101
|
Jin H, Zhang H. Changes in the meibomian glands in postmenopausal women with primary acquired nasolacrimal duct obstruction: a prospective study. BMC Ophthalmol 2023; 23:48. [PMID: 36726065 PMCID: PMC9890874 DOI: 10.1186/s12886-023-02799-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 01/30/2023] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Primary acquired nasolacrimal duct obstruction (PANDO) is frequently encountered in perimenopausal women, causing tear flow stagnation and resulting in a variety of ocular discomfort symptoms. However, little is known about the alterations in the meibomian gland in postmenopausal women with PANDO. Hence, this study investigated the changes in the meibomian gland and ocular surface in postmenopausal women with PANDO. METHODS This prospective study included 60 eyes of 60 postmenopausal women with PANDO (PANDO group) and 30 eyes of 30 postmenopausal women without PANDO (control group). The PANDO group was further subdivided into incomplete and complete PANDO groups, based on the degree of nasolacrimal duct obstruction. The patients' symptoms were evaluated using the ocular surface disease index questionnaire. The meibomian gland and ocular surface were assessed using the Keratograph 5 M. Other ophthalmologic examinations included the tear break-up time, corneal fluorescein staining, meibomian gland expression, and Schirmer I test. The correlations between the degree of nasolacrimal duct obstruction and other metrics were analyzed. RESULTS The loss ratio of the upper eyelid was greater in the incomplete PANDO group than in the control group (p = 0.023). Meibomian gland distortion of the upper eyelid was more severe in the control group than in the complete PANDO group (p = 0.022). The non-invasive tear meniscus height was greater, whereas the intensity of corneal fluorescein staining was lower in the PANDO group than in the control group (all p < 0.05). The degree of nasolacrimal duct obstruction was positively associated with the non-invasive tear meniscus height and ocular surface disease index scores (p < 0.001 and p < 0.001, respectively). Corneal fluorescein staining and meibomian gland distortion of the upper eyelid were negatively correlated with the degree of nasolacrimal duct obstruction (p = 0.01 and p = 0.007, respectively). CONCLUSION Postmenopausal women with PANDO exhibit significant morphological changes in the meibomian gland. More attention should be paid to meibomian gland loss in postmenopausal women with incomplete PANDO, as it is crucial for identifying meibomian gland impairments in patients with PANDO.
Collapse
Affiliation(s)
- Haili Jin
- grid.265021.20000 0000 9792 1228Department of Ophthalmology, Tianjin Medical University, NO. 22, Qixiangtai Road, Tianjin, 300052 China ,grid.440648.a0000 0001 0477 188XDepartment of Ophthalmology, Wuhu Eye Hospital, Anhui University of Science & Technology, 378 Santan Road, Yijiang District, Wuhu, 241002, Anhui China
| | - Hong Zhang
- grid.265021.20000 0000 9792 1228Department of Ophthalmology, Tianjin Medical University, NO. 22, Qixiangtai Road, Tianjin, 300052 China ,grid.265021.20000 0000 9792 1228Department of Ophthalmology, Sino-Singapore Eco-City Hospital of Tianjin Medical University, NO. 3333, Hechang Road, Sino-Singapore Eco-City, Binhai New Area, Tianjin, 3000467 China
| |
Collapse
|
102
|
Yang Q, Liu L, Li J, Yan H, Cai H, Sheng M, Li B. Evaluation of meibomian gland dysfunction in type 2 diabetes with dry eye disease: a non-randomized controlled trial. BMC Ophthalmol 2023; 23:44. [PMID: 36721131 PMCID: PMC9887780 DOI: 10.1186/s12886-023-02795-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Accepted: 01/25/2023] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND The purpose of this investigation was to evaluate the morphology and physiological function of the meibomian glands between type 2 diabetics with dry eye disease (DED) and control subjects. Doing so will help to better reveal the pathologic mechanisms of meibomian gland dysfunction (MGD) and DED in type 2 diabetes mellitus (T2DM). METHODS Ninety subjects were divided into the following four groups: DM-DED group: T2DM patients with DED (n = 30); DM control group: DM patients without DED (n = 18); DED group: DED patients without DM (n = 26); and normal control group: normal subjects (n = 16). All participants administered the ocular surface disease index (OSDI) questionnaire, tear meniscus height (TMH), noninvasive Keratograph tear film break-up time (NIKBUT), Schirmer I test (SIT), corneal fluorescein staining (CFS), eyelid margin abnormality examinations, meibum quality and meibomian gland (MG) dropout evaluations. RESULTS The percentage of MG dropout in the upper and lower lids was significantly higher in the DM-DED group than the DED group (P < 0.05 or P < 0.01). However, there was no significant difference in other MG parameters between these two groups. Oppositely, Significant difference was observed in all of MG parameters except MG dropout in the lower lids comparing DM group with normal controls (P < 0.05 or P < 0.01). While the SIT values decreased in the DM-DED group compared to the DED group (P < 0.05), no significant differences were found in the values of other tear parameters. CONCLUSIONS The higher prevalence and increased severity of MGD was found in patients with both T2DM and DED compared to those only with DED. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR1800019939, date of registration December 9, 2018, prospectively registered.
Collapse
Affiliation(s)
- Qin Yang
- grid.460149.e0000 0004 1798 6718Department of Ophthalmology, Yangpu Hospital, Tongji University School of Medicine, 450 Tengyue Road, Shanghai, 20090 China
| | - Lihua Liu
- grid.460149.e0000 0004 1798 6718Department of Ophthalmology, Yangpu Hospital, Tongji University School of Medicine, 450 Tengyue Road, Shanghai, 20090 China
| | - Jing Li
- grid.460149.e0000 0004 1798 6718Department of Ophthalmology, Yangpu Hospital, Tongji University School of Medicine, 450 Tengyue Road, Shanghai, 20090 China
| | - Hui Yan
- grid.460149.e0000 0004 1798 6718Department of Ophthalmology, Yangpu Hospital, Tongji University School of Medicine, 450 Tengyue Road, Shanghai, 20090 China
| | - Haiying Cai
- grid.460149.e0000 0004 1798 6718Department of Ophthalmology, Yangpu Hospital, Tongji University School of Medicine, 450 Tengyue Road, Shanghai, 20090 China
| | - Minjie Sheng
- grid.460149.e0000 0004 1798 6718Department of Ophthalmology, Yangpu Hospital, Tongji University School of Medicine, 450 Tengyue Road, Shanghai, 20090 China
| | - Bing Li
- grid.460149.e0000 0004 1798 6718Department of Ophthalmology, Yangpu Hospital, Tongji University School of Medicine, 450 Tengyue Road, Shanghai, 20090 China
| |
Collapse
|
103
|
Garcia-Queiruga J, Pena-Verdeal H, Sabucedo-Villamarin B, Giraldez MJ, Garcia-Resua C, Yebra-Pimentel E. Meibomian gland secretion quality association with ocular parameters in university students during COVID- 19 restrictions. Int Ophthalmol 2023:10.1007/s10792-023-02632-2. [PMID: 36692700 PMCID: PMC9873396 DOI: 10.1007/s10792-023-02632-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 01/10/2023] [Indexed: 01/25/2023]
Abstract
PURPOSE To determine if the Meibomian Gland (MG) secretion quality is associated with symptoms of ocular discomfort, hours of Video Display Terminals (VDT) use, eyelid margin abnormalities, conjunctival hyperemia, and Meibomian Gland Loss Area (MGLA) in a sample of university students. METHODS An online survey that included an Ocular Surface Disease Index (OSDI) questionnaire and an extra question about hours of VDT use recruited an initial sample of 183 participants. Only 120 participants that fulfilled the inclusion criteria were scheduled for a battery of ocular surface and MG specific exam. The tests include: 1) meibometry, 2) slit lamp exploration of eyelid margin abnormalities (irregularity, hyperemia and MG orifices plugging), MG secretion quality and conjunctival hyperemia, and 3) Meibography. RESULTS Significant positive correlations between the MG secretion quality and eyelid margin hyperemia, MG orifices plugging, MGLA, nasal conjunctival hyperemia, and temporal conjunctival hyperemia (Spearman Rho; all r>0.186, p<0.042) were found. Multivariate regression found association between OSDI with hours of VDT use (B=0.316, p=0.007), and eyelid hyperemia (B=0.434, p≤ 0.001). A statistical association between MG secretion quality and eyelid margin hyperemia, MG orifices plugging, MGLA and conjunctival hyperemia (Fisher's exact; all p<0.039) were found. Multivariate regression found association between MG secretion quality with MG orifices plugging (B=0.295, p=0.004) and meibometry (B=-0.001, p=0.029). CONCLUSION Participants with higher values in MG secretion quality have higher values in eyelid margin hyperemia, MG plugging, MGLA, and conjunctival hyperemia. No direct relationship between MG secretion quality and hours of VDT use or OSDI were found.
Collapse
Affiliation(s)
- Jacobo Garcia-Queiruga
- GI-2092 - Optometry, Department of Applied Physics (Optometry Area), Universidade de Santiago de Compostela, Campus Vida s/n, Santiago de Compostela, Spain.
| | - Hugo Pena-Verdeal
- GI-2092 - Optometry, Department of Applied Physics (Optometry Area), Universidade de Santiago de Compostela, Campus Vida s/n, Santiago de Compostela, Spain
| | - Belén Sabucedo-Villamarin
- GI-2092 - Optometry, Department of Applied Physics (Optometry Area), Universidade de Santiago de Compostela, Campus Vida s/n, Santiago de Compostela, Spain
| | - Maria J Giraldez
- GI-2092 - Optometry, Department of Applied Physics (Optometry Area), Universidade de Santiago de Compostela, Campus Vida s/n, Santiago de Compostela, Spain
| | - Carlos Garcia-Resua
- GI-2092 - Optometry, Department of Applied Physics (Optometry Area), Universidade de Santiago de Compostela, Campus Vida s/n, Santiago de Compostela, Spain
| | - Eva Yebra-Pimentel
- GI-2092 - Optometry, Department of Applied Physics (Optometry Area), Universidade de Santiago de Compostela, Campus Vida s/n, Santiago de Compostela, Spain
| |
Collapse
|
104
|
Yılmaz Tuğan B, Sönmez HE, Şahin N, Yüksel N. Analysis of Meibomian Glands in Juvenile Systemic Lupus Erythematosus Patients without Dry Eye Symptoms and Signs. Jpn J Ophthalmol 2023; 67:32-37. [PMID: 36315324 DOI: 10.1007/s10384-022-00946-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 08/25/2022] [Indexed: 01/26/2023]
Abstract
PURPOSE To evaluate meibomian gland loss and its possible association with disease duration and activity in Juvenile Systemic Lupus Erythematosus (JSLE) patients' without dry eye symptoms or signs. STUDY DESIGN Prospective clinical study. METHODS Ten eyes of 10 JSLE patients were evaluated using the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) and 14 eyes of 14 healthy controls were also enrolled. Ocular Surface Disease Index (OSDI) questionnaire and Schirmer I test were performed. Lid margin score, meibum quality and expressibility scores were evaluated. Noninvasive first breakup time (NIF-BUT) and noninvasive average breakup time (NIAvg-BUT), meibomian gland dropout area (MGDA) and meibography scores were evaluated using non-contact meibography (Sirius; CSO). RESULTS There was no significant difference between the JSLE patients and the healthy controls in the OSDI, NIF-BUT, NIAvg-BUT and Schirmer I tests. Also lid margin score, meibum quality and expressibility scores were not significantly different between the groups. However, JSLE patients had increased upper and lower lid MGDA and increased upper lid, lower lid and total meibography scores compared to the healthy subjects. Furthermore, the duration of JSLE showed a high positive correlation with upper and lower lid MGDA and meibography scores. CONCLUSION Meibomian gland loss could be observed in JSLE patients with no clinical signs and symptoms of dry eye. Considering the longer life expectancy of children, the positive correlation of disease duration with the meibomian gland reveals the importance of routine eye examinations from the diagnosis of the disease.
