Evaluation of the Clinical Characteristics of Dry Eye Secondary to Different Types of Liver Diseases

Shang Li; Ao Li; Fang Ruan; Wei Zhang; Jie Chen; Chunyang Huang; Ying Jie

doi:10.1007/s40123-023-00747-4

Evaluation of the Clinical Characteristics of Dry Eye Secondary to Different Types of Liver Diseases

Ophthalmol Ther. 2023 Oct;12(5):2493-2503. doi: 10.1007/s40123-023-00747-4. Epub 2023 Jun 23.

Authors

Shang Li^{1

2}, Ao Li¹, Fang Ruan², Wei Zhang², Jie Chen², Chunyang Huang², Ying Jie³

Affiliations

¹ Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Ophthalmology and Visual Sciences Key Lab, Beijing Tongren Hospital, Capital Medical University, No. 1 Dong Jiao Min Xiang, Dong Cheng District, Beijing, 100730, China.
² Department of Ophthalmology, Beijing YouAn Hospital, Capital Medical University, Beijing, China.
³ Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Ophthalmology and Visual Sciences Key Lab, Beijing Tongren Hospital, Capital Medical University, No. 1 Dong Jiao Min Xiang, Dong Cheng District, Beijing, 100730, China. jie_yingcn@aliyun.com.

Abstract

Introduction: This study compares the clinical characteristics of dry eye secondary to primary biliary cholangitis (PBC), drug-induced liver injury (DILI), and viral hepatitis B(HBV) to evaluate the ocular surface damage caused by different types of liver diseases.

Methods: Thirty healthy people were included as control group. Sixty patients with dry eye secondary to different types of liver disease were included, including 19 cases of PBC, 18 cases of DILI, and 23 cases of HBV. All patients were evaluated by the SPEED questionnaire, corneal fluorescein staining (CFS), noninvasive tear breakup time (NIBUT), Schirmer I test (SIt), tear meniscus height test (TMH), the area of meibomian glands dropout (MG dropout), partial blinking rate (PBR), lipid layer thickness (LLT), meibum expressibility, and meibum quality.

Results: There are statistical differences in ophthalmic examination results between different types of liver diseases and normal people (P < 0.05). Compared with DILI and HBV groups, the CFS score of PBC group score was higher (P < 0.05), the PBR was higher (P < 0.05), and the SIt was lower (P < 0.01). The TMH of PBC and DILI groups were significantly lower than the HBV group, and the difference was statistically significant (P < 0.05). Compared with the PBC group, the LLT of the DILI group decreased (P < 0.01). The area of meibomian glands dropout of the three groups had mild-to-moderate defects, but there was no significant statistical difference between groups (P > 0.05).The Meibum quality score in the DILI group was significantly higher than the HBV group (P < 0.05).

Conclusions: The PBC group was more prone to aqueous-deficient dry eye. The DILI group was more prone to obstructive meibomian gland dysfunction (MGD).The HBV group was more prone to nonobstructive MGD. The symptoms of dry eye in the PBC group are mild-to-moderate discomfort, but the degree of corneal damage is higher, indicating that the corneal sensitivity is reduced, which may be related to the high rate of partial blinking.

Keywords: Drug-induced liver injury; Dry eye; Hepatitis B; Meibomian gland dysfunction; Ocular surface damage; Primary biliary cirrhosis.