Presence Of Meibomian Gland Dysfunction Research Articles

The Duration of Cataract Surgery and the Change in Postoperative Dry Eye Disease Parameters: A Retrospective Cohort Study

Objective: The aim of this study was to evaluate the correlation between the duration of cataract surgery and the postoperative dry eye disease (DED) parameters. Methods: A retrospective cohort study was conducted on individuals who received cataract surgery at our institution. In total, 72 and 36 eyes were split into the short and long surgery groups, respectively. The main outcomes were the postoperative tear break-up time (TBUT), the Schirmer II test result, the ocular surface staining score, the DED symptoms, and the presence of meibomian gland dysfunction (MGD). A generalized linear model was employed to compare the changes in the DED parameters between the two groups. Results: The uncorrected visual acuity (UDVA) was significantly better in the short surgery group compared to the long surgery group (p = 0.031). The latter group also demonstrated a significantly shorter TBUT and a higher ocular surface stain score compared to those of the short surgery group (both p < 0.05). The change in the TBUT and ocular surface stain score were significantly higher in the long surgery group than the short surgery group (both p < 0.05). No DED parameters were significantly associated with the postoperative UDVA in the short surgery group (all p > 0.05). However, the TBUT and the ocular surface stain score correlated with worse postoperative UDVA in the long surgery group (both p < 0.05). Conclusions: Operating on a cataract for more than 20 min correlates with a long TBUT and a poor ocular surface staining score, which could influence the postoperative UDVA.

Improvement in signs and symptoms of severe dry eye disease after dual therapy with high-potency steroids and 0.05% cyclosporine

Objective To evaluate the effectiveness and safety of combining 0.05% cyclosporine A (CsA) with high-potency steroids for treating severe dry eye disease (DED). Materials and methods This retrospective comparative case series included 93 patients treated with 0.05% CsA for severe DED. Among them, we included data from 54 eyes of 27 patients who received high-potency steroids in the study group and from 132 eyes of 66 patients who did not receive high-potency steroids in the control group. Data on demographic characteristics, comorbidities, medications and intraocular pressure (IOP) were recorded. The primary outcomes were changes in symptom and sign scores. The ocular surface disease index was used as the symptom score, whereas tear break-up time, Schirmer I test without anaesthesia, ocular surface staining scores and presence of meibomian gland dysfunction were considered as sign scores. Repeated one-way ANOVA and generalized linear mixed models were used to evaluate differences. Results In the control group, symptom scores decreased from 1 to 2 months and from 2 to 3 months after treatment (p = .002 and .049). In the high-potency steroid group, symptom scores improved during these intervals (p = .003 and .005). The sign score in the control group remained unchanged (all p > .05), while the high-potency steroid group exhibited progressive improvement in sign scores (all p < .05). The high-potency steroid group had more favourable symptom (p = .035) and sign (p < .001) scores than did the control group. However, multiple systemic diseases were associated with poor symptom (p = .025) and sign (p = .014) scores. The risks for glaucoma and cataract formation were similar between the two groups (all p > .05). Conclusions Dual therapy combining high-potency steroids and 0.05% CsA significantly improved the signs and symptoms of severe DED compared with 0.05% CsA monotherapy, without severe complications.

Influence of video display terminal use and meibomian gland dysfunction on the ocular surface and tear neuromediators.

