scholarly journals Morphological and Functional Assessment of Meibomian Glands in Keratoconus

2021 ◽  
Author(s):  
Ömür Ö Uçakhan ◽  
Gökçen Özcan
Keyword(s):  
Ocular Surface ◽  
Tear Film ◽  
Early Screening ◽  
Ocular Surface Disease Index ◽  
Non Invasive ◽  
The Mean ◽  
Meibomian Glands ◽  
Break Up ◽  
And Function ◽  
Corneal Staining

Abstract Purpose: To evaluate the morphology and function of the meibomian glands (MG) in keratoconus patients.Methods: One hundred eyes of 100 keratoconus patients and 100 eyes of 100 age-matched healthy subjects were included into this study. Ocular Surface Disease Index (OSDI) scores, non-invasive break up time (NIBUT), meibography findings, fluorescein staining of the ocular surface, tear film break-up time (TBUT), and Schirmer I test were recorded in all patient eyes and were compared with controls.Results: The mean TBUT and NIBUT were significantly lower, corneal staining and OSDI scores were statistically higher in the keratoconus group (p<0.05). The mean meiboscore, partial gland, gland dropout and gland thickening scores of the upper and lower eyelids were significantly higher in keratoconus patients compared to controls (p<0.05). The NIBUT measurements significantly correlated with MG loss in both upper and lower eyelids (p<0.05). The severity of keratoconus seemed to correlate with meiboscore, partial gland, gland thickening scores in both upper and lower eyelids. Conclusion: Our data suggest that corneal ectasia in keratoconus is associated with alterations in ocular surface, tear film function and MG morphology. Early screening and treatment of MG dysfunction may improve ocular surface quality and allow better disease management in keratoconus patients.

scholarly journals Changes of Dry Eye Related Markers and Tear Inflammatory Cytokines After Upper Blepharoplasty

2021 ◽  
Vol 8 ◽  
Author(s):  
Songjiao Zhao ◽  
Nan Song ◽  
Lan Gong
Keyword(s):  
Inflammatory Cytokines ◽  
Dry Eye ◽  
Ocular Surface ◽  
Clinical Manifestations ◽  
Tear Film ◽  
Ocular Surface Disease Index ◽  
Necrosis Factor Alpha ◽  
Tnf Α ◽  
Break Up ◽  
Upper Blepharoplasty

Objectives: To investigate the changes of dry eye-related clinical manifestations, ocular surface parameters, and tear inflammatory cytokines after upper blepharoplasty.Methods: Forty eyes of 20 who underwent upper blepharoplasty were divided into either the group with or the group without preexisting dry eye before upper blepharoplasty. Ocular Surface Disease Index (OSDI), Schirmer I test, tear meniscus height, lipid layer thickness, non-invasive tear break-up time (NIKBUT), fluorescein tear film break-up time (FBUT), corneal fluorescein staining, meibum expression, lid margin changes, and tear inflammatory cytokines were assessed preoperatively and at 1, 3, and 6 months postoperatively. Correlations between inflammatory cytokines and dry eye-related parameters were determined.Results: The OSDI scores increased significantly at 1 month (p = 0.040) and subsequently decreased to the preoperative levels at 6 months postoperatively in subjects with dry eye. First (f)-NIKBUT and FBUT were significantly shortened at 1, 3, and 6 months postoperatively in subjects with dry eye (f-NIKBUT: p &lt;0.001, p = 0.010, p = 0.042; FBUT: p = 0.002, p = 0.005, p = 0.037, respectively), but were only shortened at 1 month (p = 0.028, p = 0.005) and returned to baseline levels at 6 months postoperatively in subjects without preexisting dry eye. A significant increasing trend of interleukin (IL)-6 was found in both dry eye and subjects without preexisting dry eye (p = 0.016, p = 0.008), while IL-8 and tumor necrosis factor alpha (TNF-α) were only found to be increased in subjects with dry eye postoperatively (p = 0.031, p = 0.031). The levels of IL-8 and TNF-α were positively correlated with OSDI scores (p = 0.046, p = 0.043, respectively) and negatively correlated with f-NIKBUT and FBUT (p = 0.026, p = 0.006, respectively).Conclusions: Upper blepharoplasty might increase the release of tear inflammatory cytokines and tear film instability that contribute to the development of postoperative dry eye in the early postoperative period and the changes most relieved in 6 months. Preexisting dry eye is a higher risk factor for worse and persistent ocular surface damage after upper blepharoplasty.

