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Factors affecting long-term changes of meibomian gland in MGD patients

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Abstract

Purpose

To explore the long-term course of patients with meibomian gland dysfunction (MGD), and to analyse potential factors affecting the recovery of meibomian gland (MG) dropout.

Methods

Seventy-nine MGD patients (79 eyes) aged 36.03±15.78 years old who underwent more than one year of follow-up were enrolled in this retrospective study. Corneal fluorescein staining (CFS), tear meniscus height (TMH), noninvasive breakup time (NIBUT), and noncontact meibography at baseline and last visit were collected and analysed. Then an automatic MG analyzer was used to measure the morphological and functional parameters of MGs, including their area ratio (AR), tortuosity index (TI), and signal index (SI). The patients whose AR increased by more than 5% were defined as MG improvement, and AR decreased by more than 5% was MG worsening.

Results

A total of 79 patients (79 eyes) were assessed with at least 1-year of follow-up. More than 1/3 of MGD patients (27 eyes, 34.2%) underwent MG improvement, and 30.4% of MGs became worsened. Age (P=0.002), gender (P<0.001), IPL treatment (P=0.013), the change of CFS (P=0.0015), and the recovery of SI (P=0.035) showed significant differences among different recovery groups. Age(P<0.001), female sex (P=0.003), ΔCFS (P<0.001), AR at baseline (P<0.001) were negative correlation with AR recovery, and the change of SI (P=0.003) and IPL treatment (P=0.003) had a positive correlation with it. Among them, age (P=0.038), the change of CFS (P=0.004), and AR at baseline (P=0.007) were confirmed as negatively correlated factors predicting the long-term change of the MG.

Conclusion

Although the MGD treatment has continued for more than 1 year, only 34.2% of MGD patients were observed to undergo MG improvement. Younger patients and patients with better CFS recovery seem to have more opportunities to improve their MGs.

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Data availability

All data supporting the findings of this study are available within the paper.

References

  1. Geerling G, Baudouin C, Aragona P et al (2017) Emerging strategies for the diagnosis and treatment of meibomian gland dysfunction: proceedings of the OCEAN group meeting. Ocul Surf 15:179–192

    Article  PubMed  Google Scholar 

  2. Stapleton F, Alves M, Bunya VY et al (2017) TFOS DEWS II epidemiology report. Ocul Surf 15:334–365

    Article  PubMed  Google Scholar 

  3. Siak JJ, Tong L, Wong WL et al (2012) Prevalence and risk factors of meibomian gland dysfunction: the Singapore Malay eye study. Cornea 31:1223–1228

    Article  PubMed  Google Scholar 

  4. Deng Y, Wang Q, Luo Z et al (2021) Quantitative analysis of morphological and functional features in meibography for meibomian gland dysfunction: diagnosis and grading. EClinicalMedicine 40:101132

    Article  PubMed  PubMed Central  Google Scholar 

  5. Sheppard JD, Nichols KK (2023) Dry eye disease associated with meibomian gland dysfunction: focus on tear film characteristics and the therapeutic landscape. Ophthalmol Ther 12:1397–1418

    Article  PubMed  PubMed Central  Google Scholar 

  6. Ha M, Oh SE, Whang WJ et al (2022) Relationship between meibomian gland loss in infrared meibography and meibum quality in dry eye patients. BMC Ophthalmol 22:292

    Article  PubMed  PubMed Central  Google Scholar 

  7. Saha RK, Chowdhury AM, Na KS et al (2022) Automated quantification of meibomian gland dropout in infrared meibography using deep learning. Ocul Surf 26:283–294

    Article  PubMed  Google Scholar 

  8. Wu Y, Li H, Tang Y et al (2017) Morphological evaluation of meibomian glands in children and adolescents using noncontact infrared meibography. J Pediatr Ophthalmol Strabismus 54:78–83

    Article  PubMed  Google Scholar 

  9. The definition and classification of dry eye disease (2007) report of the Definition and Classification Subcommittee of the International Dry Eye WorkShop (2007). Ocul Surf 5(2):75–92. https://doi.org/10.1016/s1542-0124(12)70081-2

    Article  Google Scholar 

  10. Yin Y, Gong L (2017) Reversibility of Gland Dropout and Significance of Eyelid Hygiene Treatment in Meibomian Gland Dysfunction. Cornea 36:332–337

    Article  PubMed  Google Scholar 

  11. Wu Y, Jiang H, Zhou X et al (2022) Morphological and functional changes of meibomian glands in pediatric and adult patients with allergic conjunctivitis. J Clin Med 11:1427

    Article  PubMed  PubMed Central  Google Scholar 

  12. Zhai Z, Jiang H, Wu Y et al (2022) Safety and feasibility of low fluence intense pulsed light for treating pediatric patients with moderate-to-severe blepharitis. J Clin Med 11:3080