To evaluate the effects of video display terminal (VDT) work and meibomian gland dysfunction (MGD) on ocular surface parameters, tear cytokine and substance P (SP) levels, and their association with dry eye disease (DED). This cross-sectional study included 60 patients with evaporative DED and 20 healthy individuals. The DED patients were divided into three groups according to daily VDT work time and presence of MGD. The ocular surface and tear film were assessed using the Ocular Surface Disease Index questionnaire (OSDI), tear film break-up time (TBUT), ocular surface staining, Schirmer II test, and corneal sensitivity. MGD was evaluated with meibography. Corneal nerve alterations were evaluated using in vivo confocal microscopy (IVCM). The tear levels of 30 cytokines and SP were examined. Compared to controls, DED patients had higher OSDI score (p < 0.001), increased corneal staining with fluorescein and lissamine green (p = 0.046, p = 0,038), and lower TBUT (p < 0.001). Tear interleukin-6 levels were higher in DED patients, while tear SP levels did not differ between the groups (p = 0.265). VDT work time showed a weak positive correlation with OSDI (r = 0.274, p = 0.014) and SP level (r = 0.284, p = 0.011). The results of this study show that VDT use and MGD have an adverse effect on the ocular surface. It was also observed that the combination of VDT use and MGD did not significantly increase the ocular surface disease, but longer VDT exposure may be associated with more complaints of ocular discomfort.

The preoperative management of meibomian gland dysfunction prior to corneal refractive surgery.

To describe the significance of meibomian gland dysfunction (MGD) in corneal refractive surgery and to describe available approaches to preoperative evaluation and treatment based on current research. There are several methods available for the evaluation and treatment of MGD. These are relevant for refractive surgeons to understand, as the presence of MGD preoperatively plays a role in the severity of MGD after corneal refractive surgery. Refractive surgery itself can exacerbate MGD. Treatment of MGD prior to surgery may have a meaningful impact on postoperative MGD. Surgeons should include meibomian gland assessment in the preoperative refractive evaluation and should treat MGD proactively prior to performing refractive surgery. Relevant information in this field is growing; additional prospectively designed studies are needed to further enhance our understanding.

Short tear film breakup time-type of dry eye in India.

Purpose:The aim of this study was to describe the clinical characteristics and risk factors of short tear film break-up time (TBUT) type of dry eye disease and compare it with other types of dry eye diseases.Methods:This cross-sectional study included 570 patients (≥ 20 years) from the outpatient department using systematic random sampling.Results:The age-adjusted prevalence of short TBUT type of dry eye disease was 5.4% (95% confidence interval: 3.2–6.8%). There was no difference (P > 0.05) between the total and subscale scores of the Ocular Surface Disease Index® questionnaire between patients with short TBUT and those with aqueous tear deficiency. Both these groups differed significantly (P < 0.05) in the findings of TBUT, Schirmer I test, and Lissamine green staining score. The common symptoms in patients with short TBUT type of dry eye disease were eye fatigue (25.4%), heaviness in the eye (19.7%), and an uncomfortable sensation (14.1%). The symptoms in the aqueous tear deficiency group were light sensitivity (28.2%), dryness (19.2%), burning (13.0%), foreign body sensation (12.8%), and blurring of vision (14.1%). The risk factors associated with short TBUT type of dry eye disease were the presence of meibomian gland dysfunction (odds ratio: 3.759 [95% confidence interval: 2.135–6.618], P < 0.0001) and female sex [odds ratio: 1.954 (95% confidence interval: 1.042–3.667), P = 0.037].Conclusion:Patients with short TBUT type of dry eye disease have symptom severity similar to aqueous tear-deficient dry eyes, but the pattern is different. The finding of this type of dry eye disease in India indicates its global presence, and ophthalmologists should consider it in their differential diagnoses.

Dry eye in rheumatoid arthritis patients under TNF-inhibitors: conjunctival goblet cell as an early ocular biomarker