Longitudinal assessment of meibomian glands and tear film layer in systemic isotretinoin treatment

2021 ◽  
pp. 112067212110183
Author(s):  
Cafer Tanriverdi ◽  
Burcu Nurozler Tabakci ◽  
Sumbule Donmez
Keyword(s):  
Morphological Changes ◽  
Tear Film ◽  
Longitudinal Assessment ◽  
Ocular Surface Disease Index ◽  
Eyelid Margin ◽  
Long Time ◽  
Film Layer ◽  
Meibomian Glands ◽  
The Right ◽  
Corneal Staining

Purpose: This study aimed to analyze the changes in meibomian glands (MGs) and tear film layer over time in patients taking systemic isotretinoin treatment. Methods: Patients who received systemic isotretinoin treatment between 4 and 8 months were prospectively followed up. In addition to full ophthalmologic examination, MG dysfunction (MGD), noncontact meibography, noninvasive and invasive tear break-up time (TBUT), ocular surface disease index (OSDI), corneal staining, and eyelid margin abnormality scores were recorded before, during, and after treatment. Results: A total of 88 eyes of 88 patients were included in the study. The right eyes of all the patients were included. The mean age of the patients was 21 ± 2.9 years. Of the 88 patients, 70 (79.6%) were females and 18 (20.4%) were males. Before the treatment, MGD, noncontact meibography, first noninvasive TBUT, mean noninvasive TBUT, invasive TBUT, OSDI, corneal staining, and eyelid margin abnormality scores were 0.29 ± 0.45, 4.93 ± 3.50, 13.78 ± 3.89 s, 14.47 ± 3.09 s, 12.96 ± 3.61 s, 0.54 ± 1.00, 0.04 ± 0.20, and 0.09 ± 0.28, respectively. Twelve months after the end of treatment, the scores were 0.97 ± 0.87 ( p < 0.001), 9.62 ± 3.89 ( p < 0.001), 11.24 ± 3.52 s ( p < 0.001), 12.34 ± 3.02 s ( p < 0.001), 11.31 ± 2.90 s ( p < 0.001), 1.90 ± 2.44 ( p < 0.001), 0.20 ± 0.40 ( p < 0.001), and 0.56 ± 0.49 ( p < 0.001), respectively. Conclusion: Systemic isotretinoin treatment causes morphological changes in the MGs. However, this treatment may negatively affect the tear film layer of patients. Some of these changes may persist for a long time even if the treatment is discontinued.

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 Analysis of basal and reflex human tear osmolarity in normal subjects: assessment of tear osmolarity

2018 ◽  
Vol 10 ◽  
pp. 251584141879488 ◽  
Author(s):  
Ali A. Abusharha ◽  
Tariq M. AlShehri ◽  
Abdullah Y. Hakami ◽  
Ali M. Alsaqr ◽  
Raied A. Fagehi ◽  
...  
Keyword(s):  
Ocular Surface ◽  
Tear Film ◽  
Normal Subjects ◽  
Mean Value ◽  
Disease Index ◽  
Ocular Surface Disease ◽  
Normal Male ◽  
Phenol Red ◽  
Ocular Surface Disease Index ◽  
The Mean

