◽  
One Year ◽  
The Impact

Introduction/Objective. Dry eye development after phacoemulsification is a very common complication of cataract surgery. Combined with other risk factors, such as pseudoexfoliation (PEX), this complication becomes more frequent. The aim of this study was to expose the influence of phacoemulsification associated with PEX on the development of dry eye in patients who underwent cataract surgery. Methods. The study included 160 eyes (160 patients) who underwent phacoemulsification. The patients were divided into four groups (n = 40 patients). Groups I and II involved patients without PEX. The patients from Group II were prescribed artificial tears (AT) postoperatively. The patients from Groups III and IV had a presentation of PEX. The patients from Group IV got AT postoperatively. Ocular Surface Disease Index, the tear breakup time (TBUT) test, fluorescein staining, and Schirmer?s test served as ?dry eye? tests in this study. The ?2 test and paired t-test were used for data analysis. Results. Measurements were taken for every patient preoperatively, on the first and the seventh day after the surgery, one month and three months, and one year after the surgery. The tests showed postoperatively developed dry eye in all the groups, with the recovery of the tear film within three months, except for Group III. The highest statistical significance (p < 0.001) was recorded between Groups II and III, three and 12 months after the surgery. Values of TBUT (6.09 ? 1.29 seconds) and Schirmer?s test (8.91 ? 2.14 mm) in Group III strongly indicated that dry eye was still present one year after phacoemulsification. The greatest recovery of the tear film was recorded in Group II in all the measurements. Conclusion. The study showed how strongly PEX and the use of AT affect the tear film during the first postoperative year. Based on our experience, we highly recommend the use of AT after performing phacoemulsification.

scholarly journals Rear 4-minute Schirmer Test, A Modified Indicator of Schirmer Test in Diagnosing Dry Eye

2021 ◽  
Author(s):  
Xin Wang ◽  
Xiaojing Fan ◽  
Yaying Wu ◽  
Yujie Mou ◽  
Jinjin Min ◽  
...  
Keyword(s):  
Dry Eye ◽  
Tear Film ◽  
Meibomian Gland ◽  
Patient Evaluation ◽  
Schirmer Test ◽  
Ocular Surface Disease Index ◽  
Tear Secretion ◽  
Standard Patient ◽  
The Mean ◽  
Breakup Time

Abstract This study was desgined to find a reliable and convenient indicator (a modified Schirmer test) to improve the accuracy of assessing tear secretion and diagnosing dry eye. This is a prospective continuous study on 180 volunteers. Schirmer test I without anesthesia was performed once on both eyes to determine the value of normal Schirmer test. The values of tear secretion were recorded in each minute. Examined individuals also underwent other examinations: the standard patient evaluation of eye dryness (SPEED), the Ocular Surface Disease Index (OSDI), fluorescein stain, tear film breakup time (BUT), and Meibomian gland (MG)grading. The participants were divided into two groups: dry eye (DE) groupand non-dry eye (ND) group. The mean age was 39.41±14.05 years in DE group and 37.62±13.17 in ND group. The value of 2-minute Schirmer test, rear 3-minute Schirmer test, rear 4-minute Schirmer test and 5-minute Schirmer test was 5.36±4.63, 5.57±2.11, 7.21±4.13 and 10.93±6.30 respectively in DE group. And these indicators was 8.25±6.80, 2.73±2.31, 7.36±3.42, 11.84±6.16 in ND group. The rear 4-minute ST has significant correlation with OSDI and SPEED in DE group (r =-0.242/-0.183) and in ND gruop(r =-0.316 /-0.373). Meanwhile, rear 4-minute ST had stronger connection with fBUT(r =0.159) and MG (r =-0.162) in DE gruop. And rear 4-minute ST also had higher accuracy in diagnosing severe dry eye and borderline dry eye.The rear 4-minute Schirmer test may be a supplement indicator in assessing tear secretion and diagnosing dry eye.

scholarly journals Impact of Unilateral Orbital Radiotherapy on the Structure and Function of Bilateral Human Meibomian Gland

2018 ◽  
Vol 2018 ◽  
pp. 1-7
Author(s):  
Di Chen ◽  
Xiaowei Liu ◽  
Ying Li ◽  
Hui Guan ◽  
Fuquan Zhang
Keyword(s):  
Tear Film ◽  
Lower Eyelid ◽  
Meibomian Gland ◽  
Structure And Function ◽  
Ocular Surface Disease Index ◽  
Orbital Radiotherapy ◽  
Staining Score ◽  
And Function ◽  
The Impact ◽  
Normal Controls

Background. Radiotherapy (RT) has widely been used to treat ocular tumors, yet the impact of orbital radiation to the meibomian gland has rarely been studied. Our study aims at evaluating the bilateral meibomian gland structure and function 12 months after unilateral orbital RT in patients with ocular tumors. Methods. An observational case-control study. A total of 10 eyes 12 months after unilateral orbital RT, 10 contralateral eyes, and 10 normal controls were enrolled. Meibomian gland loss (MGL), lipid layer thickness (LLT), tear film breakup time (TBUT), Schirmer I test, and cornea fluorescein staining were measured. Ocular Surface Disease Index (OSDI) of the RT patients was assessed and compared with normal controls. Results. The cumulative median radiotherapy dosage for the patients was 45 (range: 30, 70) Gy. The OSDI score of the patients was significantly greater than the normal controls (22.92 (range: 10.42, 37.50) vs 6.25 (range: 2.08, 10.42), p≤0.001). Significant differences of upper MGL, lower MGL, LLT, and TBUT were found between the diseased eyes and normal controls (37.79% (range: 12.87, 92.41) vs 12.63% (range: 6.13, 42.34), p=0.007; 61.31% (range: 44.67, 87.98) vs 15.53% (range: 7.65, 45.13), p≤0.001; 40 ICU (range: 23, 100) vs 81.5 ICU (range: 54, 100), p=0.007; 3.5 s (range: 2, 8) vs 6.5 s (range: 5, 10), p=0.002). The upper MGL and TBUT of the contralateral eyes were also considerably damaged compared with normal controls. Lower eyelid MGL and cornea staining score of the diseased eye were significantly correlated with radiation dosage (r = 0.913 and 0.680; p=0.001 and 0.044, respectively). Conclusion. Orbital radiotherapy could cause significant damage to the meibomian gland structure and function, not only the diseased eyes but also the contralateral eyes.

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