Dry eye disease (DED) is common in Rheumatoid Arthritis (RA) patients. The application of conjunctival goblet cell count as a clinical biomarker to diagnose and respond to treatment can take place in rheumatoid arthritis patients under TNF-inhibitors (TNFi) therapy. This study aimed to investigate the ocular surface parameters and the long-term effects of TNFi therapy on ocular surface features and goblet cell count of rheumatoid arthritis patients. At baseline, rheumatoid arthritis patients eligible to TNFi were compared to healthy controls (similar age/gender), regarding Ocular Surface Disease Index (OSDI) questionnaire, Schirmer I test, tear break-up time test, vital dye staining of the ocular surface, and conjunctival impression cytology. DED severity grade, impression cytology score, and goblet cell count were analyzed. Rheumatoid arthritis patients were followed after three (3 M) and 12 months (12 M), during TNFi treatment. Sixteen rheumatoid arthritis patients and 24 controls were compared: a higher frequency of abnormal OSDI (68.8% vs. 16.7%, p = 0.002), Schirmer’s test < 10 mm (37.5% vs. 8.3%, p = 0.042), meibomian gland dysfunction (50% vs. 8.3%, p = 0.007), abnormal impression cytology (75% vs. 8.3%, p < 0.001), and mild to moderate DED (81.3% vs. 4.2%, p < 0.001) were observed in rheumatoid arthritis patients, who also had lower goblet cell count [325 (274–707) cells/mm2 vs. 742 (562–863) cells/mm2, p = 0.004]. The presence of Meibomian gland dysfunction was associated with higher disease activity scores (p < 0.05). The prospective early observation of these patients at 3 M showed an increase improvement in tear production by Schirmer’s test [13 (7.5–17.5) vs. 23.5 (16–35); p = 0.001], and an improvement in impression cytology score [1 (0.5–2) vs. 1 (0–1), p = 0.031] and in goblet cell count [325 (274–707) vs. 931 (656–1,244), p < 0.001]. Eight RA responders to TNFi were also re-evaluated at 12 M with further improvement in goblet cell count [393 (275–827) vs. 872 (502–1,185) vs. 1,079 (867–1,244), p = 0.047]. Multifactorial DED is frequent in RA patients, comprising aqueous, lipid, and mucin components. TNFi prompt improves tear production and recovers the goblet cells, which can be a biomarker of the pathological process and response to therapy in this population.

Eyelid Disorders Highly Prevalent in Ophthalmology Practice; Results From a Large International Epidemiological Study in Eleven Countries

AbstractPurposeAnecdotal evidence suggests that eyelid disorders are common, although estimates of its prevalence vary. A cross‐sectional epidemiological survey was conducted among patients attending routine ophthalmological consultations to determine the prevalence of eyelid disorders, Meibomian Gland Dysfunction (MGD) and related pathologies (in particular ocular surface disease).MethodDuring the consultation a quality of life questionnaire and a clinical examination were completed by the ophthalmologist. In eleven countries, 349 investigator ophthalmologists were recruited who provided data from 6525 patients.ResultsPatients were predominantly female (61.6%), mean age 57.0 ± 17.6 y. Eyelid disorders were diagnosed in 78.3% of patients and were statistically associated with atopic dermatitis, seborrheic dermatitis, dry eye, age‐related macular degeneration, diabetes, cataract, allergy and MGD. Eyelid abnormalities were identified in 38.5% of patients; abnormalities of the eyelid margin in 59.8%, and abnormal meibomian gland secretion in 34.5%. Conjunctival or corneal abnormalities were observed in 64.9% and 27.9% of patients respectively. MGD was diagnosed in 54.0% of patients and was statistically significantly associated with the presence of eyelid disorders and eyelid margin abnormality. Dry eye was diagnosed in 61.2% of patients and was concomitant with MGD in most cases. Most patients reported some degree of impairment of vision and daily/work activities. These effects on daily life were associated with the presence of MGD. Impact on contact lens usage and on emotions and quality of sleep were also reported.ConclusionIn conclusion, eyelid disorders were highly prevalent in this clinic population. Routine ophthalmological consultations may provide a useful opportunity to improve patients’ quality of life and to modify topical therapy where this is an aetiological factor in eyelid disorders.

Meibomian gland dysfunction (MGD), as diagnosed by non-contact infrared Meibography, in dogs with ocular surface disorders (OSD): a retrospective study

BackgroundMeibomian 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).ResultsOne 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).ConclusionsMGD 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.

