●AIM:To investigate a pioneering framework for the segmentation of meibomian glands(MGs),using limited annotations to reduce the workload on ophthalmologists and enhance the efficiency of clinical diagnosis.●METHODS...●AIM:To investigate a pioneering framework for the segmentation of meibomian glands(MGs),using limited annotations to reduce the workload on ophthalmologists and enhance the efficiency of clinical diagnosis.●METHODS:Totally 203 infrared meibomian images from 138 patients with dry eye disease,accompanied by corresponding annotations,were gathered for the study.A rectified scribble-supervised gland segmentation(RSSGS)model,incorporating temporal ensemble prediction,uncertainty estimation,and a transformation equivariance constraint,was introduced to address constraints imposed by limited supervision information inherent in scribble annotations.The viability and efficacy of the proposed model were assessed based on accuracy,intersection over union(IoU),and dice coefficient.●RESULTS:Using manual labels as the gold standard,RSSGS demonstrated outcomes with an accuracy of 93.54%,a dice coefficient of 78.02%,and an IoU of 64.18%.Notably,these performance metrics exceed the current weakly supervised state-of-the-art methods by 0.76%,2.06%,and 2.69%,respectively.Furthermore,despite achieving a substantial 80%reduction in annotation costs,it only lags behind fully annotated methods by 0.72%,1.51%,and 2.04%.●CONCLUSION:An innovative automatic segmentation model is developed for MGs in infrared eyelid images,using scribble annotation for training.This model maintains an exceptionally high level of segmentation accuracy while substantially reducing training costs.It holds substantial utility for calculating clinical parameters,thereby greatly enhancing the diagnostic efficiency of ophthalmologists in evaluating meibomian gland dysfunction.展开更多
AIM:To develop normative data for meibomian gland dysfunction(MGD)parameters,using non-contact meibography technique of Sirius Costruzione Strumenti Oftalmici(CSO)machine,in an Egyptian population sample.METHODS:Obser...AIM:To develop normative data for meibomian gland dysfunction(MGD)parameters,using non-contact meibography technique of Sirius Costruzione Strumenti Oftalmici(CSO)machine,in an Egyptian population sample.METHODS:Observational,cross-sectional,analytic study,in which 104 Egyptian volunteers were included.Both upper lids were examined,using“Sirius CSO”machine.Each eyelid was given a degree of meibomian gland loss(MGL),which was calculated by the software of the machine.RESULTS:Mean percentage MGL in right upper lid was of 30.9%±12.6%,and that of left upper lid was 32.6%±11.8%.Thirty-four volunteers(32.7%)had first-degree MGL in their right upper lid,and 67.3%had second-degree loss.One volunteer(1%)had zero-degree MGL in left upper lid,28(26.9%)had first-degree loss,and 75(72.1%)had second-degree loss.Degree of MGL in right upper eyelid was not related to age,but degree of MGL in left upper eyelid increased with age.There was statistically significant difference between both genders for degree of MGL in right eye(P=0.036)and in left eye(P=0.027).CONCLUSION:Noncontact meibography is a useful non-invasive tool for diagnosing MGL.MGL is diagnosed in 100%of apparently normal individuals;26.9%-32.7%of which have first-degree MGL,and 67.3%-72.1%have second-degree MGL.展开更多
AIM:To evaluate lacrimal gland adenoid cystic carcinoma(LGACC)of prognosis in patients who underwent different treatment regimens.METHODS:We searched PubMed,EMBASE,and the Cochrane Library for studies done on the trea...AIM:To evaluate lacrimal gland adenoid cystic carcinoma(LGACC)of prognosis in patients who underwent different treatment regimens.METHODS:We searched PubMed,EMBASE,and the Cochrane Library for studies done on the treatment of LGACC,between January 1987 and April 2022.A Metaanalysis was conducted to pool the 5-year overall survival rate(OR),and the 5-year recurrence rate(RR)and 5-year metastasis rate(MR)were assessed.RESULTS:The 30 studies involved 585 patients were included in the Meta-analysis.The pooled 5-year OR with surgery alone was 50%,the 5-year RR was 63%,and the 5-year MR was 34%.The pooled 5-year OR with surgery and adjuvant radiotherapy combined was 67%(95%CI 61%,73%),the 5-year RR was 41%,and the 5-year MR was 35%.The pooled 5-year OR with surgery and adjuvant chemoradiotherapy combined was 72%(95%CI 59%,84%),the 5-year RR was 48%,and the 5-year MR was 36%.The pooled 5-year OR with surgery,intra-arterial cytoreductive chemotherapy,and adjuvant chemoradiotherapy combined was 78%(95%CI 68%,89%),the 5-year RR was 15%,and the 5-year MR was 27%.CONCLUSION:Comprehensive treatment is more effective than surgery alone.Surgery combined with intraarterial chemotherapy and adjuvant chemoradiotherapy seems to add value to the therapeutic effect of comprehensive treatment of LGACC but further high-quality research is required to validate this.展开更多
AIM:To evaluate the differences between human lacrimal gland adenoid cystic carcinoma with high-grade transformation(LACC-HGT)primar y cells cultured by high-grade transformation tissue and non-high-grade transformati...AIM:To evaluate the differences between human lacrimal gland adenoid cystic carcinoma with high-grade transformation(LACC-HGT)primar y cells cultured by high-grade transformation tissue and non-high-grade transformation(non-HGT)primary cells cultured by non-highgrade transformation tissue in proliferation,metastasis,drug susceptibility,and genes.METHODS:LACC-HGT primary cells were established by tissue block culture,and the 4^(th)to 10^(th)generation primary cells were selected as research objects.The cells were preliminarily identified by immunofluorescent staining.The differences between non-HGT and LACC-HGT primary cells in terms of proliferation,metastasis,and drug susceptibility were compared by cell counting kit-8(CCK-8)assay,wound healing,and drug sensitivity experiments.Differentially expressed genes were screened using mRNA array.Gene expression was analyzed using real-time quantitative polymerase chain reaction(RT-qPCR).RESULTS:LACC-HGT primary cells were successfully cultured by tissue block culture.Immunofluorescence staining results showed that cytokeratin(CK)and CK7 expression levels were positive in LACC-HGT primary cells.CCK-8 results showed that the proliferation ability of LACCHGT cells was significantly higher than that of non-HGT cells.Wound healing experiment showed that the migration ability of LACC-HGT cells was significantly higher than that of non-HGT cells.LACC-HGT cells were also less sensitive to cisplatin and paclitaxel than non-HGT cells.Compared with non-HGT cells,9566 differentially expressed genes were found in LACC-HGT primary cells,of which 5162 were upregulated and 4404 were down-regulated.The expression of N-acetylneuraminate pyruvate lyase(NPL),MARVEL domain containing 3(MARVELD3),syntabulin(SYBU),and allograft inflammatory factor 1(AIF1)was higher in LACCHGT cells than in non-HGT cells,whereas that of periostin(POSTN)was lower.CONCLUSION:LACC-HGT primary cells have faster proliferation,stronger migration ability,and poorer sensitivity to chemotherapy drugs than non-HGT primary cells.The expression of mRNAs in non-HGT and LACC-HGT primary cells are significantly different.These features are speculated to be the reasons why high-grade transformation tissues exhibit higher malignant degree and poorer prognosis than their counterparts.展开更多
AIM:To observe ocular surface changes after phacovitrectomy in patients with mild to moderate meibomian gland dysfunction(MGD)-type dry eye and track clinical treatment response using a Keratograph 5M and a Lipi View ...AIM:To observe ocular surface changes after phacovitrectomy in patients with mild to moderate meibomian gland dysfunction(MGD)-type dry eye and track clinical treatment response using a Keratograph 5M and a Lipi View interferometer.METHODS:Forty cases were randomized into control group A and treatment group B;the latter received meibomian gland treatment 3d before phacovitrectomy and sodium hyaluronate before and after surgery.The average non-invasive tear film break-up time(NITBUTav),first noninvasive tear film break-up time(NITBUTf),non-invasive measured tear meniscus height(NTMH),meibomian gland loss(MGL),lipid layer thickness(LLT)and partial blink rate(PBR)were measured preoperatively and 1wk,1 and 3mo postoperatively.RESULTS:The NITBUTav values of group A at 1wk(4.38±0.47),1mo(6.76±0.70),and 3mo(7.25±0.68)were significantly lower than those of group B(7.45±0.78,10.46±0.97,and 11.31±0.89;P=0.002,0.004,and 0.001,respectively).The NTMH values of group B at 1wk(0.20±0.01)and 1mo(0.22±0.01)were markedly higher than those of group A(0.15±0.01 and 0.15±0.01;P=0.008 and P<0.001,respectively);however,there was no difference at 3mo.The LLT of group B at 3mo[91.5(76.25-100.00)]significantly exceeded that of group A[65.00(54.50-91.25),P=0.017].No obvious intergroup difference was found in MGL or PBR(P>0.05).CONCLUSION:Mild to moderate MGD dry eye worsens in the short term after phacovitrectomy.Preoperative cleaning,hot compresses,and meibomian gland massage as well as preoperative and postoperative sodium hyaluronate promote the rapid recovery of tear film stability.展开更多