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Xiao J, Adil MY, Olafeeon J et al (2019) Diagnostic test efficacy of meibomian gland morphology and function. Sci Rep 9:17345

    Article  ADS  PubMed  PubMed Central  Google Scholar 

  14. Arita R, Suehiro J, Haraguchi T et al (2013) Topical diquafosol for patients with obstructive meibomian gland dysfunction. Br J Ophthalmol 97:725–729

    Article  PubMed  Google Scholar 

  15. Arita R, Fukuoka S, Morishige N (2019) Therapeutic efficacy of intense pulsed light in patients with refractory meibomian gland dysfunction. Ocul Surf 17:104–110

    Article  PubMed  Google Scholar 

  16. Gupta PK, Stevens MN, Kashyap N et al (2018) Prevalence of meibomian gland atrophy in a pediatric population. Cornea 37:426–430

    Article  PubMed  PubMed Central  Google Scholar 

  17. Hwang HS, Parfitt GJ, Brown DJ et al (2017) Meibocyte differentiation and renewal: Insights into novel mechanisms of meibomian gland dysfunction (MGD). Exp Eye Res 163:37–45

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Reneker LW, Irlmeier RT, Shui YB et al (2020) Histopathology and selective biomarker expression in human meibomian glands. Br J Ophthalmol 104:999–1004

    Article  PubMed  Google Scholar 

  19. Beardsley RM, De Paiva CS, Power DF, Pflugfelder SC (2008) Desiccating stress decreases apical corneal epithelial cell size--modulation by the metalloproteinase inhibitor doxycycline. Cornea 27(8):935–940. https://doi.org/10.1097/ICO.0b013e3181757997

  20. Chen Y, Li J, Wu Y et al (2021) Comparative evaluation in intense pulsed light therapy combined with or without meibomian gland expression for the treatment of meibomian gland dysfunction. Curr Eye Res 46:1125–1131

    Article  CAS  PubMed  Google Scholar 

  21. Ferrari G, Colucci A, Barbariga M et al (2019) High frequency electrotherapy for the treatment of meibomian gland dysfunction. Cornea 38:1424–1429

    Article  PubMed  Google Scholar 

  22. Cuevas M, González-García M, Castellanos E et al (2012) Correlations among symptoms, signs, and clinical tests in evaporative-type dry eye disease caused by Meibomian gland dysfunction (MGD). Curr Eye Res 37:855–863

    Article  PubMed  Google Scholar 

  23. Daniel E, Maguire MG, Pistilli M et al (2019) Grading and baseline characteristics of meibomian glands in meibography images and their clinical associations in the Dry Eye Assessment and Management (DREAM) study. Ocul Surf 17:491–501

    Article  PubMed  PubMed Central  Google Scholar 

  24. Kim HM, Eom Y, Song JS (2018) The relationship between morphology and function of the meibomian glands. Eye Contact Lens 44:1–5

    Article  PubMed  Google Scholar 

  25. Ballesteros-Sánchez A, Gargallo-Martínez B, Sánchez-González MC et al (2013) Intense pulse light combined with low-level light therapy in dry eye disease: a systematic review. Eye Contact Lens 49:8–13

    Article  Google Scholar 

  26. Yin Y, Liu N, Gong L et al (2018) Changes in the meibomian gland after exposure to intense pulsed light in meibomian gland dysfunction (MGD) patients. Curr Eye Res 43:308–313

    Article  PubMed  Google Scholar 

  27. Dell SJ (2017) Intense pulsed light for evaporative dry eye disease. Clin Ophthalmol 11:1167–1173

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Funding

This work was supported by the National Natural Science Foundation of China (81970766 and 82171102), the Shanghai Medical Innovation Research Program (22Y21900900), and the Shanghai Key Clinical Research Program (SHDC2020CR3052B).

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Authors and Affiliations

  1. Department of Ophthalmology, Eye, Ear, Nose and Throat Hospital of Fudan University, Shanghai, China

    Xichen Wan, Yuqing Wu, Zimeng Zhai, Pei Yang, Shuyun Zhou, Han Ye, Yiteng Lu, Xujiao Zhou & Jiaxu Hong

  2. Institutes of Biomedical Sciences of Fudan University, Shanghai, China

    Feng Zhou

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  1. Xichen Wan
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  2. Yuqing Wu
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  3. Zimeng Zhai
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  4. Pei Yang
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  8. Feng Zhou
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Correspondence to Jiaxu Hong.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the EENT Hospital of Fudan University (EENTIRB-20190301) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Wan, X., Wu, Y., Zhai, Z. et al. Factors affecting long-term changes of meibomian gland in MGD patients. Graefes Arch Clin Exp Ophthalmol 262, 527–535 (2024). https://doi.org/10.1007/s00417-023-06210-1

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  • DOI: https://doi.org/10.1007/s00417-023-06210-1

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