Subjective versus objective dry eye disease in patients with moderate-severe thyroid eye disease

PurposeTo compare the subjective versus Objective dry eye disease (DED) in patients with moderate-severe thyroid eye disease (TED). MethodIncluded were the patients with moderate-severe TED and ≥18 years old. They completed the ocular surface disease index (OSDI) questionnaire and had Schirmer, Tear breakup time (TBUT), fluorescein staining, osmolarity, corneal aesthesiometry, and meibomian gland dysfunction (MGD) tests. Excluded were patients with history of any disease, surgery and or medications which might be affecting the ocular surface and incomplete tests results. Subjective DED was defined as OSDI score of ≥13 and objective as one abnormal sign (TBUT, Schirmer, Osmolarity, and Staining). Presence of both was defined as definite DED. ResultsIncluded were 38 patients (74 eyes) with mean age of 40 years. Subjective DED was detected in 77%, objective in 89.2%, and definite in 67.7% of the eyes. Severe subjective and objective DED were found in 36.5% and 24.3% of the eyes, respectively. TBUT was the most frequent positive test (63.5%). MGD was observed in 56.8% of the eyes. Mean clinical activity score, palpebral fissure, rundle grading, proptosis, corneal aesthesiometry, and presence of MGD were not significantly different between the eyes with and without subjective, objective, or definite DED. ConclusionDefinite DED was found in more than 2/3 of the eyes with moderate-severe TED. While frequency of objective DED was higher, severe form of subjective DED was more frequent. No variable was significantly different between the eyes with and without subjective, objective and definite DED.

Influence of Meibomian Gland Dysfunction and Friction-Related Disease on the Severity of Dry Eye

To evaluate the effect of meibomian gland dysfunction (MGD) and friction-related disease (FRD) on the severity of dry eye disease (DED). Cross-sectional observational study. This study enrolled 449 patients with DED (63 men and 386 women; mean age, 62.6±15.7 years [range, 21-90 years]) for analysis. Subjective symptoms, the ocular surface, tear function, and the presence of MGD and FRD (superior limbic keratoconjunctivitis, conjunctivochalasis, and lid wiper epitheliopathy) were investigated. Schirmer value, tear film breakup time (TBUT), and keratoconjunctival score. We classified the participants into aqueous-deficient dry eye (ADDE; n= 231 [51.4%]) and short TBUT dry eye subtype (TBUT-DE; n= 109 [24.3%]) subgroups. The TBUT was shorter in patients with MGD than in those without MGD, whereas other ocular signs showed no difference (TBUT: MGD present, 1.97±1.02 seconds; MGD absent, 2.94±1.63 seconds [P < 0.001]; ADDE/MGD present, 1.94±1.08 seconds; ADDE/MGD absent, 2.77±1.61 seconds [P < 0.001]; short TBUT-DE/MGD present, 2.07±0.97 seconds; short TBUT-DE/MGD absent, 2.94±1.23 seconds [P= 0.01]). The ADDE patients with FRD showed a worse TBUT than ADDE patients without FRD (TBUT: ADDE/FRD present, 2.08±1.39 seconds; ADDE/FRD absent, 2.92±1.54 seconds; P<0.001). This study showed associations between MGD, FRD, or both and ocular signs in DED. In the presence of MGD, FRD, or both, TBUT was significantly shortened regardless of the dry eye status or subtype.

Eyelid Changes Related to Meibomian Gland Dysfunction in Early Middle-Aged Patients Using Topical Glaucoma Medications.