AIM:To study retinal microvascular and microstructural alterations in meibomian gland dysfunction(MGD)in severely obese population using optical coherence tomography angiography(OCTA).METHODS:Twelve MGD patients with ...AIM:To study retinal microvascular and microstructural alterations in meibomian gland dysfunction(MGD)in severely obese population using optical coherence tomography angiography(OCTA).METHODS:Twelve MGD patients with severely obese population(PAT group;24 eyes)and 12 healthy controls(HC group;24 eyes)were recruited.OCTA images were segmented into five[superior(S),nasal(N),inferior(I),temporal(T),and central foveal(C)]or nine[inner superior(IS),outer superior(OS),inner nasal(IN),outer nasal(ON),inner inferior(II),outer inferior(OI),inner temporal(IT),outer temporal(OT),and C]subregions.The superficial vessel density(SVD),retinal thickness(RT),foveal avascular zone(FAZ)parameters,and retinal volume were measured.RESULTS:Visual acuity was significantly different between two groups(0.8±0.17 in PAT group vs 0.2±0.06 in HC group).SVD was significantly lower in PATs in N,T,OS,IN,OT,and ON.The area under the receiver operating characteristic curve(AUC)for T was 0.961[95% confidence interval(CI):0.908 to 1.000],for OS was 0.962(95%CI:0.915 to 1.000).RT was significantly lower in PATs in IS,OS,OI,OT,ON,IT,IN,and II.AUC for OT was 0.935(95%CI:0.870 to 0.999),for IS was 0.915(95%CI:0.838 to 0.992).Angiography results showed significantly lower area and perimeter of FAZ,SVD of the inner retina and both retinal volume and the average volume thickness in the PAT group.CONCLUSION:Vision may be affected in patients with MGD due to changes in retinal microvessels and microstructures.These changes detected by OCTA may be a potential marker for diagnosing MGD in severe obesity.展开更多
BACKGROUND Eccrine porocarcinoma(EPC)is a rare skin tumor that mainly affects the elderly population.Tumors often present with slow growth and a good prognosis.EPCs are usually distinguished from other skin tumors usi...BACKGROUND Eccrine porocarcinoma(EPC)is a rare skin tumor that mainly affects the elderly population.Tumors often present with slow growth and a good prognosis.EPCs are usually distinguished from other skin tumors using histopathology and immunohistochemistry.However,surgical management alone may be inadequate if the tumor has metastasized.However,currently,surgical resection is the most commonly used treatment modality.CASE SUMMARY A seventy-four-year-old woman presented with a slow-growing nodule in her left temporal area,with no obvious itching or pain,for more than four months.Histopathological examination showed small columnar and short spindle-shaped cells;thus,basal cell carcinoma was suspected.However,immunohistochemical analysis revealed the expression of cytokeratin 5/6,p63 protein,p16 protein,and Ki-67 antigen(40%),and EPC was taken into consideration.The skin biopsy was repeated,and hematoxylin and eosin staining revealed ductal differentiation in some cells.Finally,the patient was diagnosed with EPC,and Mohs micrographic surgery was performed.We adapted follow-up visits in a year and not found any recurrence of nodules.CONCLUSION This case report emphasizes the diagnosis and differentiation of EPC.展开更多
AIM: To observe the changes of microcellular structure of meibomian glands(MGs) in type 2 diabetes mellitus(DM), and to explore its correlation with the duration of diabetes.METHODS: The study assessed 132 eyes of 132...AIM: To observe the changes of microcellular structure of meibomian glands(MGs) in type 2 diabetes mellitus(DM), and to explore its correlation with the duration of diabetes.METHODS: The study assessed 132 eyes of 132 patients with type 2 diabetes mellitus(DM group) and 100 eyes of 100 non-diabetic participants(NDM group). All patients underwent the examination of the Keratograph 5 M system to obtain the meibography which were used to evaluate the structure dropout of the MGs. And then laser scanning confocal microscopy(LSCM) was performed for observing the acinar cells and ducts of the MGs to obtain the following parameters: the MG acinar unit density(MGAUD), MG acinar longest diameter(MGALD) and MG acinar shortest diameter(MGASD). The examination results of the right eye were selected for analysis.RESULTS: Compared with that in NDM group, the meiboscore was significantly higher(Z=-4.057, P<0.001), and there were more MGs dropout in DM group. With the prolongation of the course of diabetes, the absence of MGs aggravated and the MGs dropout score increased(r=0.596;P<0.001). LSCM showed that there were various cytological alterations in acinar cells of MGs with the progress of diabetes duration, such as expansion, atrophy or fibrosis of MG acinar units, decreased density of MG acinar units, deposition of lipid substances, infiltration of inflammatory cells, proliferation of fibrous tissues, etc. And the opening of the glandular duct changed from smooth at the beginning to narrow, blocked, fibrotic and so on. Compared with that in NDM group, the MGAUD in DM group was significantly lower(Z=-9.713;P<0.001), the MGALD and MGASD were significantly larger(Z=-9.751,-6.416;P<0.001). With the duration of diabetes, the MGAUD reduced, the MGASD increased(r=0.860, 0.364, P<0.001);but the MGALD had no correlation with diabetic duration(r=0.133, P=0.151).CONCLUSION: With the progress of diabetes, the meibomian glandular acinar cells of diabetic patients show various manifestations. Those changes may result in the dysfuction of the MGs, tear film instability and dry eye symptoms in patients with type 2 DM.展开更多
A depressed lesion was found at a gastric angle of 76-yearold Japanese woman by esophagogastroduodenoscopy. Four years prior, she was diagnosed with a Helicobacter pylori infection but no eradication was performed. Th...A depressed lesion was found at a gastric angle of 76-yearold Japanese woman by esophagogastroduodenoscopy. Four years prior, she was diagnosed with a Helicobacter pylori infection but no eradication was performed. The pathological diagnosis of biopsy specimens was signet-ring cell carcinoma. Endoscopic submucosal dissection(ESD) was performed. Histopathological examination of the ESD specimen revealed proliferation of well-differentiated tubular adenocarcinoma mimicking fundic gland cells at the deep layer of the lamina propria mucosae. These tumor cells expressed focally pepsinogen-Ⅰ, diffusely MUC6, and scattered H^+/K^+ ATPase according to immunohistochemistry. Therefore, we diagnosed this tumor as gastric adenocarcinoma of fundic gland type(GA-FG). Adjacent to the GA-FG, proliferation of signet-ring cell carcinoma which diffusely expressed MUC 2 and MUC 5AC was observed. Intestinal metaplasia was focally observed in the surrounding mucosa of the signet-ring cell carcinoma. To the best of our knowledge, this is the first case report of GA-FG with a signet-ring cell carcinoma component. The origin of signet-ring cell carcinoma, i.e., whether it accidentally arose from a non-neoplastic mucosa and coexisted with the GA-FG or dedifferentiated from the GA-FG is unclear at present. We expect the accumulation of similar cases and further analysis to clarify this issue.展开更多