Purpose: The aim of this study is to evaluate the difference between reflex and basal tear osmolarity among healthy normal subjects. Method: The right eyes of 20 healthy normal male subjects aged 20 to 40 years were recruited for this study. The inclusion criteria for the subjects were the Ocular Surface Disease Index questionnaire score of less than 12 and wetting length of the phenol red thread of more than 10 mm. Tear film osmolarity was assessed using TearLab osmometer. Basic tear osmolarity was measured normally without inducing any irritation to the eye. In order to stimulate reflex tear, subjects were asked to open their eye as long as they can till they feel ocular surface irritation (minimum 20 s). Results: The mean score on the Ocular Surface Disease Index questionnaire was 5.5 ± 3. The mean value obtained from the phenol red thread was 21 ± 4.5 mm. There were no statistically significant differences between the osmolarity readings of basal and reflex tear osmolarity ( p > 0.05). The mean value was 308 ± 12 and 306 ± 9 mOsm/l for basic and reflex tear osmolarity, respectively. Conclusion: This study found that the osmolarity of the basal and reflex tears fell within the same range. The values found in this study are in agreement with published results for normal subjects.

scholarly journals Ocular surface analysis and automatic non-invasive assessment of tear film breakup location, extension and progression in patients with glaucoma

2019 ◽  
Author(s):  
Adriano Guarnieri ◽  
Elena Carnero ◽  
Anne-Marie Bleau ◽  
Nicolás López de Aguileta Castaño ◽  
Marcos Llorente Ortega ◽  
...  
Keyword(s):  
Ocular Surface ◽  
Tear Film ◽  
Control Group ◽  
Film Rupture ◽  
Film Stability ◽  
Non Invasive ◽  
Parametric Data ◽  
Break Up ◽  
Glaucoma Group ◽  
Non Parametric

Abstract Background Tear film stability is the key event in ocular surface diseases. The purpose of this study is to evaluate spatial and temporal progression of the tear film break-up using an automatic non-invasive device. Methods Non-invasive tear break-up time (NITBUT) parameters, such as First NITBUT (F-NITBUT) and Average NITBUT (A-NITBUT), were evaluated in 132 glaucoma and 87 control eyes with the Keratograph 5M device. Further analysis of this data was used to determine size, location and progression of tear film break-up with automatically identified break-up areas (BUA). The progression from First BUA (F-BUA) to total BUA (T-BUA) was expressed as Dry Area Growth Rate (DAGR). Differences between both groups were analysed using Student t-test for parametric data and Mann-Whitney U test for non-parametric data. Pearson's correlation coefficient was used to assess the relationship between parametric variables and Spearman in the case of non-parametric variables. Results F-NITBUT was 11.43±7.83 seconds in the control group and 8.17±5.73 in the glaucoma group (P=0.010). A-NITBUT was 14.04±7.21 and 11.82±6.09 seconds in control and glaucoma groups, respectively (P=0.028). F-BUA was higher in the glaucoma group than in the control group (2.73 and 2.28; P=0.022) and was more frequently located at the centre of the cornea in the glaucoma group (P=0.039). T-BUA was also higher in the glaucoma group than in the control group (13.24% and 9.76%; P=0.012) and the DAGR was steeper in the glaucoma group than in the control group (34.38º and 27.15º; P=0.009). Conclusions Shorter NITBUT values and bigger, more central tear film break-up locations were observed in the glaucoma group than in the control group. The DAGR indicates that tear film rupture is bigger and increases faster in glaucomatous eyes than in normal eyes.

scholarly journals Characterization and Prediction of the Clinical Outcome of Intense Pulsed Light-Based Treatment in Dry Eye Associated to Meibomian Gland Dysfunction

2021 ◽  
Vol 10 (16) ◽  
pp. 3573
Author(s):  
María T. Iradier ◽  
María Ángeles del Buey ◽  
Cristina Peris-Martínez ◽  
Priscilla Cedano ◽  
David P Piñero
Keyword(s):  
Case Series ◽  
Tear Film ◽  
Meibomian Gland ◽  
Intense Pulsed Light ◽  
Meibomian Gland Dysfunction ◽  
Successful Outcome ◽  
Pulsed Light ◽  
Ocular Surface Disease Index ◽  
Non Invasive ◽  
Break Up