Collapse
Affiliation(s)
- Büşra Yılmaz Tuğan
- Department of Ophthalmology, Kocaeli University Medical School, Kocaeli, Turkey.
| | - Hafize Emine Sönmez
- Department of Pediatrics, Division of Pediatric Rheumatology, Kocaeli University Medical School, Kocaeli, Turkey
| | - Nihal Şahin
- Derince Training and Research Hospital, Division of Pediatrics, Department of Pediatric Rheumatology, Kocaeli, Turkey
| | - Nurşen Yüksel
- Department of Ophthalmology, Kocaeli University Medical School, Kocaeli, Turkey
| |
Collapse
|
105
|
Habbe KJ, Frings A, Saad A, Geerling G. The influence of a mineral oil cationic nanoemulsion or perfluorohexyloctane on the tear film lipid layer and higher order aberrations. PLoS One 2023; 18:e0279977. [PMID: 36652431 PMCID: PMC9847907 DOI: 10.1371/journal.pone.0279977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 12/04/2022] [Indexed: 01/19/2023] Open
Abstract
PURPOSE To prospectively assess the effect of a single and regular application of either a cationic nanoemulsion of mineral oil (CN) or perfluorohexyloctane (F6H8) on the lipid layer of the tear film and higher order aberrations (HOA) in patients with Dry Eye Disease (DED). METHODS Fifty-seven patients with a lipid layer thickness (LLT) ≤ 75 interferometric colour units (ICU) were included in the study. In group A (20 patients) the effect of a single drop of F6H8 or CN on HOA and LLT was assessed immediately after application and up to two hours later. For long term effects (Group B) 37 patients applied CN or F6H8 five times a day for 12 weeks. Measurement of LLT, HOA, non-invasive-tear-break-up-time (NIBUT) and meibography were assessed prior to as well as at 4 weeks and 12 weeks after initiation of treatment. Our study is registered in the "German Clinical Trials Register" under the trial number: DRKS00028696. RESULTS CN led to an increase of the LLT from 46.8 ± 16.9 ICU to 76.3 ± 23.5 ICU (p = 0.021) and to an increase of HOA from 0.43 ± 0.06 μm to 0.48 ± 0.08 μm immediately after application (p = 0.027). There was no correlation between the increase of LLT and HOA (r = -0.04; p = 0.90). In group B an increase of LLT was observed in the F6H8 group from 45.8 ± 8.8 ICU at baseline to 66.7 ± 19.5 ICU at 12 weeks (p = 0.002). No changes of HOA were measured throughout the observation period in group B. After 12 weeks CN increased NIBUT from 9.9 ± 5.3 seconds to 15.5 ± 5.6 seconds (p = 0.04). F6H8 increased NIBUT from 12.4 ± 5.9 seconds to 16.9 ± 4.7 seconds (p = 0.02) after 12 weeks. CONCLUSION CN leads to a short-term increase in LLT and HOA, but only immediately after application. In contrast F6H8 does lead to an increase of LLT after regular long-term use but has no effect on HOA. The regular application of lipid-based products does not seem to decrease the quality of vision as measured in HOA. Instead, CN and F6H8, both are able to stabilize the tear film after regular application.
Collapse
Affiliation(s)
| | - Andreas Frings
- Department of Ophthalmology, Heinrich Heine University, Düsseldorf, Germany
- * E-mail:
| | - Amr Saad
- Department of Ophthalmology, Heinrich Heine University, Düsseldorf, Germany
| | - Gerd Geerling
- Department of Ophthalmology, Heinrich Heine University, Düsseldorf, Germany
| |
Collapse
|
106
|
Tauber J, Berdy GJ, Wirta DL, Krösser S, Vittitow JL. NOV03 for Dry Eye Disease Associated with Meibomian Gland Dysfunction: Results of the Randomized Phase 3 GOBI Study. Ophthalmology 2022; 130:516-524. [PMID: 36574848 DOI: 10.1016/j.ophtha.2022.12.021] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 11/29/2022] [Accepted: 12/20/2022] [Indexed: 12/25/2022] Open
Abstract
PURPOSE To evaluate the efficacy and safety of NOV03 (perfluorohexyloctane) ophthalmic drop in patients with dry eye disease (DED) associated with meibomian gland dysfunction (MGD). DESIGN Eight-week, phase 3, multicenter, randomized, double-masked, saline-controlled study. PARTICIPANTS Adults ≥ 18 years with a history of DED for ≥ 6 months, tear film breakup time of ≤ 5 seconds, Schirmer I test (without anesthesia) score ≥ 5 mm, MGD score ≥ 3 (0-15 scale), and total corneal fluorescein staining (tCFS) score ≥ 4 and ≤ 11 (0-15 National Eye Institute [NEI] scale). METHODS Patients were randomized 1:1 to NOV03 or hypotonic (0.6%) saline 4 times daily. MAIN OUTCOME MEASURES The primary sign and symptom end points were change from baseline in tCFS and eye dryness score (0-100 visual analog scale [VAS]) at week 8. Key secondary end points were change from baseline in eye dryness score at week 2, tCFS at week 2, eye burning or stinging score (0-100 VAS) at week 8, and central corneal fluorescein staining (cCFS; 0-3 NEI scale) at week 8. RESULTS Of the 599 patients randomized, 597 were treated (NOV03, n = 303; saline, n = 294). At week 8, improvement from baseline was significantly greater (P < 0.001) with NOV03 versus saline for tCFS (least square [LS] mean treatment difference, -0.97; 95% confidence interval [CI]: -1.40, -0.55) and VAS dryness score (-7.6; 95% CI: -11.8, -3.4). Improvement from baseline also significantly (P < 0.01) favored NOV03 on all key secondary end points: LS mean treatment difference (95% CI) was -4.7 (-8.2, -1.2) for VAS dryness score at week 2, -0.6 (-0.9, -0.2) for tCFS at week 2, -5.5 (-9.5, -1.6) for VAS burning or stinging score at week 8, and -0.2 (-0.4, -0.1) for cCFS at week 8. Most ocular adverse events (AEs) were mild in severity; no serious ocular AEs occurred. One patient discontinued NOV03 because of an AE (eye irritation). CONCLUSIONS In patients with DED associated with MGD, NOV03 demonstrated statistically significant and clinically meaningful improvements versus hypotonic saline in signs and symptoms of DED and was well tolerated. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found after the references.
Collapse
|
107
|
Pucker AD, Rueff E, Ngo W, Tichenor AA, Conto JE. LipiFlow for the treatment of dry eye disease. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2022; 2022:CD015448. [PMCID: PMC9754914 DOI: 10.1002/14651858.cd015448] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To evaluate the effectiveness of the LipiFlow Thermal Pulsation System on dry eye signs and symptoms compared to placebo or other commercially available treatments for meibomian gland dysfunction in adults.
Collapse
Affiliation(s)
| | - Andrew D Pucker
- School of OptometryUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Erin Rueff
- The Southern California College of OptometryMarshall B. Ketchum UniversityFullertonCaliforniaUSA
| | - William Ngo
- School of Optometry & Vision ScienceUniversity of WaterlooWaterlooCanada
| | | | - John E Conto
- Ophthalmology and Visual ScienceMedical College of WisconsinMilwaukeeWisconsinUSA
| |
Collapse
|
108
|
Deng X, Tian L, Zhang Y, Li A, Cai S, Zhou Y, Jie Y. Is histogram manipulation always beneficial when trying to improve model performance across devices? Experiments using a Meibomian gland segmentation model. Front Cell Dev Biol 2022; 10:1067914. [PMID: 36544900 PMCID: PMC9760981 DOI: 10.3389/fcell.2022.1067914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 11/14/2022] [Indexed: 12/12/2022] Open
Abstract
Meibomian gland dysfunction (MGD) is caused by abnormalities of the meibomian glands (MG) and is one of the causes of evaporative dry eye (DED). Precise MG segmentation is crucial for MGD-related DED diagnosis because the morphological parameters of MG are of importance. Deep learning has achieved state-of-the-art performance in medical image segmentation tasks, especially when training and test data come from the same distribution. But in practice, MG images can be acquired from different devices or hospitals. When testing image data from different distributions, deep learning models that have been trained on a specific distribution are prone to poor performance. Histogram specification (HS) has been reported as an effective method for contrast enhancement and improving model performance on images of different modalities. Additionally, contrast limited adaptive histogram equalization (CLAHE) will be used as a preprocessing method to enhance the contrast of MG images. In this study, we developed and evaluated the automatic segmentation method of the eyelid area and the MG area based on CNN and automatically calculated MG loss rate. This method is evaluated in the internal and external testing sets from two meibography devices. In addition, to assess whether HS and CLAHE improve segmentation results, we trained the network model using images from one device (internal testing set) and tested on images from another device (external testing set). High DSC (0.84 for MG region, 0.92 for eyelid region) for the internal test set was obtained, while for the external testing set, lower DSC (0.69-0.71 for MG region, 0.89-0.91 for eyelid region) was obtained. Also, HS and CLAHE were reported to have no statistical improvement in the segmentation results of MG in this experiment.
Collapse
Affiliation(s)
- Xianyu Deng
- Health Science Center, School of Biomedical Engineering, Shenzhen University, Shenzhen, China,Marshall Laboratory of Biomedical Engineering, Shenzhen, China
| | - Lei Tian
- Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Institute of Ophthalmology, Capital Medical University, Beijing, China,Ophthalmology and Visual Sciences Key Laboratory, Beijing, China
| | - Yinghuai Zhang
- Health Science Center, School of Biomedical Engineering, Shenzhen University, Shenzhen, China,Marshall Laboratory of Biomedical Engineering, Shenzhen, China
| | - Ao Li
- Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Institute of Ophthalmology, Capital Medical University, Beijing, China,Ophthalmology and Visual Sciences Key Laboratory, Beijing, China
| | - Shangyu Cai
- Health Science Center, School of Biomedical Engineering, Shenzhen University, Shenzhen, China,Marshall Laboratory of Biomedical Engineering, Shenzhen, China
| | - Yongjin Zhou
- Health Science Center, School of Biomedical Engineering, Shenzhen University, Shenzhen, China,Marshall Laboratory of Biomedical Engineering, Shenzhen, China,*Correspondence: Yongjin Zhou, ; Ying Jie,
| | - Ying Jie
- Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Institute of Ophthalmology, Capital Medical University, Beijing, China,Ophthalmology and Visual Sciences Key Laboratory, Beijing, China,*Correspondence: Yongjin Zhou, ; Ying Jie,
| |
Collapse
|
109
|
Lee SH, Kim M, Lee WJ, Chun YS, Kim KW. Different Number of Sessions of Intense Pulsed Light and Meibomian Gland Expression Combination Therapy for Meibomian Gland Dysfunction. KOREAN JOURNAL OF OPHTHALMOLOGY 2022; 36:527-542. [PMID: 36281571 DOI: 10.3341/kjo.2022.0068] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 10/13/2022] [Indexed: 12/14/2022] Open
Abstract
PURPOSE To evaluate the effect of the intense pulsed light (IPL) and meibomian gland (MG) expression (MGX) combination therapy according to the total numbers of sessions in the meibomian gland dysfunction (MGD). METHODS Ninety patients with MGD were included. Patients had maximal five sessions of IPL (Aqua Cel, Jeisys Medical) and MGX combination therapy at 2-week intervals. The ocular surface disease index (OSDI) questionnaire score, MG profile grades, tear matrix metalloproteinase-9 (MMP-9), tear break-up time (BUT), tear osmolarity, tear secretion, and corneal erosions were evaluated. RESULTS The number of patients who had a total of one to five sessions (1S to 5S) was 10, 25, 17, 20, and 18, respectively. The time-serial decrease of OSDI scores was significant in patients who had three or more sessions (3S, p = 0.002; 4S, p < 0.001; 5S, p < 0.001). The MG expressibility grade decreased with two or more sessions (2S-5S, p < 0.001), but the meibum quality significantly improved with all sessions (1S, p = 0.012; 2S, p = 0.024; 3S, p = 0.015; 4S, p < 0.001; 5S, p < 0.001). Although tear BUT increased even in patients with one session (1S, p = 0.040; 3S, p = 0.005; 4S, p = 0.006; 5S, p = 0.021), tear MMP-9, osmolarity, Schirmer I, and corneal erosions were not improved in every number of sessions. The female sex was the sole contributor to the final symptomatic improvement (p = 0.042), and the MGD stages were not related to the final OSDI decrease. CONCLUSIONS The OSDI score, MGD grades, and BUT were improved after the IPL and MGX combination therapy in MGD patients. Unlike MGD grades and tear film instability might be improved just after a few sessions, the overall subjective relief was accomplished in three or more sessions.
Collapse
Affiliation(s)
- Seung Hyeun Lee
- Department of Ophthalmology, Chung-Ang University College of Medicine, Seoul, Korea
| | - Minjeong Kim
- Department of Ophthalmology, Chung-Ang University College of Medicine, Seoul, Korea
| | - Won Jun Lee
- Department of Ophthalmology, Chung-Ang University College of Medicine, Seoul, Korea
| | - Yeoun Sook Chun
- Department of Ophthalmology, Chung-Ang University College of Medicine, Seoul, Korea
| | - Kyoung Woo Kim
- Department of Ophthalmology, Chung-Ang University College of Medicine, Seoul, Korea
| |
Collapse
|
110
|
Kim WJ, Ahn YJ, Kim MH, Kim HS, Kim MS, Kim EC. Lipid layer thickness decrease due to meibomian gland dysfunction leads to tear film instability and reflex tear secretion. Ann Med 2022; 54:893-899. [PMID: 35379048 PMCID: PMC8986263 DOI: 10.1080/07853890.2022.2056238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To determine the clinical effects of ocular surface and Meibomian gland parameters on tear film stability among individuals with Meibomian gland dysfunction (MGD), those with aqueous deficient dry eye (ADDE), individuals with both conditions and normal controls. METHODS Patients were divided into four groups: normal controls, patients with ADDE, patients with MGD, and patients who fulfilled diagnostic criteria for ADDE and MGD (Mixed Group). Data for ocular symptom score, lid margin abnormality, ocular staining, tear break-up time, meiboscore, and lipid layer thickness (LLT) measured by a Lipiview interferometer, Schirmer test, and MGD severity score were collected. RESULTS A total of 109 patients (109 eyes) were evaluated. In patients with MGD, LLT was significantly lower than the ADDE patients. However, the Schirmer test value was the highest in the MGD group. The LLT negatively correlated with meiboscore and MGD severity score in the MGD group. Significant correlation between Schirmer test value and meiboscore was definite in the MGD group. CONCLUSIONS Tear fluid secretion is more increased and lipid layer thickness is more decreased in MGD patients than in ADDE patients. Decreased lipid layer thickness caused by MGD-related tear film instability may stimulate reflex tear secretion. The obstructive MGD is more prevalent than hypersecretary MGD.Key messagesThe tear film stability is affected by Mebomian gland dysfunction (MGD). The measurement of the tear film parameters including lipid layer thickness suggests that the obstructive MGD is more prevalent than hypersecretary MGD and the aqueous layer compensates the decreased lipid layer caused by MGD.