To observe the clinical changes of meibomian gland dysfunctipn(MGD)and ocular Demodex infestation after intense pulsed light(IPL)treatment to further examine the mechanism of IPL treating patients with MGD and ocular ...To observe the clinical changes of meibomian gland dysfunctipn(MGD)and ocular Demodex infestation after intense pulsed light(IPL)treatment to further examine the mechanism of IPL treating patients with MGD and ocular Demodex infestation.The medical records of 25 patients(49 eyes)with MGD treated with IPL,were retrospectively examined to determine outcomes.Associated ocular-surface parameters(ocular surface disease index,OSD1;lipid layer thickness,LLT;noninvasive first breakup time,NIF-BUT;noninvasive average breakup time,NIAvg?BUT;tear film breakup area,TBUA;Schirmer I Test,SIT;corneal fluorescein staining,CFS),eyelid margin abnormalities,meibum quality and expressibility,MG morphological parameters(macrostructure and microstructure),and the number of Demodex infestation were examined before and after treatment.The MG microstructure and the Demodex infestation were examined via in vivo confocal microscopy(IVCM).The results showed that there were statistically significant differences in associated ocular-surface parameters(all P<0.05)before and after IPL treatment,except SIT(P=0.065).Eyelid margin abnormalities,meibum quality and expressibility obviously improved in upper and lower eyelid after IPL treatment(all P<0.0001).MG macrostructure(MG dropouts)decreased in upper(P=0.002)and lower eyelid(P=0.001)after IPL treatment.The nine parameters of MG microstructure in upper and lower eyelid all distinctly improved after IPL treatment(all P<0.0001).The mean number of Demodex mites on the upper lid margin(6.59±7.16 to 3.12±3.81/9 eyelashes)and lower lid margin(2.55±2.11 to 1.29±1.53/9 eyelashes)significantly reduced after IPL treatment(all P<0.0001).The Demodex eradication rate was 20%(8/40)in upper lid margin and 34.15%(14/41)in lower lid margin.These findings indicate that IPL shows great therapeutic potential for patients of MGD and ocular Demodex infestation.展开更多
AIM: To compare the anti-inflammatory effects of intense pulsed light(IPL) with tobramycin/dexamethasone plus warm compress through clinical signs and cytokines in tears.METHODS: Eighty-two patients with dry eye disea...AIM: To compare the anti-inflammatory effects of intense pulsed light(IPL) with tobramycin/dexamethasone plus warm compress through clinical signs and cytokines in tears.METHODS: Eighty-two patients with dry eye disease(DED) associated meibomian gland dysfunction(MGD) were divided into two groups. Group A was treated with IPL, and Group B was treated with tobramycin/dexamethasone plus warm compress. Ocular Surface Disease Index(OSDI), tear film breakup time(TBUT), corneal fluorescein staining(CFS), meibomian gland expressibility(MGE), meibum quality, gland dropout and tear cytokine levels were evaluated before treatment, 1 wk and 1 mo after treatment. RESULTS: TBUT in Group A was higher(P=0.035), and MGE score was lower than Group B at 1 mo(P=0.001). The changes of interleukin(IL)-17 A and IL-1β levels in tears were lower in Group A compared with that in Group B at 1 wk after treatment(P=0.05, P=0.005).CONCLUSION: Treatment with IPL can improve TBUT and MGE and downregulate levels of IL-17 A and IL-1β in tears of patients with DED associated MGD better than treatment with tobramycin/dexamethasone plus warm compress in one-month treatment period.展开更多
Meibomian gland,the largest sebaceous gland of the body,is responsible for the biosynthesis of lipid layer of the tear film to prevent excessive evaporation.The loss of normal functions of meibomian gland,known as mei...Meibomian gland,the largest sebaceous gland of the body,is responsible for the biosynthesis of lipid layer of the tear film to prevent excessive evaporation.The loss of normal functions of meibomian gland,known as meibomian gland dysfunction(MGD),is a chronic disease and is the leading cause of dry eye symptoms in the clinics.Studies have found sex hormones,especially androgen,play vital roles in the regulation of the functions of meibomian gland.Recently,androgen has also been preliminarily applied in clinics for the treatment of MGD and showed promising results,especially in people with endogenous androgen deficiency.This review summarized the mechanisms of the function of androgen on meibomian gland based on molecular,animal,and clinical studies,and proposed evidence-based views about its potential applications for the treatment of MGD.展开更多
AIM:To evaluate the clinical efficacy of dietary supplement of high dose DHA omega-3 in dry eye with meibomian gland dysfunction(MGD).METHODS:Prospective randomized double-masked,placebo-controlled clinical trial was ...AIM:To evaluate the clinical efficacy of dietary supplement of high dose DHA omega-3 in dry eye with meibomian gland dysfunction(MGD).METHODS:Prospective randomized double-masked,placebo-controlled clinical trial was conducted in mild to moderate dry eye patients with MGD.Patients have no history of taking any dietary omega-3 supplements before 3 mo.Patients were divided into two groups:24 patients in the omega-3 group and 26 patients in the placebo group.The omega-3 group received two capsules of Easyeye Dry?,total containing 600 mg of EPA and 1640 mg of DHA,while the placebo group received two capsules containing 3000 mg of olive oil.All patients take two pills once a day.The examination of MGD scores,tear break-up time(TBUT),corneal staining test(NEI),strip meniscometry(SM tube),and ocular surface disease index(OSDI)scores were performed at baseline,after 4 and 8 wk.RESULTS:A total of 50 patients were included.There were no differences in baseline characteristics between the two groups,such as age,sex,and other ocular examination findings.The TBUT,NEI,and OSDI scores significantly improved after 4 and 8 wk in both groups.While after 8 wk TBUT(6.00±1.62 s vs 5.08±1.28 s,P=0.034)and MGD score(7.2±1.8 vs 8.1±2.6,P=0.033)in the omega-3 group was more significantly improved than that of the placebo group.CONCLUSION:Dry eye with the MGD patient,a high dose of DHA omega-3 dietary supplement can improve TBUT and MGD score after 8 wk,effective in stabilizing the tear film.展开更多
AIM: To investigate the morphological changes of meibomian glands in patients with type 2 diabetes mellitus(DM).·METHODS: Of 118 eyes(118 patients) with type 2 DM(DM group) and 100 eyes of 100 control subjects(co...AIM: To investigate the morphological changes of meibomian glands in patients with type 2 diabetes mellitus(DM).·METHODS: Of 118 eyes(118 patients) with type 2 DM(DM group) and 100 eyes of 100 control subjects(control group) were enrolled. After completing an ocular surface disease index(OSDI) questionnaire, the non-invasive tear film break-up time(NI-BUT) and the structure of the meibomian glands(MGs, meibography) were assessed by the Keratograph 5M system. Partial or complete loss of MG was scored for each eyelid from grade 0(no loss) to grade 3(lost area was >2/3 of the total MG area), which were also examined by laser scanning confocal microscopy(LSCM). The primary outcomes were meibomian gland acinar unit density(MGAUD),meibomian gland acinar longest diameter(MGALD) and meibomian gland acinar shortest diameter(MGASD).·RESULTS: Compared with control group, the OSDI was significantly higher in DM group(Z =-5.916; P <0.001),while the NI-BUT was significantly lower(Z =-7.765; P <0.001). Keratograph showed that there were more MGs dropout in DM group than that in control group. The meiboscore was significantly higher in DM group compared with control group(Z =-3.937; P <0.001).LSCM revealed that there were cytological alterations of MGs in DM group compared with control group, which included enlargement of MG acinar units and decreased in density of MG acinar units. Specifically, there were lower MGAUD, larger MGALD and MGASD in DM group than control group(Z =-10.120,-9.4442,-7.771; P <0.001).· CONCLUSION: Compared with the normal control participants, the patients with type 2 DM had more unstable tear films and severe symptoms of dry eye.Using Keratograph 5M system and LSCM, we found that the patients with type 2 DM had more significant morphological and cytological changes and dysfunction in MGs.展开更多