To investigate the relationship between topical glaucoma medications and meibomian gland dysfunction (MGD) in early middle-aged patients with glaucoma. In this cross-sectional study, 50 patients with glaucoma younger than 50 years who had used topical glaucoma medications for more than 6 months and 40 normal controls of similar age were included. Patients in each group were graded for MGD (0-4) using slit-lamp microscopy. Tear film breakup time (BUT), ocular surface staining, and Marx line scores were also evaluated. Differences between both groups were analyzed statistically. The prevalence of MGD was 82% in the group using topical glaucoma medications and 52.5% in the control group. The average period of topical glaucoma medication use was 27.4 months. There were significant differences in the breakup time and Marx line score according to the presence of MGD. Although the duration of topical glaucoma medication use and the severity of MGD did not show a significant correlation, the degree of MGD and the Marx line score were significantly correlated. Glaucoma eye drops may be one factor affecting the eyelid changes associated with MGD. The Marx line score may be used as an index to evaluate MGD in patients with glaucoma.

Factors that influence tear meniscus area and conjunctivochalasis: The Singapore Indian eye study

ABSTRACTPurpose: Assessment of tear film and conjunctiva is critical to define presence and severity of ocular surface disease. We aimed to characterize tear meniscus area (TMA) and conjunctivochalasis by anterior segment optical coherence tomography (ASOCT) in population-based patients and identify potential factors associated with low TMA and severe conjunctivochalasis.Methods: Study subjects were enrolled from The Singapore Indian Eye Study, a population-based study of Asian Indian in Singapore. Imaging with ASOCT was performed on three ocular regions (nasal, central and temporal). TMA was obtained by measuring the cross-sectional area of the inferior tear meniscus. Severity of conjunctivochalasis was quantified by measuring the conjunctivochalasis ratio (CCR), the ratio of area of redundant conjunctiva to the TMA. Ocular symptoms and demographic factors were assessed by standardized questionnaires.Results: A total of 403 participants (52.9% women) 40 years of age and older were included. TMA centrally was 2818 ± 5308 pixel2. Female sex and the presence of meibomian gland dysfunction (MGD), but not older age, were associated with a lower TMA (p = 0.031, p = 0.031 and p = 0.956 respectively). In this population, 9.2% had severe conjunctivochalasis (CCR>0.7) whereas 39.0% had mild to no conjunctivochalasis (CCR≤0.3). Conjunctivochalasis was more severe in temporal, followed by nasal and central sections. Older age was associated with severe conjunctivochalasis (p < 0.001).Conclusion: MGD and female gender were associated with lower TMA, while older age was associated with increased severity of conjunctivochalasis. Objective measurement of TMA and CCR using ASOCT imaging may be useful in the assessment of tear volume and ocular surface tear function.

Assessment of the Tear Meniscus by Strip Meniscometry and Keratograph in Patients With Dry Eye Disease According to the Presence of Meibomian Gland Dysfunction

We aimed to compare the tear meniscus measurements using strip meniscometry (SM) and Keratograph5M (K5M) between 3 subtypes of dry eye disease patient groups, classified according to the presence of meibomian gland dysfunction (MGD), and normal subjects. We enrolled 145 eyes from 145 subjects and measured the tear meniscus using SM and K5M, tear film breakup time, ocular surface staining, and ocular surface disease index; the Schirmer test; and examined lid margins and meibomian glands. Correlation of tear meniscus parameters with other parameters and efficacy of the 2 measurements were evaluated. The SM and K5M results were significantly lower in the non-Sjögren syndrome aqueous-deficient dry eye (non-SS ADDE) with and without MGD groups than in the MGD-only group and normal subjects. The SM or K5M results correlated with each other and with other ocular surface parameters. The area under the curve (AUC) of the SM and K5M results was 0.637 (P = 0.012) and 0.610 (P = 0.042), respectively. Except for the MGD group, the AUC of the SM and K5M results were 0.721 (P < 0.001) and 0.694 (P = 0.001), respectively. The AUC of SM and K5M were 0.947 (P < 0.001) and 0.784 (P = 0.002), differentiating non-SS ADDE-only patients from those with normal eyes. Tear meniscus measurements using SM and K5M can compensate for detection of aqueous-deficient components of dry eye. These results should be interpreted according to the presence or absence of MGD.