Collapse
Affiliation(s)
- Wung Jae Kim
- Gwangjin St. Mary's Eye Clinic, Seoul, Republic of Korea
| | - Ye Jin Ahn
- Gwangjin St. Mary's Eye Clinic, Seoul, Republic of Korea
| | - Min Ho Kim
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hyun Seung Kim
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Man Soo Kim
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Eun Chul Kim
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| |
Collapse
|
111
|
Zahn I, Garreis F, Schicht M, Rötzer V, Waschke J, Liu Y, Altersberger VL, Paulsen F, Dietrich J. A New Organotypic 3D Slice Culture of Mouse Meibomian Glands Reveals Impact of Melanocortins. Int J Mol Sci 2022; 23:ijms232314947. [PMID: 36499274 PMCID: PMC9737810 DOI: 10.3390/ijms232314947] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 11/20/2022] [Accepted: 11/24/2022] [Indexed: 12/05/2022] Open
Abstract
The meibomian glands (MGs) within the eyelids produce a lipid-rich secretion that forms the superficial layer of the tear film. Meibomian gland dysfunction (MGD) results in excessive evaporation of the tear film, which is the leading cause of dry eye disease (DED). To develop a research model similar to the physiological situation of MGs, we established a new 3D organotypic slice culture (OSC) of mouse MGs (mMGs) and investigated the effects of melanocortins on exocrine secretion. Tissue viability, lipid production and morphological changes were analyzed during a 21-day cultivation period. Subsequently, the effects on lipid production and gene expression were examined after stimulation with a melanocortin receptor (MCR) agonist, α-melanocyte-stimulating hormone (α-MSH), and/or an MCR antagonist, JNJ-10229570. The cultivation of mMGs OSCs was possible without impairment for at least seven days. Stimulation with the MCR agonists induced lipid production in a dose-dependent manner, whereas this effect was tapered with the simultaneous incubation of the MCR antagonist. The new 3D OSC model is a promising approach to study the (patho-) physiological properties of MG/MGD while reducing animal studies. Therefore, it may accelerate the search for new treatments for MGD/DED and lead to new insights, such as that melanocortins likely stimulate meibum production.
Collapse
Affiliation(s)
- Ingrid Zahn
- Institute of Functional and Clinical Anatomy, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany
- Correspondence: (I.Z.); (F.P.); Tel.: +49-9131-85-26734 (I.Z.); +49-9131-85-22865 (F.P.)
| | - Fabian Garreis
- Institute of Functional and Clinical Anatomy, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany
| | - Martin Schicht
- Institute of Functional and Clinical Anatomy, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany
| | - Vera Rötzer
- Department of Anatomy, Ludwig-Maximilians-Universität, 80336 Munich, Germany
| | - Jens Waschke
- Department of Anatomy, Ludwig-Maximilians-Universität, 80336 Munich, Germany
| | - Yuqiuhe Liu
- Institute of Functional and Clinical Anatomy, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany
| | - Valerian L. Altersberger
- Institute of Functional and Clinical Anatomy, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany
- Department of Anatomy, Ludwig-Maximilians-Universität, 80336 Munich, Germany
| | - Friedrich Paulsen
- Institute of Functional and Clinical Anatomy, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany
- Correspondence: (I.Z.); (F.P.); Tel.: +49-9131-85-26734 (I.Z.); +49-9131-85-22865 (F.P.)
| | - Jana Dietrich
- Institute of Functional and Clinical Anatomy, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany
| |
Collapse
|
112
|
Analysis of Cytokine Levels in Meibum and Clinical Correlations with Meibomian Gland Dysfunction. DISEASE MARKERS 2022; 2022:4259067. [DOI: 10.1155/2022/4259067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 09/03/2022] [Accepted: 10/11/2022] [Indexed: 11/24/2022]
Abstract
Objectives. This study is aimed at investigating the difference of meibum chemokines in MGD subjects with different degrees of MGD and the correlations of meibum chemokines with ocular surface parameters. Methods. Twenty MGD subjects (MQ
) and twenty MGD subjects (MQ
) were enrolled to examine ocular surface parameters, including meibomian gland function (MGE, MQ meibograde, and lid margin), tear stability (NIKBUT, FBUT, and LLT), tear secretion (SIT and TMH), OSDI questionnaire, and CFS. These subjects also obtained meibum samples, and then meibum chemokines (MIG, IFN-γ, IL-8, IP-10, and MCP-1) were examined and analyzed the correlations with ocular surface parameters. Results. MIG, IP-10, and MCP-1 were found clearly elevated in MGD subjects with higher MQ score than that in MGD subjects with low MQ score (MIG:
, IP-10:
, MCP-1:
). The meibomian function was found mostly positively correlated with level of MIG (MGE:
,
; MQ:
,
) and IP-10 (MGE:
,
; MQ:
,
). The tear stability was found negatively correlated with the level of MIG (NIKBUT:
,
; LLT:
,
) and MCP-1 (NIKBUT:
,
; LLT:
,
). The OSDI was positively correlated with IL-8, IFN-γ, and MIG. Conclusion. Chemokines in meibum were significantly evaluated in MGD subjects suffering from severe meibomian gland quality. These findings indicate that chemokines play roles in the pathogenesis of MGD, and molecules targeted by chemokines may develop as novel agents for MGD therapy, perhaps through inhibiting inflammation in meibomian glands and microvascular in the eyelid margin.
Collapse
|
113
|
Jing D, Jiang X, Ren X, Su J, Huang C, Yang J, Hao R, Li X. Metagenomic nanopore sequencing of ocular microbiome in patients with meibomian gland dysfunction. Front Med (Lausanne) 2022; 9:1045990. [PMID: 36438054 PMCID: PMC9682043 DOI: 10.3389/fmed.2022.1045990] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 10/26/2022] [Indexed: 07/30/2023] Open
Abstract
PURPOSE To explore the composition of the ocular microbiome in patients with Meibomian gland dysfunction (MGD) using metagenomic nanopore sequencing. METHODS A total of 98 participants were recruited from September to December 2021, including 86 patients with MGD and 12 controls. Symptoms and signs of dry eye were assessed, and bacterial samples in the conjunctival sac (CS) and meibomian gland (MG) secretions were then identified by bacterial culture identification and metagenomic nanopore sequencing. RESULTS The positive rate of CS bacterial culture in the MGD group was significantly higher than that in the normal group. A more complex composition of bacterial genera was detected in the mild and moderate MGD groups than in the control. However, the severe MGD groups had the simplest composition of bacteria. Metagenomic nanopore sequencing detected more species of bacteria than traditional culture. CONCLUSION The CS and MG of MGD patients may have different degrees of bacterial microbiota imbalance. Metagenomic nanopore sequencing technology provides a new way for us to understand the composition of "real-world" ocular surface microorganisms.
Collapse
Affiliation(s)
- Dalan Jing
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
| | - Xiaodan Jiang
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
| | - Xiaotong Ren
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
| | - Jie Su
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
| | - Chen Huang
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
- Medical Research Center, Peking University Third Hospital, Beijing, China
| | - Jiarui Yang
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
| | - Ran Hao
- Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Xuemin Li
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
| |
Collapse
|
114
|
Prevalence and associations of dry eye disease and meibomian gland dysfunction in the ural eye and medical study. Sci Rep 2022; 12:18849. [PMID: 36344615 PMCID: PMC9640718 DOI: 10.1038/s41598-022-22580-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 10/17/2022] [Indexed: 11/09/2022] Open
Abstract
To assess the prevalence of dry eye disease (DED) and Meibomian gland dysfunction (MGD) in a population in Russia. The population-based Ural Eye and Medical Study was conducted in an urban and rural region in Bashkortostan/Russia and included 5899 (80.5%) out of 7328 eligible persons, aged 40 + years. DED and MGD were assessed by Schirmer´s test, slit-lamp based examination of the Meibomian glands, and an interview with DED-related questions. The study included 5153 (87.4%) individuals with DED and MGD assessments (mean age: 58.5 ± 10.5 years). The mean Schirmer´s test result was 11.8 ± 6.8 mm and 12.5 ± 7.1 mm for the right/left eye, with a result of ≤ 5 mm measured in 1098 (21.3%; 95% confidence intervals (CI) 20.2, 22.4) of the worse eyes. The mean subjective dry eye symptoms score was 1.37 ± 1.82. MGD grade 1 (telangiectasia at the lid margin), 2, 3, 4 or any grade in the worse eye was diagnosed in 901 (21.1%), 1161 (27.1%), 158 (3.7%), 32 (0.7%), and 2252 (52.6%; 95% CI 51.1, 54.1) eyes respectively. The prevalence of DED diagnosis #1, #2 and #3 (Schirmer´s test ≤ 5 mm, and dry eye score ≥ 1, ≥ 2, and ≥ 3, respectively), #4 (dry eye score ≥ 1, Schirmer test ≤ 5 mm, MGD grade 1 +), and #5 (dry eye score ≥ 1, Schirmer test ≤ 5 mm, MGD grade 2 +) were 598/5142 (11.6%), 426/5153 (8.3%), 273/5142 (5.3%), 335/5142 (6.5%), and 186/5142 (3.6%), respectively. Mean depression score as applied was 5.1 ± 3.8. Higher DED prevalence (definition #4) was associated (multivariable analysis) with female sex (odds ratio (OR) 1.71; 95% CI 1.31, 2.22; P < 0.001), higher depression score (OR 1.04; 95% CI 101, 1.07; P = 0.009), and higher prevalence of thyroid disease history (OR 1.63; 95% CI 1.19, 2.24; P = 0.006). DED and MGD were common in this rural and urban population, and their prevalence was associated with female sex, thyroid disease, and depression.
Collapse
|
115
|
Matossian C, Crowley M, Periman L, Sorkin S. Personalized Management of Dry Eye Disease: Beyond Artificial Tears. Clin Ophthalmol 2022; 16:3911-3918. [DOI: 10.2147/opth.s384819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 11/01/2022] [Indexed: 11/24/2022] Open
|
116
|
Kim ES, Afshin EE, Elahi E. The Lowly Chalazion. Surv Ophthalmol 2022:S0039-6257(22)00154-0. [PMID: 36395826 DOI: 10.1016/j.survophthal.2022.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 10/31/2022] [Accepted: 11/07/2022] [Indexed: 11/16/2022]
Abstract
Chalazia are localized cysts of chronic lipogranulomatous inflammation arising from the obstruction of sebaceous glands of the eyelid tarsal plate, including the Meibomian gland (deep chalazion) or Zeis gland (superficial chalazion). This disease entity is differentiated from the hordeolum (stye), an acute purulent localized swelling of the eyelid often associated with an eyelash follicle, Zeis gland, or Moll gland obstruction and infection. Ambiguously, the chalazion, hordeolum, and blepharitis are commonly categorized and described on a continuum in the literature. While it is one of the most common eyelid disorders across all age demographics, the chalazion remains largely understudied and pathophysiological, epidemiological, and therapeutic findings exist fragmented in the literature. We discuss current understandings of the chalazion and provide current best practice guidelines supported by clinical anecdotal evidence.
Collapse
Affiliation(s)
- Eliott S Kim
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Fifth Avenue Eye Associates, New York, NY, USA
| | - Evan E Afshin
- Fifth Avenue Eye Associates, New York, NY, USA; Department of Physiology and Biophysics, Weill Cornell Medicine, New York, NY, USA
| | - Ebby Elahi
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Fifth Avenue Eye Associates, New York, NY, USA; Departments of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| |
Collapse
|
117
|
Chen Y, Wu Y, Gao M, Gao R, Zhang K. Differential response to topical lubrication in patient with dry eye disease, based on age. BMC Ophthalmol 2022; 22:396. [PMID: 36199043 PMCID: PMC9532823 DOI: 10.1186/s12886-022-02609-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 09/09/2022] [Accepted: 09/20/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To compare the Ocular surface disease index (OSDI) score, Schirmer I test (SIT), fluorescein break up time (FBUT) and fluorescence staining (FLCS) score of dry eye patients at different ages. METHODS 90 eyes of 90 patients with mild to moderate dry eye from September 2020 to September 2021 were retrospectively included and were divided into young group (20-39 years, n = 29), middle-age group (40-59 years, n = 30), and elder group (> 60 years, n = 31). Patients were given a 28-day topical lubricating ocular surface and repair-promoting drugs combined with local physical therapy. Patients were followed up at 7, 14 and 28 days. The OSDI score, SIT, FBUT and FLCS score were examined. RESULTS There were differences between the OSDI score in three groups at each time point (all P < 0.001). SIT were different among the three groups (F = 350.61, P < 0.001), and a time effect was found (F = 80.87, P < 0.001). SIT at 14 and 28 days after treatment in middle-age and elder groups were lower than young group (all P < 0.001). SIT at 7, 14 and 28 days in elder group were lower than middle-age group (all P < 0.001). FLCS score was lower at 28 days than other time points (all P < 0.001). CONCLUSION Dry eye patients are given a 28-day topical lubricating ocular surface and repair-promoting drugs combined with local physical therapy, which can promote tear secretion, film stability, and the recovery of corneal integrity. Age affects the treatment effect of mild to moderate dry eye, among which tear secretion is the most significant.