This non-comparative prospective case series was conducted to characterize the clinical impact of intense pulsed light (IPL)-based treatment in dry eyes associated to Meibomian gland dysfunction (MGD), defining the predicting factors for a successful outcome with this therapy in a large case series. A total of 390 eyes (195 patients, range: 23–93 years) received four sessions of Optima IPL system (Lumenis, Yokneam, Israel). Significant changes were observed in tear film osmolarity in both eyes (p < 0.001) and in meibum quality (p < 0.001), with more eyes showing clear or yellow secretions after therapy. Mean change in the ocular surface disease index (OSDI) was −8.61, ranging from −27.00 to 11.00. This change was significantly correlated with the baseline value of OSDI (r = −0.489, p < 0.001). The change in osmolarity correlated significantly with the baseline osmolarity in both eyes (right r = −0.636, left r = −0.620, p < 0.001). A linear predicting model of the change in OSDI with therapy was obtained: change OSDI = 10.99 − 0.35 × OSDI − 1.03 × NIBUTRE-LE (mean non-invasive break up time of right and left eye) −2.03 × Meibum quality grade (p = 0.001; R2: 0.325). In conclusion, the improvement in symptomatology achieved with an IPL-based therapy can be predicted at baseline using a linear model considering the level of MGD and the magnitude of OSDI and NIBUT (non-invasive break-up time).

scholarly journals Comparison of Clinical Use of Ocular-surface Disease Index Questionnaire, Tear Film Break-up time, and Schirmer Tests in Diagnosing Dry-eye

2019 ◽  
pp. 1-7
Author(s):  
Suwarna Suman ◽  
Prachi Goyal
Keyword(s):  
Dry Eye ◽  
Ocular Surface ◽  
Tear Film ◽  
Dry Eye Disease ◽  
Disease Index ◽  
Ocular Surface Disease ◽  
Eye Disease ◽  
Ocular Surface Disease Index ◽  
Schirmer’S Test ◽  
The Mean

Aims:  To evaluate and compare the diagnostic values and clinical utility of the Ocular Surface Disease Index (OSDI) questionnaire, the tear film break-up time test (TBUT), and the Schirmer’s test in diagnosing dry eye disease in patients presenting with dry eye symptoms. Study Design: A prospective observational study. Place and Duration of Study: Department of Ophthalmology, AIIMS Jodhpur, Rajasthan, India. Two-month period between July 2016 and September 2016. Methodology: We have included 100 patients aged >20 years having foreign body sensations, burning sensations, pain, dryness, blurred vision, photophobia, redness in the study. Routine ophthalmological examination was performed after OSDI questionnaire, followed by TBUT and Schirmer’s test and outcomes were evaluated. Results: The mean age of 100 participants was 43 ± 15.97years (range 20–78 years). The mean OSDI, TBUT, and Schirmer’s test scores were 58.67± 12.12 (range 30.0–88.9), 5.77 ± 3.49 seconds (range 0–17 seconds), and 09.78 ± 7.93 mm (range 0–32.5 mm), respectively. There was a statistically highly significant inverse correlation between the OSDI and TBUT (r = −0.597, P = <0.0001), statistically significant correlation between TBUT and Schirmer test (r= -0.227, p= 0.023), whereas no significant correlation noted between the OSDI and Schirmer’s test (r= -0.142, p= 0.158).  Conclusion: The prevalence of dry eye disease (DED) is increasing these days. For early recognition and treatment, we need rapid, reliable and less invasive diagnostic test in daily practice. The OSDI together with the TBUT is less time consuming, easy to perform and can be useful in diagnosis of DED.

scholarly journals Changes in Ocular Surface Disease Evaluated after Nonpenetrating Deep Sclerectomy

2021 ◽  
Author(s):  
Carlota Fuente-García ◽  
Francisco José Muñoz-Negrete ◽  
Elisabet de Dompablo-Ventura ◽  
Javier Moreno-Montañés ◽  
Gema Rebolleda
Keyword(s):  
Ocular Surface ◽  
Anterior Segment ◽  
Tear Film ◽  
Ocular Surface Disease ◽  
Control Group ◽  
Deep Sclerectomy ◽  
Ocular Surface Disease Index ◽  
Non Invasive ◽  
Group A ◽  
Tear Meniscus Height