● AIM: To find a stable, inexpensive, and reliable method to produce a rat meibomian gland dysfunction(MGD) model.● METHODS: We inserted slim guidewires into the meibomian gland orifices of twelve Brown Norway rats ...● AIM: To find a stable, inexpensive, and reliable method to produce a rat meibomian gland dysfunction(MGD) model.● METHODS: We inserted slim guidewires into the meibomian gland orifices of twelve Brown Norway rats and fulgurized every guidewire to destroy part of the meibomian gland. We then observed the morphological changes in the eyelid margin, and compared the data of tear breakup time(TBUT), Schirmer I test, and the corneal fluorescence staining scores at different times(1, 2, 4, and 6 wk). We observed pathological changes of the cornea, conjunctiva and meibomian gland, and we used real-time polymerase chain reaction to analyze epithelial growth factor(EGF), interleukin-6(IL-6), IL-8, tumor necrosis factor-α(TNF-α), and Ki67.● RESULTS: In the fourth week, compared with the control group, the TBUT of the model group began to decreased(P<0.05). The tear secretion remained stable(P>0.05). The corneal dots were significantly increased in the fourth week when the fusion stain began to appear(P<0.05). In the fourth week, partial meibomian gland openings had hoary secretions blocked, orifices were expanded, and there was a partial convex deformation. In the sixth week, the tissue section showed that the number of conjunctival goblet cells was decreased, epithelial cells were irregular, the epithelium was detached and rough, and meibomian glands were lost. The expressions of EGF, IL-6, IL-8, and TNF-α in corneal, conjunctival, and meibomian tissues were highly increased(P<0.05), but no statistical difference was found in the expression of Ki67 in corneal and conjunctival tissues(P>0.05).● CONCLUSION: The MGD rat model, produced via electrocauterization of meibomian gland orifices, matched clinical manifestations and cytokine levels. Our research provides a new method of achieving an MGD animal model.展开更多
AIM: To investigate the association between ocular demodex folliculorum infestation and ocular surface manifestations in meibomian gland dysfunction(MGD).METHODS: Eight-six patients with MGD were enrolled. All enrolle...AIM: To investigate the association between ocular demodex folliculorum infestation and ocular surface manifestations in meibomian gland dysfunction(MGD).METHODS: Eight-six patients with MGD were enrolled. All enrolled subjects were tested in the following sequence: ocular surface disease index(OSDI), slit-lamp biomicroscope examination, corneal surface regularity index(SRI) and surface asymmetry index(SAI), tear fluid collection, fluorescein tear film break-up time(F-BUT), corneal fluorescein staining(CFS), Schirmer I test(SIT) and demodex folliculorum counting. Tear matrix metalloproteinase(MMP)-9 activity was assessed using MMP-9 activity assay kit.RESULTS: Among 86 MGD patients, 40 were positive for demodex. The ocular demodex-positive group showed significantly increased scores of OSDI(25.96±13.74 vs 18.07±11.55, P=0.01), lid margin abnormality(2.38±0.87 vs 1.98±0.91, P=0.04) and CFS(1.28±2.00 vs 0.94±1.36, P=0.01) compared to the ocular demodex-free group. The tear MMP-9 activity was higher in the ocular demodex-positive group(102.9±32.4 ng/mL) than the ocular demodex-free group(46.2±19.2 ng/mL, P=0.03). There was no significant difference in meibum quality and expressibility, SRI, SAI, F-BUT and SIT between the two groups(P>0.05 for each). No significant correlation was noted between the number of demodex and ocular surface parameters in demodexpositive MGD group(P>0.05 for each).CONCLUSION: Ocular demodex folliculorum infestation may be associated with ocular discomfort and ocular surface damage in MGD.展开更多
AIM: To investigate the abnormalities in the meibomian gland in patients with dry eye disease(DED) associated with chronic ocular graft-versus-host disease(coGVHD) in comparison with Sj?gren's syndrome(SS), a majo...AIM: To investigate the abnormalities in the meibomian gland in patients with dry eye disease(DED) associated with chronic ocular graft-versus-host disease(coGVHD) in comparison with Sj?gren's syndrome(SS), a major form of aqueous deficient DED and meibomian gland dysfunction(MGD), a common cause of evaporative DED.METHODS: A total 135 eyes of 135 subjects included in this study: patients with DED associated with coGVHD(n=30), patients with SS(n=35), patients with MGD(n=35), and normal controls(n=35). All participants completed the Ocular Surface Disease Index(OSDI) questionnaire, ocular surface examination [Schirmer test, tear film breakup time(TFBUT), and ocular surface staining], and meibomian gland assessment [meiboscore(gland dropout detected on meibography using infrared camera of the Keratograph 5 M), meibum expressibility score(MES), meibum quality score(MQS), lid margin abnormality]. In addition, correlations of meibomian gland characteristics with ocular surface parameters as well as disease severity score were investigated in coGVHD group.RESULTS: The coGVHD group showed significantly higher meiboscore, MES, and MQS than the other 3 groups(all P<0.05). In the coGVHD group, parameters of meibomian gland showed a significant correlation each other and those of ocular surface. The correlation between meibomian gland parameters and severity score of co GVHD was also established(meiboscore, r=0.62; MES, r=0.47; MQS, r=0.47; lid margin abnormality score, r=0.55; all P<0.05).CONCLUSION: Patients with DED associated with co GVHD show poorer gland morphology and worse glandfunction than other types of DED. In addition, meibomian gland damage is not only associated with ocular surface damage but also disease severity of coGVHD.展开更多
AIM: To investigate the efficacy of combined topical 0.05% cyclosporine A(CsA; Restasis~?, Allergan pharmaceuticals, USA) and 0.1% sodium hyaluronate treatment in dry eyes with meibomian gland dysfunction(MGD).METHODS...AIM: To investigate the efficacy of combined topical 0.05% cyclosporine A(CsA; Restasis~?, Allergan pharmaceuticals, USA) and 0.1% sodium hyaluronate treatment in dry eyes with meibomian gland dysfunction(MGD).METHODS: In a retrospective analysis, 53 patients(106 eyes) with MGD were enrolled and performed lid warm massage for 10 min daily and be instilled preservative free sodium hyaluronate 0.1% eye drops 4 times daily. Patients were divided into subjects treated with topical 0.05% CsA and preservative free sodium hyaluronate vehicle(experimental group, n=74 eyes) and subjects treated with the preservative free sodium hyaluronate vehicle(control group, n=32 eyes). They were evaluated at baseline and 1, 2, and 3 mo for subjective symptoms and objective signs including tear film break-up time(t BUT), Schirmer test, corneal staining(CS) score, lid margin telangiectasia(LMT), meibomian gland secretion(MGS), and conjunctival injection(CI).RESULTS: In the short-term treatment, the experimental group showed a statistically significant improvement in the ocular surface disease index(OSDI; P<0.001), tBUT(P=0.004), Schirmer test score(P=0.008) and LMT(P=0.021) by repeated measure ANOVA. Additionally, mean changes from baseline in OSDI(P<0.001), tBUT(P=0.001), Schirmer test score(P=0.029), CS score(P=0.047), LMT(P=0.002), CI(P=0.030) were improved better in the experimental group than in the control group at 3 mo. However, there was no significant difference between the two groups in MGS(P=0.67).CONCLUSION: In dry eyes with MGD, 0.05% CsA improves the tear film stability as well as subjective ocular discomfort, and is effective in controlling lid margin inflammation.展开更多
BACKGROUND Primary sebaceous carcinoma of lacrimal gland(SCLG) is extremely rare. Due to its clinical characteristics, it is often misdiagnosed. It is known to be aggressive so delay in diagnosis can increase the chan...BACKGROUND Primary sebaceous carcinoma of lacrimal gland(SCLG) is extremely rare. Due to its clinical characteristics, it is often misdiagnosed. It is known to be aggressive so delay in diagnosis can increase the chance of local recurrence and metastasis. We report a case of primary SCLG.CASE SUMMARY A 75-year-old man was referred with a painful swelling in the right eyelid. Computed tomography scan demonstrates a 2.6 cm mass in upper outer quadrant of right orbit. After the incisional biopsy of the mass, he was diagnosed with squamous cell carcinoma of lacrimal gland. A right orbital exenteration, cervical lymph node dissection was performed. There was no involvement of the overlying periorbital skin, eyelid, or conjunctiva. Histological examination of the exenteration specimen showed tumor arising from the lacrimal gland, which had been entirely replaced by sebaceous carcinoma with sarcomatous and squamous differentiation. Neoplastic cells which were large and contained prominent nucleoli. Focal tumor remained in the posterior resection margin. Patient underwent adjuvant radiotherapy, total dose of 56 Gy with doseper-fraction 2 Gy to primary lesion. There has been no sign of recurrence until 2-years follow-up.CONCLUSION We report a rare case of sebaceous carcinoma arising from the lacrimal gland. Accurate diagnosis of SCLG is important for appropriate treatment and prognosis prediction.展开更多