Collapse
Affiliation(s)
- Yingxin Chen
- Department of ophthalmology, the General Hospital of Northern Theater Command, No.83, Wenhua Road, Shenhe District, 110840, Shenyang, China
| | - Yajun Wu
- Department of ophthalmology, the General Hospital of Northern Theater Command, No.83, Wenhua Road, Shenhe District, 110840, Shenyang, China
| | - Minghong Gao
- Department of ophthalmology, the General Hospital of Northern Theater Command, No.83, Wenhua Road, Shenhe District, 110840, Shenyang, China.
| | - Ruiyao Gao
- Department of ophthalmology, the General Hospital of Northern Theater Command, No.83, Wenhua Road, Shenhe District, 110840, Shenyang, China
| | - Kai Zhang
- Department of ophthalmology, the General Hospital of Northern Theater Command, No.83, Wenhua Road, Shenhe District, 110840, Shenyang, China
| |
Collapse
|
118
|
Antibiotic treatment for dry eye disease related to meibomian gland dysfunction and blepharitis – A review. Ocul Surf 2022; 26:211-221. [DOI: 10.1016/j.jtos.2022.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 08/18/2022] [Accepted: 08/30/2022] [Indexed: 11/19/2022]
|
119
|
Hamada Y, Sasaki L, Uehara H, Suzuki T, Kinoshita S, Otsuka K, Kihara A, Yamaguchi Y, Miyake T, Doi M. Optimising the method for visualising mouse meibomian gland using eyelid whole-mount lipid staining. Ocul Surf 2022; 26:268-270. [DOI: 10.1016/j.jtos.2022.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 09/30/2022] [Accepted: 10/03/2022] [Indexed: 12/05/2022]
|
120
|
Yang X, Zhong X, Huang AJ, Reneker LW. Spontaneous acinar and ductal regrowth after meibomian gland atrophy induced by deletion of FGFR2 in a mouse model. Ocul Surf 2022; 26:300-309. [PMID: 34798325 DOI: 10.1016/j.jtos.2021.11.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 11/06/2021] [Accepted: 11/09/2021] [Indexed: 12/14/2022]
Abstract
PURPOSE We have demonstrated that deletion of fibroblast growth factor receptor 2 gene (Fgfr2) leads to Meibomian gland (MG) atrophy in an inducible conditional knockout mouse model, referred as Fgfr2CKO. Herein, we investigated whether MG spontaneously recovers after atrophy in this model. METHODS Two months old Fgfr2CKO mice were injected peritoneally once or twice of doxycycline (Dox) at 80 μg/gm of body weight to induce MG atrophy of various severities via Fgfr2 deletion. Recovery of acinar and ductal tissues was monitored by meibography, lipid staining and immunofluorescence against keratin-6a in MG whole-mount. Biomarkers for acinar and ductal differentiation and proliferation were also examined by immunostaining. RESULTS Single Dox injection in Fgfr2CKO mice caused severe acinar and moderate ductal atrophy. Severe ductal shortening or loss occurred after second Dox injection, presumably related to the reported slower cycling of the ductal epithelia. Spontaneous acinar regrowth after atrophy was observed over a period of 60 days in both injection regimens. However, less robust acinar recovery was associated with more disrupted ductal structures in twice injected Fgfr2CKO mice. CONCLUSIONS Our current findings further substantiate the role of FGFR2 in MG homeostasis, and suggest that FGFR2-signaling may provide a potential strategy for regenerating acini from age-related MG dysfunction in humans. Our data demonstrated that spontaneous MG recovery depends on the extent of ductal atrophy, suggesting that ductal epithelia may provide the progenitor cells for acinar regeneration. Nonetheless, the role of ductal tissue as the source of acinar progenitors awaits further investigation.
Collapse
Affiliation(s)
- Xiaowei Yang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Xingwu Zhong
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China; Hainan Eye Hospital and Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Haikou, China.
| | - Andrew Jw Huang
- Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, Missouri, United States
| | - Lixing W Reneker
- Mason Eye Institute, Department of Ophthalmology, University of Missouri School of Medicine, Columbia, MO, United States
| |
Collapse
|
121
|
Nuwormegbe S, Park NY, Park HJ, Jin Y, Kim SW, Jester JV. Induction of meibocyte differentiation by three-dimensional, matrigel culture of immortalized human meibomian gland epithelial cells to form acinar organoids. Ocul Surf 2022; 26:271-282. [PMID: 36341959 PMCID: PMC10364613 DOI: 10.1016/j.jtos.2022.10.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 09/20/2022] [Accepted: 10/19/2022] [Indexed: 11/05/2022]
Abstract
PURPOSE Recent studies have shown that two-dimensional (2D) culture of primary rabbit and immortalized human meibomian gland epithelial cells (iHMGEC) do not recapitulate normal meibocyte differentiation and fail to express critical enzymes necessary for synthesis of meibum lipids. The purpose of this study was to test the hypothesis that 3D-spheroid culture of iHMGEC can facilitate meibocyte differentiation and induce the expression of acyl-CoA wax-alcohol acyltransferase 2 (AWAT2), shown to be required for synthesis of meibum wax esters. METHODS iHMGEC were suspended in matrigel/basement membrane matrix and grown in proliferation media to form distinct cell clusters or spheroids. Cells were then treated with serum-free, differentiation media (advanced DMEM/F12) with and without FGF10 and synthetic agonists for the nuclear lipid receptor, peroxisome proliferator activator receptor gamma (PPARγ). Cells were then evaluated for differentiation markers using western blotting, immunocytochemistry (ICC) and real-time PCR. Control cells were grown in standard 2D culture systems. RESULTS Under proliferative conditions, 3D culture induced the formation of KRT5+ spheroids that contained a Ki67+/P63+ undifferentiated, basal cell population. When spheroids were switched to differentiation media containing PPARγ agonists, two different organoid populations were detected, a KRT6low population that was AWAT2+/PPARγ+ and a KRT6high population that was AWAT2-/PPARγ-, suggesting that iHMGEC exhibit a dual differentiation potential toward either a ductal or meibocyte organoid phenotype. CONCLUSION The 3D culturing of iHMGEC can induce the formation of both meibocyte and ductal organoids and may thus serve as a better in vitro model system for studying the regulatory mechanisms controlling meibomian gland function.
Collapse
Affiliation(s)
- Selikem Nuwormegbe
- Research Institute of Metabolism and Inflammation, Yonsei University, Wonju College of Medicine, Wonju, Ilsan-ro, Gangwon-do, 26426, Republic of Korea
| | - Na-Young Park
- Research Institute of Metabolism and Inflammation, Yonsei University, Wonju College of Medicine, Wonju, Ilsan-ro, Gangwon-do, 26426, Republic of Korea
| | - Hee Joo Park
- Research Institute of Metabolism and Inflammation, Yonsei University, Wonju College of Medicine, Wonju, Ilsan-ro, Gangwon-do, 26426, Republic of Korea
| | - Yeonwoo Jin
- Department of Ophthalmology, Yonsei University, Wonju College of Medicine, Wonju, Ilsan-ro, Gangwon-do, 26426, Republic of Korea
| | - Sun Woong Kim
- Department of Ophthalmology, Yonsei University, Wonju College of Medicine, Wonju, Ilsan-ro, Gangwon-do, 26426, Republic of Korea; Research Institute of Metabolism and Inflammation, Yonsei University, Wonju College of Medicine, Wonju, Ilsan-ro, Gangwon-do, 26426, Republic of Korea.
| | - James V Jester
- Gavin Herbert Eye Institute, University of California, Irvine, Irvine, CA, USA.
| |
Collapse
|
122
|
Predicting demographics from meibography using deep learning. Sci Rep 2022; 12:15701. [PMID: 36127431 PMCID: PMC9489726 DOI: 10.1038/s41598-022-18933-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 08/22/2022] [Indexed: 11/08/2022] Open
Abstract
This study introduces a deep learning approach to predicting demographic features from meibography images. A total of 689 meibography images with corresponding subject demographic data were used to develop a deep learning model for predicting gland morphology and demographics from images. The model achieved on average 77%, 76%, and 86% accuracies for predicting Meibomian gland morphological features, subject age, and ethnicity, respectively. The model was further analyzed to identify the most highly weighted gland morphological features used by the algorithm to predict demographic characteristics. The two most important gland morphological features for predicting age were the percent area of gland atrophy and the percentage of ghost glands. The two most important morphological features for predicting ethnicity were gland density and the percentage of ghost glands. The approach offers an alternative to traditional associative modeling to identify relationships between Meibomian gland morphological features and subject demographic characteristics. This deep learning methodology can currently predict demographic features from de-identified meibography images with better than 75% accuracy, a number which is highly likely to improve in future models using larger training datasets, which has significant implications for patient privacy in biomedical imaging.
Collapse
|
123
|
Meduri A, Oliverio GW, Tedesco G, Aragona P. Combined intense pulsed light and low-level light therapy for the treatment of refractory Meibomian gland dysfunction. Eur J Ophthalmol 2022; 33:11206721221127206. [PMID: 36112864 DOI: 10.1177/11206721221127206] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2024]
Abstract
PURPOSE To evaluate the efficacy of combined Intense Pulsed Light (IPL) and Low-Level Light Therapy (LLLT) in treatment of Meibomian Gland Dysfunction (MGD). METHODS AND ANALYSIS In this prospective study, 70 patients with refractory MGD were enrolled; group 1 received 3 consecutive sessions of IPL + LLLT treatment using Eye-light® on day 1, day 15 and day 45; group 2 received hyaluronate sodium 2 mg/ml drops 3 times a day for 6 months. Patients underwent at baseline, and after 3 and 6 months Ocular Surface Disease Index (OSDI) questionnaire, Symptom Assessment in Dry Eye (SANDE), tear-film breakup time (TBUT), fluorescein ocular surface staining, meibum expressibility and quality evaluations. Keratograph 5M (Oculus, Germany) was used to assess NIBUT, tear meniscus height (TMH), meibography, and bulbar redness score. RESULTS At 6 months a significant improvement of OSDI (p = 0.03), SANDE (p = 0.02), NIBUT (p = p < 0.0001), TMH (p = 0.04), TBUT (p = 0.02), corneal-conjunctival staining score (p = 0.02), lid margin score (p < 0.0001), and bulbar redness score (p = 0.001) were recorded in group 1. Comparing the two groups, statistically significant differences were observed at 6 months in TBUT (p = 0.03), lid margin score (p < 0.001), Meibum expressibility (p = 0.03) and NIBUT (p < 0.001). No adverse events were recorded throughout the follow-up period. CONCLUSION This study confirmed the efficacy and safety of combined IPL and LLLT demonstrating its superiority compared to topical treatment.
Collapse
Affiliation(s)
- Alessandro Meduri
- Department of Biomedical Sciences, Ophthalmology Clinic, 18980University of Messina, Messina, Italy
| | | | | | - Pasquale Aragona
- Department of Biomedical Sciences, Ophthalmology Clinic, 18980University of Messina, Messina, Italy
| |
Collapse
|
124
|
Therapeutic Efficacy and Safety of Intense Pulsed Light for Refractive Multiple Recurrent Chalazia. J Clin Med 2022; 11:jcm11185338. [PMID: 36142985 PMCID: PMC9504361 DOI: 10.3390/jcm11185338] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 09/02/2022] [Accepted: 09/07/2022] [Indexed: 11/28/2022] Open
Abstract
To evaluate the efficacy and safety of intense pulsed light (IPL) combined with meibomian gland expression (MGX) for the treatment of refractory multiple and recurrent chalazia without surgery or curettage. This was a retrospective controlled study. Patients with multiple and recurrent chalazia, who had performed the conventional treatment at least 2 months without any surgery or curettage, were enrolled in this study. Twenty-nine consecutive multiple recurrent chalazia (12 patients) were assigned to receive either the combination of IPL and MGX or MGX alone as a control. Each eye underwent one to four treatment sessions with 2-week intervals. Parameters were evaluated before and 1 month after the final treatment session. Clinical assessments included symptom, size of each chalazion, lid margin abnormalities, corneal and conjunctival fluorescein staining, meibum grade, the number of Demodex mites, the Schirmer value and meiboscore. All parameters except meiboscore and the Schirmer value were significantly improved with IPL-MGX therapy, whereas only meibum grade was significantly improved with MGX alone. There were no adverse events which occurred in either group. IPL-MGX was safe and effective for multiple and recurrent chalazia without surgery or curettage by reducing the size of chalazion and improving lid margin abnormalities and meibum grade.
Collapse
|
125
|
Chen D, Chen X, Xie HT, Hatton MP, Liu X, Liu Y. Expression of extracellular matrix components in the meibomian gland. Front Med (Lausanne) 2022; 9:981610. [PMID: 36148459 PMCID: PMC9486096 DOI: 10.3389/fmed.2022.981610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 08/18/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose Extracellular matrix (ECM) is a key component of the stem cell local microenvironment. Our study aims to explore the periglandular distribution of major components of ECM in the Meibomian gland (MG). Methods Human eyelids and mouse eyelids were collected and processed for immunofluorescence staining. Results Human MG tissues stained positive for collagen IV α1, collagen IV α2, collagen IV α5, and collagen IV α6 around the acini and duct, but negative for collagen IV α3 and collagen IV α4. The mouse MG were stained positive for the same collagen IV subunits as early as postnatal day 15. Laminin α2, laminin β1 and perlecan stained the regions surrounding the acini and the acinar/ductal junction in the human MG, but not the region around the duct. Tenascin-C was found specifically located at the junctions between the acini and the central ducts. Neither agrin nor endostatin was found in the human MG tissues. Conclusion The ECM expresses specific components in different regions around the MG, which may play a role in MG stem cell regulation, renewal, and regeneration.