Abstract Objective: To analyse the ocular surface changes in eyes after the withdraw of anti-glaucomatous drugs when non-penetrating deep sclerectomy (NPDS) is performed.Methods: 31 patients (33 eyes) diagnosed of glaucoma that underwent NPDS, were included in this prospective study. Control group included 33 eyes of 33 age and sex-matched volunteers. Five variables were studied with Keratograph 5M (K5M): ocular hyperaemia (OH), non-invasive tear film break-up time (NI-BUT), lower tear meniscus height (LTMH) and meibography. LTMH was also measured using the anterior segment module of Spectralis Fourier-Domain Optical Coherence Tomography (FD-OCT). Also, an evaluation of corneal and conjunctival staining was performed.In addition, patients were asked to answer two questionnaires: Ocular Surface Disease Index (OSDI) and National Eye Institute Visual Functioning Questionnaire (NEI VFQ-25) before and 6-months after surgery.Results: Before NPDS, treated eyes, showed worse objective data than healthy controls (p ≤0.049). In this group, a significant improvement was observed in the questionnaires (p< 0.001), LTMH FD-OCT (p=0.037) and LTMH K5M (p=0.025), K5M OH (p=0.003), NI-BUT (=0.022) and conjunctival and corneal staining (p<0.001). No significant differences were observed between groups in FD-OCT and K5M LTMH, NI-BUT, corneal-conjunctival staining and in the most OH sector values at 6 months(p ≥0.62).Conclusion: A significant improvement in the ocular surface was observed 6 months after NPDS, suggesting that the withdrawn of the topical anti-glaucomatous treatment has a beneficial effect.

scholarly journals Ocular surface analysis and automatic non-invasive assessment of tear film breakup location, extension and progression in patients with glaucoma

2019 ◽  
Author(s):  
Adriano Guarnieri ◽  
Elena Carnero ◽  
Anne-Marie Bleau ◽  
Nicolás López de Aguileta Castaño ◽  
Marcos Llorente Ortega ◽  
...  
Keyword(s):  
Ocular Surface ◽  
Tear Film ◽  
Control Group ◽  
Film Rupture ◽  
Film Stability ◽  
Non Invasive ◽  
Parametric Data ◽  
Break Up ◽  
Glaucoma Group ◽  
Non Parametric

Abstract Background Tear film stability is the key event in ocular surface diseases. The purpose of this study is to evaluate spatial and temporal progression of the tear film break-up using an automatic non-invasive device. Methods Non-invasive tear break-up time (NITBUT) parameters, such as First NITBUT (F-NITBUT) and Average NITBUT (A-NITBUT), were evaluated in 132 glaucoma and 87 control eyes with the Keratograph 5M device. Further analysis of this data was used to determine size, location and progression of tear film break-up with automatically identified break-up areas (BUA). The progression from First BUA (F-BUA) to total BUA (T-BUA) was expressed as Dry Area Growth Rate (DAGR). Differences between both groups were analysed using Student t-test for parametric data and Mann-Whitney U test for non-parametric data. Pearson's correlation coefficient was used to assess the relationship between parametric variables and Spearman in the case of non-parametric variables. Results F-NITBUT was 11.43±7.83 seconds in the control group and 8.17±5.73 in the glaucoma group (P=0.010). A-NITBUT was 14.04±7.21 and 11.82±6.09 seconds in control and glaucoma groups, respectively (P=0.028). F-BUA was higher in the glaucoma group than in the control group (2.73 and 2.28; P=0.022) and was more frequently located at the centre of the cornea in the glaucoma group (P=0.039). T-BUA was also higher in the glaucoma group than in the control group (13.24% and 9.76%; P=0.012) and the DAGR was steeper in the glaucoma group than in the control group (34.38º and 27.15º; P=0.009). Conclusions Shorter NITBUT values and bigger, more central tear film break-up locations were observed in the glaucoma group than in the control group. The DAGR indicates that tear film rupture is bigger and increases faster in glaucomatous eyes than in normal eyes.

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