Evaluation of Meibomian Gland Dysfunction in Polycystic Ovary Syndrome and Obesity

ABSTRACTPurpose/Aim of the study: The purpose of this study was to evaluate the interaction between Polycystic ovary syndrome (PCOS) and Meibomian gland dysfunction (MGD) and obesity, to reveal whether there is a correlation between the testosterone levels and body-mass index (BMI) levels and the dry-eye complaints of these patients.Material and methods: The study included 92 patients with PCOS and 52 healthy patients from March 2013 to March 2014. All patients underwent a physical examination, pelvic ultrasound, and clinical and biochemical tests, including free testosterone levels to confirm the diagnosis of PCOS. The BMIs of all subjects were recorded. In addition, the presence of posterior blepharitis, as an indicator of MGD, was recorded. All patients underwent the dry-eye tests including Schirmer 1 and tear film break-up time (BUT). Complaints of dry-eye of the patients were evaluated with the ocular surface disease index (OSDI) questionnaire. The scores of both groups were compared.Results: The presence of MGD was 72.82% in the PCOS group and 61.53% in the control group. There was no correlation between the testosterone levels and study parameters in both groups. BUT levels negatively correlated with BMI in subjects without PCOS (r = −0.520, p = 0.001), whereas positively correlated with MGD and OSDI scores (r = 0.610, p = 0.632; p = 0.001, p = 0.001; respectively).Conclusion: Tear film instability due to MGD is common in PCOS and in subjects with high BMI. The MGD in PCOS patients is independent of the BMI.

Meibomian Gland Dysfunction in Patients Receiving Long-Term Glaucoma Medications.

The purpose of this study was to evaluate the impact of meibomian gland dysfunction (MGD) on the ocular surface of patients with medically treated glaucoma. This was a cross-sectional study in which 70 subjects with glaucoma on long-term (>1 year) topical hypotensive medications were recruited. MGD was defined as the presence of signs consistent with meibomian gland terminal duct obstruction. MGD was categorized between grades 1 and 4 and plus disease according to clinical severity. The ocular surface disease index (OSDI) questionnaire was completed at the time of enrollment. Ocular surface tests consisted of tear break-up time (BUT), ocular surface staining with lissamine green (LG), and Schirmer test with anesthesia. A Student t test, χ test, and Mann-Whitney U test were used in statistical comparisons. Forty-five healthy control subjects with no evidence of intraocular or ocular surface disease were also included. MGD was detected in 56 (80.0%) subjects with glaucoma. Forty-seven patients (67.1%) had obstructive and 9 (12.9%) had atrophic type of MGD. Of these 56 cases, 47 (83.9%) had signs consistent with mild to moderate MGD. The ocular surface test results of patients with glaucoma with MGD and without MGD were significantly worse (P < 0.001) for all parameters compared with those of healthy controls. However, there were no significant differences between ocular surface disease index scores (P = 0.912), tear break-up time (P = 0.635), lissamine green scores (P = 0.248), and Schirmer results (P = 0.991) between patients with glaucoma with MGD and without MGD. Mild to moderate MGD is frequently encountered in patients with medically treated glaucoma. However, the presence of MGD does not appear to have an additional detrimental effect on the ocular surface to that already induced by chronic topical medication use.

