Abstract

Many 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.

Highlights

  • Many recent studies have showed that morphological changes are one of the key signs of meibomian gland disease (MGD)

  • The results of this study confirm the high prevalence of meibomian gland morphological alterations in patients with dry eye disease (DED) and in healthy adults

  • MG morphological alterations were more common in the lower eyelid of patients with DED than in healthy individuals

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Summary

Introduction

Many recent studies have showed that morphological changes are one of the key signs of meibomian gland disease (MGD). 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. 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). Previous studies show that morphological changes are one of the key signs of ­MGD8,11 These changes can be seen even before symptoms o­ nset[12,13], potentially underestimating the prevalence of MGD. For the evaluation of MGD, morphological assessment of meibography images is required, since dry eye tests cannot identify all MGD

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