AIM:To study the effect of uncrosslinked and crosslinked hyaluronic acid combined with other artificial tear components in patients with dry eye caused by moderate meibomian gland dysfunction.METHODS:Prospective,singl...AIM:To study the effect of uncrosslinked and crosslinked hyaluronic acid combined with other artificial tear components in patients with dry eye caused by moderate meibomian gland dysfunction.METHODS:Prospective,single-blind,contralateral eye study.Fifty eyes(25 patients)were analyzed.Eye selection for each tear type was random,and the eye drop formulations,0.4%uncrosslinked hyaluronic acid and 0.2%galactoxyloglucan(tear A)and 0.15%crosslinked hyaluronic acid,crocin,and liposomes(tear B)were used.The determined dosing schedule was three times a day for six weeks,and the study participants underwent a clinical examination before and 45 d after lubricant treatment.The Schirmer test,tear breakup time(TBUT)test,and Ocular Surface Disease Index(OSDI)questionnaire were applied before and after instillation period with both types of artificial tears.RESULTS:On the Schirmer test,a significant improvement was obtained with both tear A(P<0.01)and tear B(P<0.01).On the TBUT test,a significant improvement was obtained with tear A(P<0.01)and tear B(P<0.01).The OSDI score significantly decreased after instillation period with both artificial tear types(P<0.01).CONCLUSION:Uncrosslinked hyaluronic acid combined with other components,such as tamarind seed polysaccharide,and crosslinked hyaluronic acid combined with liposomes and crocin are effective for management symptoms of dry eye disease.展开更多
基金Supported by Natural Science Foundation of Fujian Province(No.2020J011084)Fujian Province Technology and Economy Integration Service Platform(No.2023XRH001)Fuzhou-Xiamen-Quanzhou National Independent Innovation Demonstration Zone Collaborative Innovation Platform(No.2022FX5)。
文摘●AIM:To investigate a pioneering framework for the segmentation of meibomian glands(MGs),using limited annotations to reduce the workload on ophthalmologists and enhance the efficiency of clinical diagnosis.●METHODS:Totally 203 infrared meibomian images from 138 patients with dry eye disease,accompanied by corresponding annotations,were gathered for the study.A rectified scribble-supervised gland segmentation(RSSGS)model,incorporating temporal ensemble prediction,uncertainty estimation,and a transformation equivariance constraint,was introduced to address constraints imposed by limited supervision information inherent in scribble annotations.The viability and efficacy of the proposed model were assessed based on accuracy,intersection over union(IoU),and dice coefficient.●RESULTS:Using manual labels as the gold standard,RSSGS demonstrated outcomes with an accuracy of 93.54%,a dice coefficient of 78.02%,and an IoU of 64.18%.Notably,these performance metrics exceed the current weakly supervised state-of-the-art methods by 0.76%,2.06%,and 2.69%,respectively.Furthermore,despite achieving a substantial 80%reduction in annotation costs,it only lags behind fully annotated methods by 0.72%,1.51%,and 2.04%.●CONCLUSION:An innovative automatic segmentation model is developed for MGs in infrared eyelid images,using scribble annotation for training.This model maintains an exceptionally high level of segmentation accuracy while substantially reducing training costs.It holds substantial utility for calculating clinical parameters,thereby greatly enhancing the diagnostic efficiency of ophthalmologists in evaluating meibomian gland dysfunction.
文摘AIM:To develop normative data for meibomian gland dysfunction(MGD)parameters,using non-contact meibography technique of Sirius Costruzione Strumenti Oftalmici(CSO)machine,in an Egyptian population sample.METHODS:Observational,cross-sectional,analytic study,in which 104 Egyptian volunteers were included.Both upper lids were examined,using“Sirius CSO”machine.Each eyelid was given a degree of meibomian gland loss(MGL),which was calculated by the software of the machine.RESULTS:Mean percentage MGL in right upper lid was of 30.9%±12.6%,and that of left upper lid was 32.6%±11.8%.Thirty-four volunteers(32.7%)had first-degree MGL in their right upper lid,and 67.3%had second-degree loss.One volunteer(1%)had zero-degree MGL in left upper lid,28(26.9%)had first-degree loss,and 75(72.1%)had second-degree loss.Degree of MGL in right upper eyelid was not related to age,but degree of MGL in left upper eyelid increased with age.There was statistically significant difference between both genders for degree of MGL in right eye(P=0.036)and in left eye(P=0.027).CONCLUSION:Noncontact meibography is a useful non-invasive tool for diagnosing MGL.MGL is diagnosed in 100%of apparently normal individuals;26.9%-32.7%of which have first-degree MGL,and 67.3%-72.1%have second-degree MGL.
基金Supported by Natural Science Foundation of Beijing(No.7222025)Beijing Hospitals Authority’Ascent Plan(No.DFL20190201)Beijing Science and Technology Rising Star Program.
文摘AIM:To evaluate lacrimal gland adenoid cystic carcinoma(LGACC)of prognosis in patients who underwent different treatment regimens.METHODS:We searched PubMed,EMBASE,and the Cochrane Library for studies done on the treatment of LGACC,between January 1987 and April 2022.A Metaanalysis was conducted to pool the 5-year overall survival rate(OR),and the 5-year recurrence rate(RR)and 5-year metastasis rate(MR)were assessed.RESULTS:The 30 studies involved 585 patients were included in the Meta-analysis.The pooled 5-year OR with surgery alone was 50%,the 5-year RR was 63%,and the 5-year MR was 34%.The pooled 5-year OR with surgery and adjuvant radiotherapy combined was 67%(95%CI 61%,73%),the 5-year RR was 41%,and the 5-year MR was 35%.The pooled 5-year OR with surgery and adjuvant chemoradiotherapy combined was 72%(95%CI 59%,84%),the 5-year RR was 48%,and the 5-year MR was 36%.The pooled 5-year OR with surgery,intra-arterial cytoreductive chemotherapy,and adjuvant chemoradiotherapy combined was 78%(95%CI 68%,89%),the 5-year RR was 15%,and the 5-year MR was 27%.CONCLUSION:Comprehensive treatment is more effective than surgery alone.Surgery combined with intraarterial chemotherapy and adjuvant chemoradiotherapy seems to add value to the therapeutic effect of comprehensive treatment of LGACC but further high-quality research is required to validate this.
基金Supported by the Tianjin Key Medical Discipline(Specialty)Construction Project(No.TJYXZDXK-037A)Tianjin Medical University Eye Hospital。
文摘AIM:To evaluate the differences between human lacrimal gland adenoid cystic carcinoma with high-grade transformation(LACC-HGT)primar y cells cultured by high-grade transformation tissue and non-high-grade transformation(non-HGT)primary cells cultured by non-highgrade transformation tissue in proliferation,metastasis,drug susceptibility,and genes.METHODS:LACC-HGT primary cells were established by tissue block culture,and the 4^(th)to 10^(th)generation primary cells were selected as research objects.The cells were preliminarily identified by immunofluorescent staining.The differences between non-HGT and LACC-HGT primary cells in terms of proliferation,metastasis,and drug susceptibility were compared by cell counting kit-8(CCK-8)assay,wound healing,and drug sensitivity experiments.Differentially expressed genes were screened using mRNA array.Gene expression was analyzed using real-time quantitative polymerase chain reaction(RT-qPCR).RESULTS:LACC-HGT primary cells were successfully cultured by tissue block culture.Immunofluorescence staining results showed that cytokeratin(CK)and CK7 expression levels were positive in LACC-HGT primary cells.CCK-8 results showed that the proliferation ability of LACCHGT cells was significantly higher than that of non-HGT cells.Wound healing experiment showed that the migration ability of LACC-HGT cells was significantly higher than that of non-HGT cells.LACC-HGT cells were also less sensitive to cisplatin and paclitaxel than non-HGT cells.Compared with non-HGT cells,9566 differentially expressed genes were found in LACC-HGT primary cells,of which 5162 were upregulated and 4404 were down-regulated.The expression of N-acetylneuraminate pyruvate lyase(NPL),MARVEL domain containing 3(MARVELD3),syntabulin(SYBU),and allograft inflammatory factor 1(AIF1)was higher in LACCHGT cells than in non-HGT cells,whereas that of periostin(POSTN)was lower.CONCLUSION:LACC-HGT primary cells have faster proliferation,stronger migration ability,and poorer sensitivity to chemotherapy drugs than non-HGT primary cells.The expression of mRNAs in non-HGT and LACC-HGT primary cells are significantly different.These features are speculated to be the reasons why high-grade transformation tissues exhibit higher malignant degree and poorer prognosis than their counterparts.