Collapse
Affiliation(s)
- Di Chen
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaomin Chen
- Department of Ophthalmology, Zhongnan Hospital, Wuhan University, Wuhan, China
| | - Hua-Tao Xie
- Department of Ophthalmology, Union Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Mark P. Hatton
- Ophthalmic Consultants of Boston, Boston, MA, United States
| | - Xiaowei Liu
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- *Correspondence: Xiaowei Liu
| | - Yang Liu
- Department of Ophthalmology, Zhongnan Hospital, Wuhan University, Wuhan, China
- Yang Liu
| |
Collapse
|
126
|
Li JX, Tsai YY, Lai CT, Li YL, Wu YH, Chiang CC. Lifitegrast Ophthalmic Solution 5% Is a Safe and Efficient Eyedrop for Dry Eye Disease: A Systematic Review and Meta-Analysis. J Clin Med 2022; 11:5014. [PMID: 36078948 PMCID: PMC9456613 DOI: 10.3390/jcm11175014] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 08/22/2022] [Accepted: 08/24/2022] [Indexed: 11/25/2022] Open
Abstract
Dry eye disease (DED) is a multifactorial disease that causes ocular discomfort and visual impairment on a damaged ocular surface. Lifitegrast, a novel T-cell integrin antagonist, was approved in the United States in July 2016 as a 5% (50 mg/mL) ophthalmic solution for DED management. Currently, no meta-analysis and systemic review based on relevant studies have been conducted. This study aimed to evaluate the efficacy and safety of lifitegrast in patients with DED. We systematically searched Embase, Medline, PubMed, and Web of Science for randomized controlled trials (RCTs) and nonrandomized studies evaluating lifitegrast effects on symptomatic DED. Then, inferior corneal staining score, total corneal staining score (TCSS), nasal lissamine staining score (NLSS), total lissamine staining score, ocular discomfort score (ODS), eye discomfort score (visual analog scale (VAS) score), eye dryness score (EDS), ocular surface disease index score (OSDI-S), and tear break-up time (TBUT) were assessed. Clinical global impression and safety profiles were also evaluated. The studies were pooled in a random-effects model. We included five RCTs, one case-control study, and four longitudinal or retrospective studies, comprising 3197 participants. In the meta-analysis, lifitegrast was superior to the placebo because it improved TCSS, NLSS, TBUT, ODS, eye discomfort score, EDS, and OSDI-Sin DED. However, lifitegrast showed higher risks for ocular and non-ocular treatment-emergent adverse events (TEAEs) overall or at a mild or moderate level. Nonetheless, its incidence of adverse events slightly differed from that in the placebo, especially instillation site discomforts and dysgeusia, thereby considered safe and tolerable. Claims of withdrawal during follow-up caused by TEAEs were extremely rare. Lifitegrast improves DED, although dysgeusia, installation site pain, and irritation may be a concern for some. Overall, most of the adverse events are tolerable. Lifitegrast can alleviate refractory DED and improves patients' quality of life.
Collapse
Affiliation(s)
- Jing-Xing Li
- Department of General Medicine, China Medical University Hospital, Taichung 404327, Taiwan
- School of Medicine, China Medical University, Taichung 406040, Taiwan
- Institute of Clinical Laboratory Sciences and Medical Biotechnology, National Taiwan University, Taipei 100233, Taiwan
| | - Yi-Yu Tsai
- School of Medicine, China Medical University, Taichung 406040, Taiwan
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung 404327, Taiwan
- Department of Optometry, Asia University, Taichung 413305, Taiwan
| | - Chun-Ting Lai
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung 404327, Taiwan
- School of Medicine, National Taiwan University, Taipei 100233, Taiwan
| | - You-Ling Li
- School of Medicine, China Medical University, Taichung 406040, Taiwan
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung 404327, Taiwan
| | - Ying-Hsuen Wu
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung 404327, Taiwan
| | - Chun-Chi Chiang
- School of Medicine, China Medical University, Taichung 406040, Taiwan
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung 404327, Taiwan
- Department of Optometry, Asia University, Taichung 413305, Taiwan
| |
Collapse
|
127
|
Topographical Distribution and Phenotype of Resident Meibomian Gland Orifice Immune Cells (MOICs) in Mice and the Effects of Topical Benzalkonium Chloride (BAK). Int J Mol Sci 2022; 23:ijms23179589. [PMID: 36077001 PMCID: PMC9455816 DOI: 10.3390/ijms23179589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 08/13/2022] [Accepted: 08/18/2022] [Indexed: 11/21/2022] Open
Abstract
Meibomian gland orifices (MGOs) are located along the eyelid margin and secrete meibum into the tear film. The profile of resident innate immune cells (ICs) at this site is not well understood. The distribution and phenotype of resident ICs around MGOs in mice was investigated and herein defined as MGO-associated immune cells (MOICs). The effect of topical 0.1% benzalkonium chloride (BAK) on MOICs was also assessed. Eyelids from healthy CD11ceYFP and Cx3cr1gfp/gfp mice aged three or seven months were compared. ICs were identified as CD11c+, Cx3cr1+, and MHC-II+ using four-colour immunostaining and confocal microscopy. MOIC density was variable but clustered around MGOs. There were more CD11c+ MOICs in three-month-old compared with seven-month-old mice (three-month-old: 893 ± 449 cells/mm2 vs. seven-month-old: 593 ± 493 cells/mm2, p = 0.004). Along the eyelid margin, there was a decreasing gradient of CD11c+ MOIC density in three-month-old mice (nasal: 1003 ± 369 cells/mm2, vs. central: 946 ± 574 cells/mm2, vs. temporal: 731 ± 353 cells/mm2, p = 0.044). Cx3cr1-deficient mice had two-fold fewer MHC-II+ MOICs, suggesting a role for Cx3cr1 receptor signaling in meibomian gland surveillance. CD11c+ MOIC density was lower in BAK-exposed eyes compared to saline-treated controls, suggesting a change in homeostasis. This study provides novel insight into resident ICs located at MGOs, and their contribution to MG homeostasis.
Collapse
|
128
|
Investigation of Prognostic Factors for Intense Pulsed Light Treatment with a Vascular Filter in Patients with Moderate or Severe Meibomian Gland Dysfunction. J Clin Med 2022; 11:jcm11164724. [PMID: 36012963 PMCID: PMC9410466 DOI: 10.3390/jcm11164724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 07/31/2022] [Accepted: 08/10/2022] [Indexed: 11/22/2022] Open
Abstract
We aimed to investigate the prognostic factors for, and treatment efficacy of, intense pulsed light (IPL) treatment with a vascular filter in patients with moderate or severe meibomian gland dysfunction (MGD). In this retrospective observational study, 58 moderate or severe MGD patients who underwent IPL treatment with a vascular filter were enrolled. IPL treatment was administered to the upper and lower eyelids four times at two-week intervals. At baseline, and four weeks after IPL, we evaluated the matrix metalloproteinase (MMP)-9 expression levels, tear break-up times (TBUT), ocular surface staining scores, lid margin telangiectasias, and meibomian gland characteristics. The subjective symptoms and adverse effects were reviewed and recorded. Regression analyses were performed to explore the prognostic factors affecting clinical outcomes. IPL treatment using a vascular filter led to improvements in the TBUT, ocular surface staining score, meibomian gland grade, meibum quality and consistency, lid margin telangiectasia, and symptom score (all p < 0.001). Furthermore, the positivity rate (90.2% to 70.6%, p = 0.013) and expression levels (1.92 ± 1.18 to 1.24 ± 1.18, p < 0.001) of tear MMP-9 improved after the IPL treatment. In multivariate logistic regression analysis, a young age (odds ratio = 0.867, p = 0.007) and a toothpaste-like consistency in the upper lid (odds ratio = 8.449, p = 0.046) were associated with improvements in the meibomian gland grade. No adverse effects were detected. IPL with a vascular filter is a safe and effective treatment for moderate and severe MGD. Age and the meibum consistency in the upper lid are important prognostic factors.
Collapse
|
129
|
El-Desoky SMM, Abdellah N. The morphogenesis of the rabbit meibomian gland in relation to sex hormones: Immunohistochemical and transmission electron microscopy studies. BMC ZOOL 2022; 7:46. [PMID: 37170170 PMCID: PMC10127434 DOI: 10.1186/s40850-022-00149-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 08/02/2022] [Indexed: 11/10/2022] Open
Abstract
AbstractRabbits have been proposed as a model for the human meibomian gland (MG), a large specific sebaceous gland in the eyelid that consists of secretory acini arranged laterally and related to the central duct via short ductules, with the central duct continuing as an excretory duct to open at the free margin of the lid. First detected at embryonic day 18 as an aggregation of mesenchymal cells in the tarsal plate, it completes its development approximately 2 weeks postnatal when the separation of the eyelids is completed. The Transmission electron microscopy supports the meibocytes’ gradient maturation to the meibum’s synthesis. While the differentiating cells, their cytoplasm, are well packed with lipid droplets, the basal cells are characterized by a high nuclear to cytoplasm ratio. The androgen and estrogen receptor proteins are expressed in the basal cell and the meibocytes, and increase in age increases in the expression of these proteins. Additionally, the cytokeratin (CK14) is expressed in the basal and differentiating cells of the acini and the ductal epithelium. Therefore, the duct cells of the MG are common in all stem cells. These data concluded that the MG plays a major role in maintaining the health of the ocular surface and preservation of visual acuity. Any abnormalities in the structure of the MG lead to its dysfunction and changes in lipid secretion.
Collapse
|
130
|
Martins TGDS, Sipahi AM, Mendes MA, Fowler SB, Schor P. Metaboloma use in ophthalmology. REVISTA BRASILEIRA DE OFTALMOLOGIA 2022. [DOI: 10.37039/1982.8551.20220056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
131
|
Park SK, Lee JH, Hwang HS, Kim HS, Han KD, Na KS. Association of Meibomian Gland Dysfunction with Oral Statin Use. J Clin Med 2022; 11:jcm11154632. [PMID: 35956248 PMCID: PMC9369571 DOI: 10.3390/jcm11154632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 07/29/2022] [Accepted: 08/03/2022] [Indexed: 11/22/2022] Open
Abstract
This retrospective cross-sectional study aimed to determine the association of oral statin use, dry eye disease (DED), and meibomian gland dysfunction (MGD). A total of 93 subjects were included and divided into two groups: statin users (n = 45) and nonstatin users (n = 47). Significant differences were observed in the total cholesterol (p = 0.013), low-density lipoprotein (LDL) (p = 0.005), and meiboscore (p = 0.000) levels between the two groups. For stratified analysis, the statin group was divided into subgroups according to the type or dose of statin and total duration of statin use. However, there were no differences in clinical features between the subgroups. In multiple regression analysis, meiboscore was significantly associated with age (slope = 0.05, p = 0.00) and statin use (slope = −1.19, p = 0.00), with an R2 of 0.44. Thus, older adults and participants who do not use statin appeared to have higher scores. In conclusion, although the mechanism is unclear, statins may exert a protective effect on the meibomian gland. Further lipidomic studies are required to determine the pharmacological effects of statins on the meibomian gland and other meibum components.
Collapse
Affiliation(s)
- Sun-Kyoung Park
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| | - Ji-Hye Lee
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| | - Ho-Sik Hwang
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| | - Hyun-Seung Kim
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| | - Kyung-Do Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul 03080, Korea
| | - Kyung-Sun Na
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
- Correspondence: ; Tel.: +82-2-2258-1188; Fax: +82-2-590-1693
| |
Collapse
|
132
|
Park HM, Lee WJ, Lim HW, Kim YJ. Immediate and Quantitative Changes in Tear Film Parameters and Meibomian Gland Structures after Warm Compression and Meibomian Gland Squeezing in Meibomian Gland Dysfunction Patients and Normal Subjects. J Clin Med 2022; 11:jcm11154577. [PMID: 35956192 PMCID: PMC9369951 DOI: 10.3390/jcm11154577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 07/29/2022] [Accepted: 08/04/2022] [Indexed: 11/16/2022] Open
Abstract
Meibomian gland dysfunction (MGD), a chronic abnormality of meibomian glands, causes various dry eye symptoms. Principal treatments for MGD are warm compression and mechanical squeezing of the eyelids. In this study, the immediate impact of this treatment on tear film lipid layer thickness (TFLLT) and the meibomian gland (MG) structure in MGD and normal groups was investigated to establish its efficacy and potential side effects. Nineteen MGD patients and seven normal subjects were enrolled. TFLLT and blinking parameters were evaluated before and after warm compression. Morphological changes of MG structures after mechanical squeezing were analyzed using Image J and Fiji. Differential analysis of the MGD and the normal groups of TFLLT changes after warm compression showed a significant increase in the normal group. In normal eyes, the average, maximum, and minimum TFLLT were significantly increased, and in the MGD group, only the minimum TFLLT was improved. Blinking parameters showed no significant change in either group. Morphometric analysis showed no damages of the MG after MG squeezing. A significant increase in MG length was observed in normal eyes. Warm compression immediately increased TFLLT more significantly in the normal group than in the MGD patients. Mechanical expression is a safe therapeutic option without remarkable structural MG damages.
