Effect of 3-Hydroxy-3-Methyl-Glutaryl-Coenzyme A Reductase Inhibitors on the Meibomian Gland Morphology in Patients with Dyslipidemia

Am J Ophthalmol. 2020 Nov:219:240-252. doi: 10.1016/j.ajo.2020.06.029. Epub 2020 Jul 2.

Abstract

Purpose: Previous studies have suggested an association between dyslipidemia and meibomian gland dysfunction (MGD). The aim of this prospective, nonrandomized clinical study is to evaluate the possible association of dyslipidemia and its treatment with meibomian gland (MG) morphologic changes by standardized meibography.

Design: Prospective, nonrandomized clinical study.

Methods: Two groups of participants were enrolled: group 1, comprised of patients under regular 3-hydroxy-3-methyl-glutaryl-coenzyme A (HMG-CoA) reductase inhibitor (statin) treatment for dyslipidemia, and group 2, those with newly diagnosed dyslipidemia who were under lifestyle interventions. Meibography was performed at baseline and at both the 6- and 12-month visits and were graded by meiboscores. Participants underwent slit lamp examination for signs of changes in meibum quality and MG lid morphologic features. The Ocular Surface Disease Index questionnaire was given to measure subjective symptoms of ocular surface disease. Dry eye parameters including tear meniscus height, noninvasive first and average tear film break-up time, and Schirmer test results were also recorded.

Results: Ninety-eight participants completed this longitudinal study over 12 months. There were statistically significant changes in total meiboscores (P = .01) and upper eyelid meiboscores (P = .012), lid margin abnormality scores (P = .0059), and meibum quality (P = .0002) in the statin group during follow-up visits. Similar changes of upper eyelid meiboscores (P = .046) and meibum quality (P = .046) were noted in the nonstatin group.

Conclusion: Meibomian gland atrophy and deterioration of meibum quality continued in the long term among participants with dyslipidemia even under statin usage.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Atrophy
  • Dry Eye Syndromes / chemically induced*
  • Dry Eye Syndromes / diagnosis
  • Dry Eye Syndromes / physiopathology
  • Dyslipidemias / drug therapy*
  • Female
  • Follow-Up Studies
  • Humans
  • Hydroxymethylglutaryl CoA Reductases
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / adverse effects*
  • Male
  • Meibomian Gland Dysfunction / chemically induced*
  • Meibomian Gland Dysfunction / diagnostic imaging
  • Meibomian Gland Dysfunction / physiopathology
  • Meibomian Glands / diagnostic imaging
  • Meibomian Glands / drug effects*
  • Meibomian Glands / pathology
  • Middle Aged
  • Prospective Studies
  • Slit Lamp Microscopy
  • Surveys and Questionnaires
  • Tears / physiology

Substances

  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • HMGCR protein, human
  • Hydroxymethylglutaryl CoA Reductases