基金Supported by the Natural Science Foundation of Tianjin City(No.20JCZXJC00040)Tianjin Key Medical Discipline(No.Specialty)Construction Project(No.TJYXZDXK-037A)The Science&Technology Development Fund of Tianjin Education Commission for Higher Education(No.2022ZD058)。
文摘AIM:To observe ocular surface changes after phacovitrectomy in patients with mild to moderate meibomian gland dysfunction(MGD)-type dry eye and track clinical treatment response using a Keratograph 5M and a Lipi View interferometer.METHODS:Forty cases were randomized into control group A and treatment group B;the latter received meibomian gland treatment 3d before phacovitrectomy and sodium hyaluronate before and after surgery.The average non-invasive tear film break-up time(NITBUTav),first noninvasive tear film break-up time(NITBUTf),non-invasive measured tear meniscus height(NTMH),meibomian gland loss(MGL),lipid layer thickness(LLT)and partial blink rate(PBR)were measured preoperatively and 1wk,1 and 3mo postoperatively.RESULTS:The NITBUTav values of group A at 1wk(4.38±0.47),1mo(6.76±0.70),and 3mo(7.25±0.68)were significantly lower than those of group B(7.45±0.78,10.46±0.97,and 11.31±0.89;P=0.002,0.004,and 0.001,respectively).The NTMH values of group B at 1wk(0.20±0.01)and 1mo(0.22±0.01)were markedly higher than those of group A(0.15±0.01 and 0.15±0.01;P=0.008 and P<0.001,respectively);however,there was no difference at 3mo.The LLT of group B at 3mo[91.5(76.25-100.00)]significantly exceeded that of group A[65.00(54.50-91.25),P=0.017].No obvious intergroup difference was found in MGL or PBR(P>0.05).CONCLUSION:Mild to moderate MGD dry eye worsens in the short term after phacovitrectomy.Preoperative cleaning,hot compresses,and meibomian gland massage as well as preoperative and postoperative sodium hyaluronate promote the rapid recovery of tear film stability.
基金Supported by National Natural Science Foundation of China(No.82160195)Science and Technology Project of Jiangxi Provincial Department of Education(No.GJJ200169)+1 种基金Science and Technology Project of Jiangxi Province Health Commission of Traditional Chinese Medicine(No.2020A0087)Science and Technology Project of Jiangxi Health Commission(No.202130210).
文摘AIM:To study retinal microvascular and microstructural alterations in meibomian gland dysfunction(MGD)in severely obese population using optical coherence tomography angiography(OCTA).METHODS:Twelve MGD patients with severely obese population(PAT group;24 eyes)and 12 healthy controls(HC group;24 eyes)were recruited.OCTA images were segmented into five[superior(S),nasal(N),inferior(I),temporal(T),and central foveal(C)]or nine[inner superior(IS),outer superior(OS),inner nasal(IN),outer nasal(ON),inner inferior(II),outer inferior(OI),inner temporal(IT),outer temporal(OT),and C]subregions.The superficial vessel density(SVD),retinal thickness(RT),foveal avascular zone(FAZ)parameters,and retinal volume were measured.RESULTS:Visual acuity was significantly different between two groups(0.8±0.17 in PAT group vs 0.2±0.06 in HC group).SVD was significantly lower in PATs in N,T,OS,IN,OT,and ON.The area under the receiver operating characteristic curve(AUC)for T was 0.961[95% confidence interval(CI):0.908 to 1.000],for OS was 0.962(95%CI:0.915 to 1.000).RT was significantly lower in PATs in IS,OS,OI,OT,ON,IT,IN,and II.AUC for OT was 0.935(95%CI:0.870 to 0.999),for IS was 0.915(95%CI:0.838 to 0.992).Angiography results showed significantly lower area and perimeter of FAZ,SVD of the inner retina and both retinal volume and the average volume thickness in the PAT group.CONCLUSION:Vision may be affected in patients with MGD due to changes in retinal microvessels and microstructures.These changes detected by OCTA may be a potential marker for diagnosing MGD in severe obesity.
文摘BACKGROUND Eccrine porocarcinoma(EPC)is a rare skin tumor that mainly affects the elderly population.Tumors often present with slow growth and a good prognosis.EPCs are usually distinguished from other skin tumors using histopathology and immunohistochemistry.However,surgical management alone may be inadequate if the tumor has metastasized.However,currently,surgical resection is the most commonly used treatment modality.CASE SUMMARY A seventy-four-year-old woman presented with a slow-growing nodule in her left temporal area,with no obvious itching or pain,for more than four months.Histopathological examination showed small columnar and short spindle-shaped cells;thus,basal cell carcinoma was suspected.However,immunohistochemical analysis revealed the expression of cytokeratin 5/6,p63 protein,p16 protein,and Ki-67 antigen(40%),and EPC was taken into consideration.The skin biopsy was repeated,and hematoxylin and eosin staining revealed ductal differentiation in some cells.Finally,the patient was diagnosed with EPC,and Mohs micrographic surgery was performed.We adapted follow-up visits in a year and not found any recurrence of nodules.CONCLUSION This case report emphasizes the diagnosis and differentiation of EPC.
文摘AIM: To observe the changes of microcellular structure of meibomian glands(MGs) in type 2 diabetes mellitus(DM), and to explore its correlation with the duration of diabetes.METHODS: The study assessed 132 eyes of 132 patients with type 2 diabetes mellitus(DM group) and 100 eyes of 100 non-diabetic participants(NDM group). All patients underwent the examination of the Keratograph 5 M system to obtain the meibography which were used to evaluate the structure dropout of the MGs. And then laser scanning confocal microscopy(LSCM) was performed for observing the acinar cells and ducts of the MGs to obtain the following parameters: the MG acinar unit density(MGAUD), MG acinar longest diameter(MGALD) and MG acinar shortest diameter(MGASD). The examination results of the right eye were selected for analysis.RESULTS: Compared with that in NDM group, the meiboscore was significantly higher(Z=-4.057, P<0.001), and there were more MGs dropout in DM group. With the prolongation of the course of diabetes, the absence of MGs aggravated and the MGs dropout score increased(r=0.596;P<0.001). LSCM showed that there were various cytological alterations in acinar cells of MGs with the progress of diabetes duration, such as expansion, atrophy or fibrosis of MG acinar units, decreased density of MG acinar units, deposition of lipid substances, infiltration of inflammatory cells, proliferation of fibrous tissues, etc. And the opening of the glandular duct changed from smooth at the beginning to narrow, blocked, fibrotic and so on. Compared with that in NDM group, the MGAUD in DM group was significantly lower(Z=-9.713;P<0.001), the MGALD and MGASD were significantly larger(Z=-9.751,-6.416;P<0.001). With the duration of diabetes, the MGAUD reduced, the MGASD increased(r=0.860, 0.364, P<0.001);but the MGALD had no correlation with diabetic duration(r=0.133, P=0.151).CONCLUSION: With the progress of diabetes, the meibomian glandular acinar cells of diabetic patients show various manifestations. Those changes may result in the dysfuction of the MGs, tear film instability and dry eye symptoms in patients with type 2 DM.
文摘A depressed lesion was found at a gastric angle of 76-yearold Japanese woman by esophagogastroduodenoscopy. Four years prior, she was diagnosed with a Helicobacter pylori infection but no eradication was performed. The pathological diagnosis of biopsy specimens was signet-ring cell carcinoma. Endoscopic submucosal dissection(ESD) was performed. Histopathological examination of the ESD specimen revealed proliferation of well-differentiated tubular adenocarcinoma mimicking fundic gland cells at the deep layer of the lamina propria mucosae. These tumor cells expressed focally pepsinogen-Ⅰ, diffusely MUC6, and scattered H^+/K^+ ATPase according to immunohistochemistry. Therefore, we diagnosed this tumor as gastric adenocarcinoma of fundic gland type(GA-FG). Adjacent to the GA-FG, proliferation of signet-ring cell carcinoma which diffusely expressed MUC 2 and MUC 5AC was observed. Intestinal metaplasia was focally observed in the surrounding mucosa of the signet-ring cell carcinoma. To the best of our knowledge, this is the first case report of GA-FG with a signet-ring cell carcinoma component. The origin of signet-ring cell carcinoma, i.e., whether it accidentally arose from a non-neoplastic mucosa and coexisted with the GA-FG or dedifferentiated from the GA-FG is unclear at present. We expect the accumulation of similar cases and further analysis to clarify this issue.
基金This study was supported by the National Natural Science Foundation of China(No.81670824)the Natural Science Foundation of Hubei Province of China(No.2016CFB421).