Associations Between the Grade of Meibomian Gland Dysfunction and Dyslipidemia

To examine the relationship between dyslipidemia and the severity of meibomian gland dysfunction (MGD). A prospective cohort study of 132 subjects with and 104 without MGD were recruited. A correlation between serum fasting lipids and MGD severity was performed. Mean age for all candidates was 49.4 years; and 57% were women. In all, 42.9% had no MGD, 14.8% had grade 1 MGD, 17.4% had grade 2 MGD, and 23.7% had grade 3 MGD. High cholesterol was found in 37.1% of grade 1 MGD, 43.9% of grade 2 MGD, and 50% of grade 3 MGD. High triglyceride was found in 5.7% of grade 1, 14.6% of grade 2, and 39.3% of grade 3 patients. High low-density lipoprotein was found in 17.1% of grade 1, 29.3% of grade 2, and 35.7% of grade 3 patients. The mean age of the control group was 41.2 years; and 55.4% were women. High cholesterol was found in 42.3%, triglyceride in 7.7%, low-density lipoprotein in 23.1%, low high-density lipoprotein in 3.8%, and high high-density lipoprotein in 3.8%. Although the presence of MGD does not have any correlation with dyslipidemia, the prevalence of high triglyceride and low-density lipoprotein levels increases with the increasing severity of MGD. This might highlight the significance of monitoring fasting serum lipids due to its association with the potential correlation with the progression of MGD.

Effects of Age and Dysfunction on Human Meibomian Glands

To identify age-related changes in human meibomian glands that may be associated with meibomian gland dysfunction (MGD). Excess eyelid tissue from 36 patients (age range, 18-95 years, 19 female, 17 male) who underwent canthoplasty procedures were used. Dermatologic history, age, and presence of MGD were recorded. Samples were frozen, sectioned, and stained with specific antibodies against peroxisome proliferator-activated receptor γ (PPARγ) to identify meibocyte differentiation, Ki67 nuclear antigen to identify cycling cells, and CD45 to identify inflammatory cell infiltration. Staining for PPARγ showed cytoplasmic and nuclear localization in the 2 youngest subjects (ages, 18 and 44 years). Older individuals (>60 years) showed predominantly nuclear staining, with cytoplasmic staining limited to the basal acinar cells in 17 of 31 subjects. The number of Ki67 positively stained basal cells were significantly elevated in the younger compared with older subjects based on linear regression analysis (r(2) = 0.35; P < .001). There was also a significant correlation between MG expression grade and CD45 cell infiltration (r = 0.414; P = .05). These results indicate that aging human meibomian glands show decreased meibocyte differentiation and cell cycling that is associated with the development of MGD. Findings also suggest that altered PPARγ signaling may lead to acinar atrophy and development of an age-related hyposecretory MGD. Meibomian gland dysfunction and evaporative dry eye are common age-related eyelid disorders. Understanding the underlying mechanism of MGD may lead to the development of novel therapeutic strategies to treat this disease.

Meibomian gland dysfunction and ocular discomfort in video display terminal workers

Meibomian gland dysfunction (MGD) is one of the most common ocular disorders encountered in clinical practice. The clinical manifestations of MGD are related to the changes in the tear film and ocular surface with symptoms of ocular discomfort. In recent years, many surveys have evaluated symptoms associated with the use of Video Display Terminals (VDT), and VDT use is recognized as a risk factor for eye discomfort. The aim of the present study was to determine if the presence of MGD contributes to the signs and symptoms of ocular discomfort during the use of VDT. In course of a routine health surveillance programme, a group of 70 subjects fulfilled the inclusion criteria and responded to a questionnaire about symptoms of ocular discomfort. The following ocular tests were performed: tear break-up time, fluorescein corneal stain, and basal tear secretion test. A total of 52 subjects out of 70 (74.3%) had MGD. A statistically significant correlation between the symptoms of ocular discomfort and hours spent on VDT work was observed in the total population (r=0.358; P=0.002; 95% CI 0.13-0.54) and in the group of subjects with MGD (r=0.365; P=0.009; 95% CI 0.103-0.58). Such correlation was not shown in subjects without MGD. The high prevalence of MGD among the subjects with symptoms of ocular discomfort suggests that this diagnosis should be considered when occupational health practitioners encounter ocular complaints among VDT operators. It appears that MGD can contribute to the development of ocular discomfort in VDT operators.