Collapse
Affiliation(s)
| | | | | | - Yu Jeong Kim
- Correspondence: ; Tel.: +82-2-2290-8570; Fax: +82-2-2291-8517
| |
Collapse
|
133
|
Change in Ocular Surface Staining during Eyelid Warming Is Related to Tear Cytokine Levels. J Ophthalmol 2022; 2022:5103231. [PMID: 35967518 PMCID: PMC9365595 DOI: 10.1155/2022/5103231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 06/28/2022] [Indexed: 11/18/2022] Open
Abstract
Purpose To investigate the changes in the tear cytokine profile of patients with meibomian gland dysfunction (MGD) treated with eyelid warming and to correlate these changes with clinical parameters for dry eye disease (DED). Methods Seventy patients with MGD were included and treated with the warming of eyelids. Of these, 61 still used the treatment three months after baseline, while 48 completed the whole treatment period of six months. The concentrations of 39 cytokines in the tear fluid were measured at baseline and after three and six months of treatment. All participants were examined with tests for DED, including tear film break-up time (TBUT), ocular surface staining (OSS), and the self-reporting Ocular Surface Disease Index (OSDI). Changes in cytokine concentrations were assessed from baseline to three months, from three to six months, and from baseline to six months. Correlation analyses were performed between changes in the cytokine concentrations and changes in TBUT, OSS, and OSDI during the same time intervals. Results No significant changes were found in the concentrations of the 39 cytokines during any of the three treatment intervals. However, several correlations were detected between changes in the level of cytokines and OSS from baseline to three months of treatment. Decreasing concentrations of granulocyte chemotactic protein 2 (GCP-2/CXCL6, mean effect 2.36, p=0.042), interleukin 10 (IL-10, mean effect 1.04, p=0.045), and IL-16 (mean effect 1.36, p=0.035) were associated with decreasing OSS. Decreasing concentrations of granulocyte macrophage colony-stimulating factor (GM-CSF, mean effect −2.98, p=0.024), IL-8 (IL-8/CXCL8, mean effect −1.35, p=0.026), and macrophage migration inhibitory factor (MIF, mean effect −2.44, p=0.033) were related to increasing OSS. Conclusions Warming of eyelids did not change the concentration of cytokines in the tear fluid of patients with MGD significantly. However, alterations in the level of several cytokines were associated with changes in the OSS. This finding indicates a close connection between tear cytokines and OSS in MGD patients treated with eyelid warming.
Collapse
|
134
|
Fukuoka S, Arita R. Comparison of Intense Pulsed Light Therapy on Patients with Meibomian Gland Dysfunction Using AQUA CEL and M22 Devices. J Clin Med 2022; 11:jcm11154265. [PMID: 35893356 PMCID: PMC9332253 DOI: 10.3390/jcm11154265] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 07/18/2022] [Accepted: 07/20/2022] [Indexed: 02/06/2023] Open
Abstract
The purpose of this study was to compare the efficacy of Intense Pulsed Light (IPL) therapy for meibomian gland dysfunction (MGD) using the new AQUA CEL (AC, Jeisys) device and the traditional M22 (Lumenis) device. A total of 59 eyes of 59 patients with MGD (12 men and 47 women, mean age 49 ± 12 years) were enrolled. They randomly received four sessions of IPL therapy every three weeks either with AC (30 eyes) or M22 (29 eyes). Standard Patient Evaluation of Eye Dryness (SPEED) questionnaire score, noninvasive breakup time (NIBUT), lid margin abnormalities, corneal and conjunctival fluorescein staining, fluorescein breakup time (FBUT), Schirmer’s test, meiboscore and meibum grade were evaluated before treatment and one month after treatment. Before IPL, no significant differences were seen in age, gender, or measured parameters between the AC and M22 groups (p > 0.05, respectively). SPEED score, NIBUT, lid margin abnormalities, fluorescein staining, FBUT, and meibum grade improved significantly in both groups after IPL compared to before IPL (p < 0.001, respectively). There were no significant differences in measured parameters between the two groups after IPL (p > 0.05, respectively). IPL therapy with AC and M22 devices has been shown to be equally effective for the treatment of MGD.
Collapse
Affiliation(s)
- Shima Fukuoka
- Lid and Meibomian Gland Working Group (LIME), 626-11 Minami-Nakano, Minumaku, Saitama 337-0042, Japan;
- Omiya Hamada Eye Clinic, 1-169-1 Sakuragicho, Omiyaku, Saitama 330-0854, Japan
| | - Reiko Arita
- Lid and Meibomian Gland Working Group (LIME), 626-11 Minami-Nakano, Minumaku, Saitama 337-0042, Japan;
- Department of Ophthalmology, The University of Tokyo, 7-3-1 Hongo, Bunkyoku, Tokyo 113-8655, Japan
- Correspondence: ; Tel.: +81-48-686-5588
| |
Collapse
|
135
|
Correlation between tear film lipid layer thickness and transepidermal water loss from the ocular area in patients with dry eye disease and in healthy controls. PLoS One 2022; 17:e0270810. [PMID: 35857784 PMCID: PMC9299348 DOI: 10.1371/journal.pone.0270810] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Accepted: 06/17/2022] [Indexed: 11/18/2022] Open
Abstract
Purpose This study aimed to evaluate the correlation between tear film lipid layer thickness and transepidermal water loss (TEWL) from the ocular area in patients with short tear break-up time (TBUT)-type dry eye and healthy controls. Methods This prospective study included 25 eyes of patients with short TBUT-type dry eye disease and 25 eyes of healthy controls. Results Tear film lipid layer thickness was measured using an interferometer, and TEWL from the ocular area was measured using a Tewameter TM300 with custom-made goggles. The correlation between tear film lipid layer thickness and TEWL was evaluated. Additionally, other parameters such as TBUT, Schirmer I score, ocular surface staining, the presence and type of meibomian gland dysfunction (MGD), ocular surface disease index (OSDI), and visual analog scale (VAS) scores were evaluated. Tear film lipid layer thickness did not show a significant correlation with TEWL from the ocular area measured using a Tewameter TM300. However, tear film lipid layer thickness was significantly correlated with tear break-up time (p = 0.004) and ocular surface staining by NEI (National Eye Institute) scheme (p = 0.03). TEWL showed positive correlation with the Schirmer I score (p = 0.004). Conclusions The tear film lipid layer affected the stability of the tear film more than the amount of TEWL in patients with short TBUT dry eye and healthy controls.
Collapse
|
136
|
Peng KL, Chiu CJ, Tuan HI, Lee YC, Hsu PS, Chen JL. Combination Treatment of Intense Pulsed Light Therapy and Meibomian Gland Expression for Evaporative Dry Eye. Life (Basel) 2022; 12:life12071086. [PMID: 35888174 PMCID: PMC9318257 DOI: 10.3390/life12071086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 06/27/2022] [Accepted: 07/16/2022] [Indexed: 11/28/2022] Open
Abstract
Dry eye disease (DED) is most commonly caused by evaporative subtypes and mainly induced by meibomian gland dysfunction (MGD). Intense pulsed light (IPL) combined with meibomian gland expression (MGX) is a noninvasive treatment for improvement of ocular discomfort symptoms and MGD. In this prospective study between November 2020 and May 2022, the patients with MGD and abnormal meibomian expressibility that met the criteria of both ocular surface disease index (OSDI) ≥ 13 scores and standardized patient evaluation of eye dryness (SPEED) ≥ 8 scores were enrolled in Kaohsiung Veteran General Hospital. Three separate treatment sessions of IPL therapy combined with MGX were administered to the lower lids, with an interval of 28 days. Further tear film assessment included lipid layer thickness (LLT), tear meniscus height (TMH), noninvasive tear break-up time (NIBUT), and meibomian gland loss (MGL) either before or after first and third IPL therapy combined with MGX. In addition, lissamine green staining and pain scores were also recorded. We totally enrolled 37 patients of 74 eyes. Men accounted for 18.92% (7/37). The mean age was 54.51 ± 11.72 years. The mean OSDI scores were 58.12 ± 22, while the SPEED scores were 17.03 ± 5.98. The mean Schirmer’s test was 3.66 ± 2.43 mm. After three sessions of IPL treatment with MGX, the OSDI, SPEED, LLT, TMH, MGL, MGXS, and pain scores were significantly improved. For the MGX scores (MGXS) ≤ 20 group, lissamine green scores showed nearly significant improvements. For the MGXS > 20 group, TMH revealed statistical improvement. Noninvasive IPL therapy with MGX statistically improved not only dry eye symptoms, but also tear film assessments, including LLT, TMH, and MGL.
Collapse
Affiliation(s)
- Kai-Ling Peng
- Department of Ophthalmology, Kaohsiung Veterans General Hospital, 386, Ta-Chung 1st Road, Kaohsiung 813, Taiwan; (K.-L.P.); (C.-J.C.); (H.-I.T.); (Y.-C.L.); (P.-S.H.)
- Shu-Zen Junior College of Medicine and Management, Kaohsiung 82144, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
| | - Chen-Jui Chiu
- Department of Ophthalmology, Kaohsiung Veterans General Hospital, 386, Ta-Chung 1st Road, Kaohsiung 813, Taiwan; (K.-L.P.); (C.-J.C.); (H.-I.T.); (Y.-C.L.); (P.-S.H.)
| | - Hsin-I Tuan
- Department of Ophthalmology, Kaohsiung Veterans General Hospital, 386, Ta-Chung 1st Road, Kaohsiung 813, Taiwan; (K.-L.P.); (C.-J.C.); (H.-I.T.); (Y.-C.L.); (P.-S.H.)
| | - Yi-Chen Lee
- Department of Ophthalmology, Kaohsiung Veterans General Hospital, 386, Ta-Chung 1st Road, Kaohsiung 813, Taiwan; (K.-L.P.); (C.-J.C.); (H.-I.T.); (Y.-C.L.); (P.-S.H.)
| | - Pyn-Sing Hsu
- Department of Ophthalmology, Kaohsiung Veterans General Hospital, 386, Ta-Chung 1st Road, Kaohsiung 813, Taiwan; (K.-L.P.); (C.-J.C.); (H.-I.T.); (Y.-C.L.); (P.-S.H.)
| | - Jiunn-Liang Chen
- Department of Ophthalmology, Kaohsiung Veterans General Hospital, 386, Ta-Chung 1st Road, Kaohsiung 813, Taiwan; (K.-L.P.); (C.-J.C.); (H.-I.T.); (Y.-C.L.); (P.-S.H.)
- Shu-Zen Junior College of Medicine and Management, Kaohsiung 82144, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
- Correspondence: ; Tel.: +886-73468218; Fax: +886-73468217
| |
Collapse
|
137
|
Vigo L, Pellegrini M, Carones F, Scorcia V, Giannaccare G. Outcomes of serial sessions of Activa mask combined with intense pulsed light therapy in patients with Meibomian gland dysfunction. BMC Ophthalmol 2022; 22:313. [PMID: 35854254 PMCID: PMC9295515 DOI: 10.1186/s12886-022-02538-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 07/11/2022] [Indexed: 12/18/2022] Open
Abstract
Background To evaluate the effects on ocular surface signs and symptoms of serial sessions of heating and vibrating eye mask followed by intense pulsed light (IPL) therapy for the treatment of dry eye disease owing to meibomian gland dysfunction (MGD). Methods Consecutive patients with MGD whose signs and symptoms were not satisfactorily controlled with conventional therapy were included. Patients received 3 treatments performed at day 1, 15, and 45 incorporating a session with a newly-developed eye mask (Activa, SBS Sistemi, Turin, Italy) immediately followed by IPL therapy (E > Eye device, E-Swin, Paris, France). Patients were examined before the first session (T0) and 30 days after the last session (T1) for the measurement of: noninvasive break-up time (NIBUT); lipid layer thickness (LLT); tear meniscus height (TMH); meibomian gland loss (MGL); tear osmolarity. Ocular discomfort symptoms were ascertained by ocular surface disease index (OSDI) questionnaire. Results Thirty patients were ultimately included in the study. At T1, all objective ocular surface parameters improved significantly, except for TMH: NIBUT and LLT increased from 6.4 ± 1.7 to 8.6 ± 1.7 s and from 57.7 ± 15.5 to 81.3 ± 12.0 μm (all P < 0.001), while MGL and tear osmolarity decreased from 21.1 ± 17.3 to 17.0 ± 14.1% and from 302.0 ± 8.5 to 295.7 ± 6.9 mOsm/L (respectively, P = 0.004 and P < 0.001). In parallel, OSDI score decreased significantly from 49.8 ± 13.5 to 29.8 ± 10.6 (P < 0.001). In the historical control group of patients who underwent only IPL, NIBUT, LLT, tear osmolarity and OSDI improved significantly but not MGL and TMH. Conclusions Serial sessions incorporating the application of an eye mask producing heating and vibration immediately followed by IPL therapy are able to improve all ocular surface parameters as well as ocular discomfort symptoms in MGD patients.
