Differential characteristics among asymptomatic and symptomatic meibomian gland dysfunction and those with dry eye

Yi-Ran Chiou; Pei-Yu Lin; Yu-Bai Chou; Po-Wei Huang; Nai-Wen Fan

doi:10.1186/s12886-023-02878-5

Differential characteristics among asymptomatic and symptomatic meibomian gland dysfunction and those with dry eye

BMC Ophthalmol. 2023 Apr 11;23(1):154. doi: 10.1186/s12886-023-02878-5.

Authors

Yi-Ran Chiou¹, Pei-Yu Lin^{1

2}, Yu-Bai Chou^{1

2}, Po-Wei Huang³, Nai-Wen Fan^{4

5}

Affiliations

¹ Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan.
² Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Hsinchu, 30010, Taiwan.
³ Department of Radiation Oncology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
⁴ Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan. nwfan@vghtpe.gov.tw.
⁵ Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Hsinchu, 30010, Taiwan. nwfan@vghtpe.gov.tw.

Abstract

Purpose: To identify the characteristics of asymptomatic meibomian gland dysfunction (MGD), symptomatic MGD, and MGD coexisting with dry eye disease (DED).

Methods: This cross sectional study enrolled a total of 153 eyes of 87 MGD patients. Participants filled in ocular surface disease index (OSDI) questionnaires. Age, gender, Schirmer's test, meibomian gland (MG) related parameters, lipid layer thickness (LLT) and blinking were compared among patients with asymptomatic MGD, symptomatic MGD, and MGD with DED. Multivariate regression was used to analyze the significant factor of DED in MGD. Spearman's rank correlation analysis was used to evaluate the association between the significant factors and MG function.

Results: There was no difference in age, Schirmer's test, lid changes, MG secretion, and MG morphology among three groups. The OSDI of asymptomatic MGD, symptomatic MGD and MGD coexisting with DED were 8.5 ± 2.9, 28.5 ± 12.8 and 27.9 ± 10.5, respectively. Patients with MGD coexisting with DED exhibited more frequent eye blinking than that of patients with asymptomatic MGD (8.1 ± 4.1 vs. 6.1 ± 3.5 blinks/20 sec, P = 0.022), and reduced LLT than that of patients with asymptomatic MGD (68.6 ± 17.2 vs. 77.6 ± 14.5 nm, P = 0.010) and symptomatic MGD (78.0 ± 17.1 nm, P = 0.015). Multivariate analysis identified LLT (per nm, OR = 0.96, 95% CI = 0.93-0.99, P = 0.002) as a significant factor associated with DED development in MGD. The number of expressible MG was positively correlated with LLT (Spearman's correlation coefficient = 0.299, P = 0.016) but negatively correlated with the number of blinking (Spearman's correlation coefficient = -0.298, P = 0.016) in MGD patients with DED, and these findings were not identified in those without DED.

Conclusions: Asymptomatic MGD, symptomatic MGD, and MGD coexisting with DED share similar characteristics, including meibum secretion and morphology, but MGD patients coexisting with DED exhibited significantly reduced LLT.

Keywords: Dry eye disease; Interferometry; Lipid layer thickness; Meibomian gland dysfunction; Ocular surface parameters.

MeSH terms

Blinking
Cross-Sectional Studies
Dry Eye Syndromes*
Humans
Meibomian Gland Dysfunction*
Meibomian Glands