文摘To observe the clinical changes of meibomian gland dysfunctipn(MGD)and ocular Demodex infestation after intense pulsed light(IPL)treatment to further examine the mechanism of IPL treating patients with MGD and ocular Demodex infestation.The medical records of 25 patients(49 eyes)with MGD treated with IPL,were retrospectively examined to determine outcomes.Associated ocular-surface parameters(ocular surface disease index,OSD1;lipid layer thickness,LLT;noninvasive first breakup time,NIF-BUT;noninvasive average breakup time,NIAvg?BUT;tear film breakup area,TBUA;Schirmer I Test,SIT;corneal fluorescein staining,CFS),eyelid margin abnormalities,meibum quality and expressibility,MG morphological parameters(macrostructure and microstructure),and the number of Demodex infestation were examined before and after treatment.The MG microstructure and the Demodex infestation were examined via in vivo confocal microscopy(IVCM).The results showed that there were statistically significant differences in associated ocular-surface parameters(all P<0.05)before and after IPL treatment,except SIT(P=0.065).Eyelid margin abnormalities,meibum quality and expressibility obviously improved in upper and lower eyelid after IPL treatment(all P<0.0001).MG macrostructure(MG dropouts)decreased in upper(P=0.002)and lower eyelid(P=0.001)after IPL treatment.The nine parameters of MG microstructure in upper and lower eyelid all distinctly improved after IPL treatment(all P<0.0001).The mean number of Demodex mites on the upper lid margin(6.59±7.16 to 3.12±3.81/9 eyelashes)and lower lid margin(2.55±2.11 to 1.29±1.53/9 eyelashes)significantly reduced after IPL treatment(all P<0.0001).The Demodex eradication rate was 20%(8/40)in upper lid margin and 34.15%(14/41)in lower lid margin.These findings indicate that IPL shows great therapeutic potential for patients of MGD and ocular Demodex infestation.
基金Supported by National Natural Science Foundation of China (No. 81570813)the Lin Hu Scientific Research Foundation of Department of Ophthalmology, Peking University Third Hospital+1 种基金the Scientific Research Foundation for the Excellent Returned Overseas Chinese Scholars, Peking University Third Hospitalthe Scientific Research Foundation for the Returned Overseas Chinese Scholars, State Education Ministry
文摘AIM: To compare the anti-inflammatory effects of intense pulsed light(IPL) with tobramycin/dexamethasone plus warm compress through clinical signs and cytokines in tears.METHODS: Eighty-two patients with dry eye disease(DED) associated meibomian gland dysfunction(MGD) were divided into two groups. Group A was treated with IPL, and Group B was treated with tobramycin/dexamethasone plus warm compress. Ocular Surface Disease Index(OSDI), tear film breakup time(TBUT), corneal fluorescein staining(CFS), meibomian gland expressibility(MGE), meibum quality, gland dropout and tear cytokine levels were evaluated before treatment, 1 wk and 1 mo after treatment. RESULTS: TBUT in Group A was higher(P=0.035), and MGE score was lower than Group B at 1 mo(P=0.001). The changes of interleukin(IL)-17 A and IL-1β levels in tears were lower in Group A compared with that in Group B at 1 wk after treatment(P=0.05, P=0.005).CONCLUSION: Treatment with IPL can improve TBUT and MGE and downregulate levels of IL-17 A and IL-1β in tears of patients with DED associated MGD better than treatment with tobramycin/dexamethasone plus warm compress in one-month treatment period.
基金West China Hospital of Sichuan University(No.2020HXBH044)。
文摘Meibomian gland,the largest sebaceous gland of the body,is responsible for the biosynthesis of lipid layer of the tear film to prevent excessive evaporation.The loss of normal functions of meibomian gland,known as meibomian gland dysfunction(MGD),is a chronic disease and is the leading cause of dry eye symptoms in the clinics.Studies have found sex hormones,especially androgen,play vital roles in the regulation of the functions of meibomian gland.Recently,androgen has also been preliminarily applied in clinics for the treatment of MGD and showed promising results,especially in people with endogenous androgen deficiency.This review summarized the mechanisms of the function of androgen on meibomian gland based on molecular,animal,and clinical studies,and proposed evidence-based views about its potential applications for the treatment of MGD.
文摘AIM:To evaluate the clinical efficacy of dietary supplement of high dose DHA omega-3 in dry eye with meibomian gland dysfunction(MGD).METHODS:Prospective randomized double-masked,placebo-controlled clinical trial was conducted in mild to moderate dry eye patients with MGD.Patients have no history of taking any dietary omega-3 supplements before 3 mo.Patients were divided into two groups:24 patients in the omega-3 group and 26 patients in the placebo group.The omega-3 group received two capsules of Easyeye Dry?,total containing 600 mg of EPA and 1640 mg of DHA,while the placebo group received two capsules containing 3000 mg of olive oil.All patients take two pills once a day.The examination of MGD scores,tear break-up time(TBUT),corneal staining test(NEI),strip meniscometry(SM tube),and ocular surface disease index(OSDI)scores were performed at baseline,after 4 and 8 wk.RESULTS:A total of 50 patients were included.There were no differences in baseline characteristics between the two groups,such as age,sex,and other ocular examination findings.The TBUT,NEI,and OSDI scores significantly improved after 4 and 8 wk in both groups.While after 8 wk TBUT(6.00±1.62 s vs 5.08±1.28 s,P=0.034)and MGD score(7.2±1.8 vs 8.1±2.6,P=0.033)in the omega-3 group was more significantly improved than that of the placebo group.CONCLUSION:Dry eye with the MGD patient,a high dose of DHA omega-3 dietary supplement can improve TBUT and MGD score after 8 wk,effective in stabilizing the tear film.
文摘AIM: To investigate the morphological changes of meibomian glands in patients with type 2 diabetes mellitus(DM).·METHODS: Of 118 eyes(118 patients) with type 2 DM(DM group) and 100 eyes of 100 control subjects(control group) were enrolled. After completing an ocular surface disease index(OSDI) questionnaire, the non-invasive tear film break-up time(NI-BUT) and the structure of the meibomian glands(MGs, meibography) were assessed by the Keratograph 5M system. Partial or complete loss of MG was scored for each eyelid from grade 0(no loss) to grade 3(lost area was >2/3 of the total MG area), which were also examined by laser scanning confocal microscopy(LSCM). The primary outcomes were meibomian gland acinar unit density(MGAUD),meibomian gland acinar longest diameter(MGALD) and meibomian gland acinar shortest diameter(MGASD).·RESULTS: Compared with control group, the OSDI was significantly higher in DM group(Z =-5.916; P <0.001),while the NI-BUT was significantly lower(Z =-7.765; P <0.001). Keratograph showed that there were more MGs dropout in DM group than that in control group. The meiboscore was significantly higher in DM group compared with control group(Z =-3.937; P <0.001).LSCM revealed that there were cytological alterations of MGs in DM group compared with control group, which included enlargement of MG acinar units and decreased in density of MG acinar units. Specifically, there were lower MGAUD, larger MGALD and MGASD in DM group than control group(Z =-10.120,-9.4442,-7.771; P <0.001).· CONCLUSION: Compared with the normal control participants, the patients with type 2 DM had more unstable tear films and severe symptoms of dry eye.Using Keratograph 5M system and LSCM, we found that the patients with type 2 DM had more significant morphological and cytological changes and dysfunction in MGs.
基金Supported by Tianjin Union Medical Center Hospital Level Project(No.2016YJ023)
文摘● AIM: To find a stable, inexpensive, and reliable method to produce a rat meibomian gland dysfunction(MGD) model.● METHODS: We inserted slim guidewires into the meibomian gland orifices of twelve Brown Norway rats and fulgurized every guidewire to destroy part of the meibomian gland. We then observed the morphological changes in the eyelid margin, and compared the data of tear breakup time(TBUT), Schirmer I test, and the corneal fluorescence staining scores at different times(1, 2, 4, and 6 wk). We observed pathological changes of the cornea, conjunctiva and meibomian gland, and we used real-time polymerase chain reaction to analyze epithelial growth factor(EGF), interleukin-6(IL-6), IL-8, tumor necrosis factor-α(TNF-α), and Ki67.● RESULTS: In the fourth week, compared with the control group, the TBUT of the model group began to decreased(P<0.05). The tear secretion remained stable(P>0.05). The corneal dots were significantly increased in the fourth week when the fusion stain began to appear(P<0.05). In the fourth week, partial meibomian gland openings had hoary secretions blocked, orifices were expanded, and there was a partial convex deformation. In the sixth week, the tissue section showed that the number of conjunctival goblet cells was decreased, epithelial cells were irregular, the epithelium was detached and rough, and meibomian glands were lost. The expressions of EGF, IL-6, IL-8, and TNF-α in corneal, conjunctival, and meibomian tissues were highly increased(P<0.05), but no statistical difference was found in the expression of Ki67 in corneal and conjunctival tissues(P>0.05).● CONCLUSION: The MGD rat model, produced via electrocauterization of meibomian gland orifices, matched clinical manifestations and cytokine levels. Our research provides a new method of achieving an MGD animal model.