Collapse
Affiliation(s)
- Luca Vigo
- Carones Ophthalmology Center, Milan, Italy
| | - Marco Pellegrini
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy.,Ospedali Privati Forlì "Villa Igea", Department of Ophthalmology, Forlì, Italy.,Istituto Internazionale per la Ricerca e Formazione in Oftalmologia, Forlì, Italy
| | | | - Vincenzo Scorcia
- Department of Ophthalmology, University "Magna Græcia" of Catanzaro, Viale Europa, 88100, Germaneto (Catanzaro), Italy
| | - Giuseppe Giannaccare
- Department of Ophthalmology, University "Magna Græcia" of Catanzaro, Viale Europa, 88100, Germaneto (Catanzaro), Italy.
| |
Collapse
|
138
|
Association of Serum Lipid Level with Meibum Biosynthesis and Meibomian Gland Dysfunction: A Review. J Clin Med 2022; 11:jcm11144010. [PMID: 35887773 PMCID: PMC9323051 DOI: 10.3390/jcm11144010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 06/27/2022] [Accepted: 07/05/2022] [Indexed: 11/16/2022] Open
Abstract
The primary role of meibomian glands (MGs) is to actively synthesize and secret lipids and proteins spread onto the tear film, and the glandular lipids promote tear stability, prevent evaporation, and reduce friction. Meibomian gland dysfunction (MGD) is the leading cause of dry eye disease and one of the most common ophthalmic problems worldwide. MGs are densely innervated and regulated by hormones and growth factors. However, since the polar and nonpolar lipids are produced through processes in MGs that are not completely understood, a relevant question has been raised: Would the altered systemic lipids metabolism affect the physiology and structure of MGs? This review introduces the recent update regarding the relationships between serum lipid and MGD in clinical and basic research while providing answers to this question. A causal relationship remains to be established; however, serum lipid level or dyslipidemia may be related to MGD directly or indirectly, or both. Further studies are warranted to establish the role of serum lipid level and meibocyte differentiation/maturation and lipid synthesis.
Collapse
|
139
|
Ha M, Oh SE, Whang WJ, Na KS, Kim EC, Kim HS, Kim JS, Hwang HS. Relationship between meibomian gland loss in infrared meibography and meibum quality in dry eye patients. BMC Ophthalmol 2022; 22:292. [PMID: 35788211 PMCID: PMC9252080 DOI: 10.1186/s12886-022-02509-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 06/27/2022] [Indexed: 11/10/2022] Open
Abstract
Background In the present study, we evaluated the correlation between meibomian gland dropout and meibum quality in the same central 8 meibomian glands of the eyelid. Methods Ninety-nine eyes of 91 patients with dry eye were included in the study. Dropout of the 8 central meibomian glands of the eyelids was graded as 0, 1, 2, or 3, according to the dropout area. The meibum quality was graded as follows: grade 0, no secretion; 1, inspissated/toothpaste consistency; 2, cloudy liquid secretion; and 3, clear liquid secretion. For 68 eyes of 68 patients, correlation analysis between dropout and meibum quality was performed. To precisely analyze the direct correlation between meibomian gland dropout in meibography and meibum quality, we evaluated 31 eyes of 23 patients with focal dropout in meibography. Results The median (interquartile range) meiboscore was 1.0 (2.0) in the upper eyelids and 0.0 (1.0) in the lower eyelids. The median (interquartile range) meibum quality grade was 3.0 (1.0) in the upper eyelids and 1.0 (1.0) in the lower eyelids. No significant correlation between the meiboscore and meibum quality grade was detected in the upper (p =0.746) or lower (p =0.551) eyelids. Analysis of the direct correlation between meibomian gland dropout in meibography and meibum quality in patients with focal dropout (loss of 1 or 2 adjacent meibomian glands), however, indicated that meibomian glands with dropout secreted little to no meibum. Conclusions Overall analysis revealed no relationship between meibomian gland dropout and meibum quality, but more detailed investigation of each meibomian gland alone revealed that meibomian glands with dropout secrete little to no meibum. Supplementary Information The online version contains supplementary material available at 10.1186/s12886-022-02509-5.
Collapse
Affiliation(s)
- Minji Ha
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, Republic of Korea.,Department of Ophthalmology, Yeouido St. Mary's Hospital, The Catholic University of Korea, 10, 63-ro, Yeongdeungpo-gu, Seoul, 07345, Republic of Korea
| | - Si-Eun Oh
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, Republic of Korea
| | - Woong-Joo Whang
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, Republic of Korea.,Department of Ophthalmology, Yeouido St. Mary's Hospital, The Catholic University of Korea, 10, 63-ro, Yeongdeungpo-gu, Seoul, 07345, Republic of Korea
| | - Kyung-Sun Na
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, Republic of Korea.,Department of Ophthalmology, Yeouido St. Mary's Hospital, The Catholic University of Korea, 10, 63-ro, Yeongdeungpo-gu, Seoul, 07345, Republic of Korea
| | - Eun Chul Kim
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, Republic of Korea
| | - Hyun-Seung Kim
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, Republic of Korea
| | - Jin Soo Kim
- Department of Ophthalmology, Chuncheon Sacred Heart Hospital, Hallym University, 77, Sakju-ro, Chuncheon-si, Gangwon-do, Republic of Korea
| | - Ho Sik Hwang
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, Republic of Korea. .,Department of Ophthalmology, Yeouido St. Mary's Hospital, The Catholic University of Korea, 10, 63-ro, Yeongdeungpo-gu, Seoul, 07345, Republic of Korea.
| |
Collapse
|
140
|
Fineide F, Lagali N, Adil MY, Arita R, Kolko M, Vehof J, Utheim TP. Topical glaucoma medications – Clinical implications for the ocular surface. Ocul Surf 2022; 26:19-49. [DOI: 10.1016/j.jtos.2022.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 07/21/2022] [Accepted: 07/22/2022] [Indexed: 11/25/2022]
|
141
|
Zou Z, Wang H, Zhang B, Zhang Z, Chen R, Yang L. Inhibition of Gli1 suppressed hyperglycemia-induced meibomian gland dysfunction by promoting pparγ expression. Biomed Pharmacother 2022; 151:113109. [PMID: 35594713 DOI: 10.1016/j.biopha.2022.113109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 05/01/2022] [Accepted: 05/10/2022] [Indexed: 11/19/2022] Open
Abstract
Diabetes is one of the risk factors for meibomian gland dysfunction (MGD); however, the underlying molecular mechanism remains unknown. The current study aims to examine the effects of glioma-associated oncogene homolog 1 (Gli1), a transcription factor of the sonic hedgehog (Shh) pathway, in the modulation of diabetic-related MGD. Here, using RNA sequencing and qRT-PCR, we examined the mRNA changes of Shh pathway involving genes. mRNA sequencing analysis showed that the Shh pathway involving genes Shh and Gli1 were markedly upregulated in diabetic MG, and qRT-PCR detection of Shh pathway-associated genes found that Gli1 expression increased most significantly. Contrary to the elevation of Gli1 level, the expression of pparγ was downregulated in diabetic MG and in high glucose treated organotypic cultured mouse MG. GANT61, an inhibitor of Gli1, effectively inhibited the reduction of pparγ expression and lipid accumulation induced by high glucose, which was suppressed by pparγ inhibitor T0070907. We further demonstrated that advanced glycation end products (AGEs) treatment also promoted the expression of Gli1 and pparγ in organotypic cultured mouse MG. AGEs inhibitor Aminoguanidine suppressed high glucose caused Gli1 upregulation in organotypic cultured mouse MG. These results suggest that suppression of Gli1 may be a potentially useful therapeutic option for diabetic-related MGD.
Collapse
Affiliation(s)
- Zongzheng Zou
- School of Medicine and Life Sciences, Shandong First Medical University, Jinan, China
| | - Huifeng Wang
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, China
| | - Bin Zhang
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, China
| | - Zhenzhen Zhang
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, China
| | - Rong Chen
- School of Medicine and Life Sciences, Shandong First Medical University, Jinan, China
| | - Lingling Yang
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, China.
| |
Collapse
|
142
|
2D Short-Time Fourier Transform for local morphological analysis of meibomian gland images. PLoS One 2022; 17:e0270473. [PMID: 35749421 PMCID: PMC9491703 DOI: 10.1371/journal.pone.0270473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 06/10/2022] [Indexed: 11/26/2022] Open
Abstract
Meibography is becoming an integral part of dry eye diagnosis. Being objective
and repeatable this imaging technique is used to guide treatment decisions and
determine the disease status. Especially desirable is the possibility of
automatic (or semi-automatic) analysis of a meibomian image for quantification
of a particular gland’s feature. Recent reports suggest that in addition to the
measure of gland atrophy (quantified by the well-established “drop-out area”
parameter), the gland’s morphological changes may carry equally clinically
useful information. Here we demonstrate the novel image analysis method
providing detailed information on local deformation of meibomian gland pattern.
The developed approach extracts from every Meibomian image a set of six
morphometric color-coded maps, each visualizing spatial behavior of different
morphometric parameter. A more detailed analysis of those maps was used to
perform automatic classification of Meibomian glands images. The method for
isolating individual morphometric components from the original meibomian image
can be helpful in the diagnostic process. It may help clinicians to see in which
part of the eyelid the disturbance is taking place and also to quantify it with
a numerical value providing essential insight into Meibomian gland dysfunction
pathophysiology.
Collapse
|
143
|
PENBE A, DÖNMEZ GÜN R. Kısa gözyaşı kırılma zamanı olan hastalarda etafilcon A ve nesofilcon A’nın oküler konfor seviyeleri açısından kıyaslanması: prospektif karşılaştırmalı çalışma. EGE TIP DERGISI 2022. [DOI: 10.19161/etd.1125785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Aim: The aim of the study was to compare the two different hydrogel daily disposable contact lenses (HyDDCLs) satisfaction levels in patients with meibomian gland disfunction (MGD) and allergic conjunctivitis accompanied with short noninvasive tear break-up time (NIBUT).
Material and Methods: Fifty patients who had no history of contact lens and had short NIBUT were included to the study into two groups: allergic conjunctivitis findings (group 1) and MGD findings (group 2). All patients used both etafilcon A and nesofilcon A, respectively. The OSDI (Ocular Surface Disease Index) and CLDEQ-8 (Contact Lens Dry Eye Questionnaire- 8) tests were performed by the patients for each lens and the mean scores were compared. In addition, the decisions of all patients regarding the continued use of each lens were questioned.
Results: The mean of total scores of OSDI and CLDEQ-8 were statistically lower in nesofilcon A, significantly. The mean scores of the all OSDI subscales and the CLDEQ-8 subscales of dryness, discomfort, blurred vision and closing eyes were lower in nesofilcon A. Four patients (8%) were not satisfied by any of the lenses. 36 (72%) patients preferred nesofilcon A and remaining 10 (20%) patients preferred etafilcon A to continue.
Conclusion: Due to the hydrophilic structure and low modulus of the HyDDCLs, the satisfaction rate was found to be higher in the study group (92%). HyDDCLs could be a suitable option in cases where ocular surface diseases are accompanied. Hydrogel material with higher water content offers better comfort levels at the end of the day.
Collapse
Affiliation(s)
- Aysegul PENBE
- Kartal Dr. Lutfi Kirdar Training and Research Hospital, Ophthalmology Department, Istanbul, Turkiye
| | - Raziye DÖNMEZ GÜN
- Kartal Dr. Lutfi Kirdar Training and Research Hospital, Ophthalmology Department, Istanbul, Turkiye
| |
Collapse
|
144
|
Huang R, Su C, Fang L, Lu J, Chen J, Ding Y. Dry eye syndrome: comprehensive etiologies and recent clinical trials. Int Ophthalmol 2022; 42:3253-3272. [PMID: 35678897 PMCID: PMC9178318 DOI: 10.1007/s10792-022-02320-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 04/18/2022] [Indexed: 12/07/2023]
Abstract
Dry eye syndrome (DES) is multifactorial and likely to be a cause of concern more so than ever given the rapid pace of modernization, which is directly associated with many of the extrinsic causative factors. Additionally, recent studies have also postulated novel etiologies that may provide the basis for alternative treatment methods clinically. Such insights are especially important given that current approaches to tackle DES remains suboptimal. This review will primarily cover a comprehensive list of causes that lead to DES, summarize all the upcoming and ongoing clinical trials that focuses on treating this disease as well as discuss future potential treatments that can improve inclusivity.
Collapse
Affiliation(s)
- Ruojing Huang
- Department of Ophthalmology, The First Affiliated Hospital of Jinan University, Huangpu Avenue West 613, Tianhe District, Guangzhou, 510630, China
| | - Caiying Su
- Department of Ophthalmology, The First Affiliated Hospital of Jinan University, Huangpu Avenue West 613, Tianhe District, Guangzhou, 510630, China
| | - Lvjie Fang
- Department of Ophthalmology, The First Affiliated Hospital of Jinan University, Huangpu Avenue West 613, Tianhe District, Guangzhou, 510630, China
| | - Jiaqi Lu
- Department of Ophthalmology, The First Affiliated Hospital of Jinan University, Huangpu Avenue West 613, Tianhe District, Guangzhou, 510630, China
| | - Jiansu Chen
- Institute of Ophthalmology, Medical College, Jinan University, Huangpu Avenue West 601, Tianhe District, Guangzhou, 510632, China.
| | - Yong Ding
- Department of Ophthalmology, The First Affiliated Hospital of Jinan University, Huangpu Avenue West 613, Tianhe District, Guangzhou, 510630, China.
| |
Collapse
|
145
|
Xie L, Song W, Dong W, Li Y, Chen S, Sun X, Huang M, Cheng Y, Gao Y, Yang S, Yan X. Indirect Application of Intense Pulsed Light Induces Therapeutic Effects on Experimental Murine Meibomian Gland Dysfunction. Front Med (Lausanne) 2022; 9:923280. [PMID: 35721080 PMCID: PMC9201038 DOI: 10.3389/fmed.2022.923280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 05/17/2022] [Indexed: 11/29/2022] Open
Abstract
Purpose To investigate the indirect effects of intense pulsed light (IPL) on morphological and pathological changes of the meibomian glands (MGs) in apolipoprotein E knockout (ApoE–/–) mice and explore the underlying mechanisms. Methods ApoE–/– mice were treated with or without IPL three times below the lower eyelids and MGs were not directly exposed to irradiation. The eyelids and ocular surface were observed under a stereoscope. The morphology of MGs was examined by photographing and hematoxylin and eosin staining. Lipid droplets in MGs were examined by Oil Red O staining. The ultrastructure of meibocytes and mitochondria was observed under transmission electron microscopy. The relative gene and protein expression in MGs of upper eyelids was determined by immunostaining, Western blot, and qRT–PCR. Results Three IPL treatments decreased the toothpaste-like plugging of orifices and thickening and irregularity of the upper and lower eyelid margins in ApoE–/– mice. The morphology of some MGs improved after IPL treatments, accompanied by increased proliferation of acinar basal cells and decreased ductal keratinization. Furthermore, the accumulation of hyperchromatic lipid droplets in the acini increased, and the lipid droplets distributed in the cells around the acini were round and small. Compared with untreated ApoE–/– mice, oxidative stress and apoptosis were downregulated by IPL treatment, accompanied by the improvements in mitochondrial structure. Further research showed that IPL treatments reduced the levels of tumor necrosis factor-alpha (TNF-α), interleukin (IL)-17A, IL-6 in MGs and inactivated nuclear factor kappa B (NF-κ B). Conclusion Collectively, the results demonstrate that indirect effects of IPL can improve the structure and function of MGs and mitigate the progression of MGD, which may be related to the indirect effects of photobiomodulation.
Collapse
|
146
|
Fjærvoll H, Fjærvoll K, Magno M, Moschowits E, Vehof J, Dartt DA, Utheim TP. The association between visual display terminal use and dry eye: a review. Acta Ophthalmol 2022; 100:357-375. [PMID: 34697901 DOI: 10.1111/aos.15049] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 10/06/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Dry eye disease (DED) is a multifactorial disease of the tear film and ocular surface. It causes ocular symptoms, reduced quality of life and a considerable economic burden on society. Prolonged use of visual display terminals (VDTs) has been suggested as an important risk factor for DED. PURPOSE This review aims to study the association between DED and VDT use with an emphasis on the prevalence of DED among VDT users and harmful daily duration of VDT use. METHODS A PubMed search was conducted and yielded 57 relevant articles based on a set of inclusion and exclusion criteria. The studies were subclassified according to study design. RESULTS The far majority of the studies showed an association between VDT use and DED or DED-related signs and symptoms. The prevalence of definite or probable DED in VDT and office workers ranged from 26% to 70%, with as few as 1-2 hr of VDT exposure per day being associated with DED. CONCLUSION VDT use is strongly associated with DED. VDT-associated DED is prevalent, but the exact prevalence needs to be further elucidated using standardized DED diagnosis criteria. Furthermore, a safe lower limit of daily VDT use has yet to be established. More research is needed on the effect of digitalization and digital transformation, which are particularly high during the time of the COVID-19 pandemic.
Collapse
Affiliation(s)
- Haakon Fjærvoll
- Department of Plastic and Reconstructive Surgery Oslo University Hospital Oslo Norway
- Faculty of Medicine Institute of Clinical Medicine University of Oslo Oslo Norway
| | - Ketil Fjærvoll
- Department of Plastic and Reconstructive Surgery Oslo University Hospital Oslo Norway
- Faculty of Medicine Institute of Clinical Medicine University of Oslo Oslo Norway
| | - Morten Magno
- Department of Plastic and Reconstructive Surgery Oslo University Hospital Oslo Norway
- Faculty of Medicine Institute of Clinical Medicine University of Oslo Oslo Norway
- Department of Medical Biochemistry Oslo University Hospital Oslo Norway
- Department of Ophthalmology University Medical Center Groningen University of Groningen Groningen The Netherlands
| | - Emily Moschowits
- Department of Medical Biochemistry Oslo University Hospital Oslo Norway
| | - Jelle Vehof
- Department of Ophthalmology University Medical Center Groningen University of Groningen Groningen The Netherlands
- Section of Academic Ophthalmology Faculty of Life Sciences and Medicine (FoLSM) School of Life Course Sciences King's College London St Thomas' Hospital London UK
- Department of Epidemiology University Medical Center Groningen University of Groningen Groningen The Netherlands
| | - Darlene A. Dartt
- Schepens Eye Research Institute of Massachusetts Eye and Ear Harvard Medical School Boston MA USA
| | - Tor P. Utheim
- Department of Plastic and Reconstructive Surgery Oslo University Hospital Oslo Norway
- Department of Medical Biochemistry Oslo University Hospital Oslo Norway
- Department of Ophthalmology Drammen Hospital Vestre Viken Trust Drammen Norway
- Department of Ophthalmology Sørlandet Hospital Arendal Arendal Norway
- Department of Computer Science Oslo Metropolitan University Oslo Norway
| |
Collapse
|
147
|
Mathebula SD. Latest developments on meibomian gland dysfunction: Diagnosis, treatment and management. AFRICAN VISION AND EYE HEALTH 2022. [DOI: 10.4102/aveh.v81i1.713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Background: Meibomian gland dysfunction (MGD) is one of the leading causes of evaporative dry eye disease and one of the most common ophthalmic conditions found in clinical practice. Meibomian gland dysfunction tends to be overlooked because its signs and symptoms do not cause blindness. Meibomian gland dysfunction is characterised by the obstruction of the meibomian gland terminal ducts resulting in tear film instability.Aim: The purpose of this article was to provide an update on MGD’s diagnosis and treatment.Method: A literature review was conducted using search engines such as Google Scholar, Medline and ScienceDirect databases. Keywords such as MGD diagnosis and management and treatment of MGD were used to search the databases.Results: A total of 44 relevant papers were reviewed. These papers were then curated to include only those concerning diagnosis of meibomian gland dysfunction, treatment of meibomian gland dysfunction and management options of meibomian gland dysfunction. The references of individual papers from the curated results were checked to yield a further 13 papers.Conclusion: Meibomian gland dysfunction is not a single entity but is multifactorial in origin; however, our understanding of the condition is evolving rapidly because of newer imaging technology. There is no gold standard treatment option for MGD, but many options are available that include medications and other procedures.
Collapse
|
148
|
Serrano-Robles JG, Pérez Vázquez AK, Navas A, Graue-Hernandez EO, Ramirez-Miranda A, Kahuam-López N. Safety and efficacy of pilocarpine, cevimeline, and diquafosol compared to artificial tears for the treatment of dry eye: protocol for a systematic review. Syst Rev 2022; 11:105. [PMID: 35643581 PMCID: PMC9148479 DOI: 10.1186/s13643-022-01979-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 05/12/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Dry eye disease (DED) is a condition that compromises the ocular surface and affects millions of people around the world. In recent years, a scheme has been proposed for the treatment of DED, with the use of artificial tear being the mainstay of treatment. In this scheme, the use of secretagogues is suggested as part of the treatment for patients with moderate to severe affectation. With this systematic review, we aim to evaluate the effectiveness and safety of secretagogues for DED. METHODS Electronic databases will be searched; we will include randomized controlled trials that compare secretagogues and artificial tears. Study inclusion will not be restricted on the basis of language or publication status. We will use Google Translate to assess studies written in languages other than English and Spanish. Identification, evaluation, data extraction, and assessment of risk of bias will be conducted by two authors of the review, a third review author will resolve any disagreement. The outcomes will be the ocular surface disease index score, tear film break-up time, Schirmer test score, VRQoL Score, and tear film osmolarity. We will use the Cochrane Collaboration Risk of Bias 2 (RoB 2) tool for assessing the risk of bias of the included studies. Based on the heterogeneity of the included studies, we will combine the findings in a meta-analysis using a fixed effect model if heterogeneity ≤ 50% or a random effect model if heterogeneity > 50%. If we deem meta-analysis as inappropriate, we will document the reasons and report findings from the individual studies narratively. DISCUSSION Based on the evidence obtained, we will evaluate the effect of pilocarpine, cevimeline, and diquafosol and compare it to artificial tears on multiple outcome measures. This systematic review aims to determine the efficacy and safety of the secretagogues pilocarpine, cevimeline, and diquafosol to help clinicians in the decision-making process. TRIAL REGISTRATION PROSPERO CRD42020218407 .
Collapse
Affiliation(s)
- José Gerardo Serrano-Robles
- Centro de Investigación en Ciencias de La Salud (CICSA), Facultad de Ciencias de La Salud, Universidad Anáhuac México, Campus Norte, Mexico City, Huixquilucan, Mexico
| | - Ana Karen Pérez Vázquez
- Centro de Investigación en Ciencias de La Salud (CICSA), Facultad de Ciencias de La Salud, Universidad Anáhuac México, Campus Norte, Mexico City, Huixquilucan, Mexico
| | - Alejandro Navas
- Cornea and Refractive Surgery Department, Instituto de Oſtalmología Fundación Conde de Valenciana IAP, Mexico City, Mexico
| | - Enrique O Graue-Hernandez
- Cornea and Refractive Surgery Department, Instituto de Oſtalmología Fundación Conde de Valenciana IAP, Mexico City, Mexico
| | - Arturo Ramirez-Miranda
- Cornea and Refractive Surgery Department, Instituto de Oſtalmología Fundación Conde de Valenciana IAP, Mexico City, Mexico
| | - Nicolás Kahuam-López
- Centro de Investigación en Ciencias de La Salud (CICSA), Facultad de Ciencias de La Salud, Universidad Anáhuac México, Campus Norte, Mexico City, Huixquilucan, Mexico. .,Cornea and Refractive Surgery Department, Instituto de Oſtalmología Fundación Conde de Valenciana IAP, Mexico City, Mexico.
| |
Collapse
|
149
|
Acar Eser N, Kocabeyoğlu S, Atakan N, Irkec M. The effects of the systemic isotretinoin treatment on ocular surface and meibomian glands: a prospective longitudinal study. Cutan Ocul Toxicol 2022; 41:155-161. [PMID: 35609140 DOI: 10.1080/15569527.2022.2077749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE To assess the effects of systemic isotretinoin therapy (SIT) on the ocular surface, meibomian glands (MG) and cornea microstructure in acne vulgaris (AV) patients. METHODS Patients with AV (n = 20) and healthy controls (n = 20) were enrolled in the study. All participants underwent ocular surface tests in the order of ocular surface disease index (OSDI) questionnaire, corneal sensitivity, tear break-up time (BUT), fluorescein and lissamine green (LG) staining and Schirmer II test with anaesthesia. MG alterations were evaluated with meibography for upper (UE) and lower eyelids (LE) separately. Corneal basal epithelium and subbasal nerve plexus (SNP) were evaluated using In Vivo Confocal Microscopy (IVCM). RESULTS Schirmer II test with anaesthesia, BUT, corneal sensitivity, fluorescein and LG staining grades and OSDI score results showed no difference between the control group and the baseline of the patient group. Whereas the meibomian gland dysfunction (MGD) grades, UE and LE meiboscores were higher in the patient group at the baseline (p = 0.013, p = 0.004, p = 0.008 respectively). The Control group possessed higher numbers of total and long nerve fibres compared with patients at the baseline (p ≤ 0.001 for both two values). Compared to the baseline and the third month, BUT decreased and fluorescein staining grades increased (p = 0.017 and p = 0.043, respectively). MGD grades, UE and LE meiboscores increased in the third month compared to the baseline (p < 0.001, p < 0.001, p = 0.008 respectively). Basal epithelial cell density (BECD) decreased in the third month of SIT (p = 0.043). CONCLUSIONS This prospective study showed that systemic Isotretinoin treatment effects not only ocular surface parameters but also corneal and Meibomian glands structure. Considering early alterations in the course of treatment, ophthalmological assessment and follow-up during SIT are mandatory.
Collapse
Affiliation(s)
- Nazan Acar Eser
- Department of Ophthalmology, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
| | - Sibel Kocabeyoğlu
- Department of Ophthalmology, Hacettepe University School of Medicine, Ankara, Turkey
| | | | | |
Collapse
|
150
|
Asiedu K. Candidate Molecular Compounds as Potential Indicators for Meibomian Gland Dysfunction. Front Med (Lausanne) 2022; 9:873538. [PMID: 35685417 PMCID: PMC9170961 DOI: 10.3389/fmed.2022.873538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 04/08/2022] [Indexed: 11/16/2022] Open
Abstract
Meibomian gland dysfunction (MGD) is the leading cause of dry eye disease throughout the world. Studies have shown that several molecules in meibum, including but not limited to interleukins, amino acids, cadherins, eicosanoids, carbohydrates, and proteins, are altered in meibomian gland dysfunction compared with healthy normal controls. Some of these molecules such as antileukoproteinase, phospholipase A2, and lactoperoxidase also show differences in concentrations in tears between meibomian gland dysfunction and dry eye disease, further boosting hopes as candidate biomarkers. MGD is a complex condition, making it difficult to distinguish patients using single biomarkers. Therefore, multiple biomarkers forming a multiplex panel may be required. This review aims to describe molecules comprising lipids, proteins, and carbohydrates with the potential of serving various capacities as monitoring, predictive, diagnostic, and risk biomarkers for meibomian gland dysfunction.
Collapse
|