基金Supported by the National Natural Science Foundation of China(No.81500693)
文摘AIM: To investigate the association between ocular demodex folliculorum infestation and ocular surface manifestations in meibomian gland dysfunction(MGD).METHODS: Eight-six patients with MGD were enrolled. All enrolled subjects were tested in the following sequence: ocular surface disease index(OSDI), slit-lamp biomicroscope examination, corneal surface regularity index(SRI) and surface asymmetry index(SAI), tear fluid collection, fluorescein tear film break-up time(F-BUT), corneal fluorescein staining(CFS), Schirmer I test(SIT) and demodex folliculorum counting. Tear matrix metalloproteinase(MMP)-9 activity was assessed using MMP-9 activity assay kit.RESULTS: Among 86 MGD patients, 40 were positive for demodex. The ocular demodex-positive group showed significantly increased scores of OSDI(25.96±13.74 vs 18.07±11.55, P=0.01), lid margin abnormality(2.38±0.87 vs 1.98±0.91, P=0.04) and CFS(1.28±2.00 vs 0.94±1.36, P=0.01) compared to the ocular demodex-free group. The tear MMP-9 activity was higher in the ocular demodex-positive group(102.9±32.4 ng/mL) than the ocular demodex-free group(46.2±19.2 ng/mL, P=0.03). There was no significant difference in meibum quality and expressibility, SRI, SAI, F-BUT and SIT between the two groups(P>0.05 for each). No significant correlation was noted between the number of demodex and ocular surface parameters in demodexpositive MGD group(P>0.05 for each).CONCLUSION: Ocular demodex folliculorum infestation may be associated with ocular discomfort and ocular surface damage in MGD.
基金Supported by the Chonnam National University Hospital Biomedical Research Institute(CRI 18093-1)Basic Science Research Program through the National Research Foundation of Korea(NRF)funded by the Ministry of Science,ICT&Future Planning(No.2017R1A2B4003367)
文摘AIM: To investigate the abnormalities in the meibomian gland in patients with dry eye disease(DED) associated with chronic ocular graft-versus-host disease(coGVHD) in comparison with Sj?gren's syndrome(SS), a major form of aqueous deficient DED and meibomian gland dysfunction(MGD), a common cause of evaporative DED.METHODS: A total 135 eyes of 135 subjects included in this study: patients with DED associated with coGVHD(n=30), patients with SS(n=35), patients with MGD(n=35), and normal controls(n=35). All participants completed the Ocular Surface Disease Index(OSDI) questionnaire, ocular surface examination [Schirmer test, tear film breakup time(TFBUT), and ocular surface staining], and meibomian gland assessment [meiboscore(gland dropout detected on meibography using infrared camera of the Keratograph 5 M), meibum expressibility score(MES), meibum quality score(MQS), lid margin abnormality]. In addition, correlations of meibomian gland characteristics with ocular surface parameters as well as disease severity score were investigated in coGVHD group.RESULTS: The coGVHD group showed significantly higher meiboscore, MES, and MQS than the other 3 groups(all P<0.05). In the coGVHD group, parameters of meibomian gland showed a significant correlation each other and those of ocular surface. The correlation between meibomian gland parameters and severity score of co GVHD was also established(meiboscore, r=0.62; MES, r=0.47; MQS, r=0.47; lid margin abnormality score, r=0.55; all P<0.05).CONCLUSION: Patients with DED associated with co GVHD show poorer gland morphology and worse glandfunction than other types of DED. In addition, meibomian gland damage is not only associated with ocular surface damage but also disease severity of coGVHD.
基金Supported by a grant from University Research Park Project of Busan National University funded by Busan Institute of S&T Evaluation and Planning(No.201726550002)
文摘AIM: To investigate the efficacy of combined topical 0.05% cyclosporine A(CsA; Restasis~?, Allergan pharmaceuticals, USA) and 0.1% sodium hyaluronate treatment in dry eyes with meibomian gland dysfunction(MGD).METHODS: In a retrospective analysis, 53 patients(106 eyes) with MGD were enrolled and performed lid warm massage for 10 min daily and be instilled preservative free sodium hyaluronate 0.1% eye drops 4 times daily. Patients were divided into subjects treated with topical 0.05% CsA and preservative free sodium hyaluronate vehicle(experimental group, n=74 eyes) and subjects treated with the preservative free sodium hyaluronate vehicle(control group, n=32 eyes). They were evaluated at baseline and 1, 2, and 3 mo for subjective symptoms and objective signs including tear film break-up time(t BUT), Schirmer test, corneal staining(CS) score, lid margin telangiectasia(LMT), meibomian gland secretion(MGS), and conjunctival injection(CI).RESULTS: In the short-term treatment, the experimental group showed a statistically significant improvement in the ocular surface disease index(OSDI; P<0.001), tBUT(P=0.004), Schirmer test score(P=0.008) and LMT(P=0.021) by repeated measure ANOVA. Additionally, mean changes from baseline in OSDI(P<0.001), tBUT(P=0.001), Schirmer test score(P=0.029), CS score(P=0.047), LMT(P=0.002), CI(P=0.030) were improved better in the experimental group than in the control group at 3 mo. However, there was no significant difference between the two groups in MGS(P=0.67).CONCLUSION: In dry eyes with MGD, 0.05% CsA improves the tear film stability as well as subjective ocular discomfort, and is effective in controlling lid margin inflammation.
文摘BACKGROUND Primary sebaceous carcinoma of lacrimal gland(SCLG) is extremely rare. Due to its clinical characteristics, it is often misdiagnosed. It is known to be aggressive so delay in diagnosis can increase the chance of local recurrence and metastasis. We report a case of primary SCLG.CASE SUMMARY A 75-year-old man was referred with a painful swelling in the right eyelid. Computed tomography scan demonstrates a 2.6 cm mass in upper outer quadrant of right orbit. After the incisional biopsy of the mass, he was diagnosed with squamous cell carcinoma of lacrimal gland. A right orbital exenteration, cervical lymph node dissection was performed. There was no involvement of the overlying periorbital skin, eyelid, or conjunctiva. Histological examination of the exenteration specimen showed tumor arising from the lacrimal gland, which had been entirely replaced by sebaceous carcinoma with sarcomatous and squamous differentiation. Neoplastic cells which were large and contained prominent nucleoli. Focal tumor remained in the posterior resection margin. Patient underwent adjuvant radiotherapy, total dose of 56 Gy with doseper-fraction 2 Gy to primary lesion. There has been no sign of recurrence until 2-years follow-up.CONCLUSION We report a rare case of sebaceous carcinoma arising from the lacrimal gland. Accurate diagnosis of SCLG is important for appropriate treatment and prognosis prediction.
文摘AIM:To study the effect of uncrosslinked and crosslinked hyaluronic acid combined with other artificial tear components in patients with dry eye caused by moderate meibomian gland dysfunction.METHODS:Prospective,single-blind,contralateral eye study.Fifty eyes(25 patients)were analyzed.Eye selection for each tear type was random,and the eye drop formulations,0.4%uncrosslinked hyaluronic acid and 0.2%galactoxyloglucan(tear A)and 0.15%crosslinked hyaluronic acid,crocin,and liposomes(tear B)were used.The determined dosing schedule was three times a day for six weeks,and the study participants underwent a clinical examination before and 45 d after lubricant treatment.The Schirmer test,tear breakup time(TBUT)test,and Ocular Surface Disease Index(OSDI)questionnaire were applied before and after instillation period with both types of artificial tears.RESULTS:On the Schirmer test,a significant improvement was obtained with both tear A(P<0.01)and tear B(P<0.01).On the TBUT test,a significant improvement was obtained with tear A(P<0.01)and tear B(P<0.01).The OSDI score significantly decreased after instillation period with both artificial tear types(P<0.01).CONCLUSION:Uncrosslinked hyaluronic acid combined with other components,such as tamarind seed polysaccharide,and crosslinked hyaluronic acid combined with liposomes and crocin are effective for management symptoms of dry eye disease.
