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 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
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 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 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 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
AIM:To establish a new inflammatory animal model of meibomian gland dysfunction(MGD)in C57BL/6 mice.METHODS:C57BL/6 mice were randomly divided into complete Freund’s adjuvant(CFA)group(14 animals,14 eyes),naphthazoli...AIM:To establish a new inflammatory animal model of meibomian gland dysfunction(MGD)in C57BL/6 mice.METHODS:C57BL/6 mice were randomly divided into complete Freund’s adjuvant(CFA)group(14 animals,14 eyes),naphthazolin hydrochloride(NH)group(14 animals,14 eyes)and control group(14 animals,14 eyes).In CFA group,CFA was used in eyelid conjunctiva injection;in NH group,NH eye drops were used twice a day;control group was injected with equal dose of saline at the same time point and same site with animals in CFA group.The meibomian gland orifices score(MGOS)was evaluated on a scale of 0 to 3 in the middle five meibomian gland orifices of the upper and lower eyelid using slit lamp.After the successful induction of each animal model,intense pulsed light(IPL)was introduced on each mouse in CFA and NH group.Oil red O(ORO),hematoxylin and eosin(H&E)staining were performed before and after successful induction of CFA,NH and control group.RESULTS:At 12wk after CFA injection,inflammatory cell infiltration and fiber necrosis was observed,with acinar density and duct dilatation significantly lower compared with control group.In NH group,the meibomian gland acini were relatively smaller and deformed compared with control group,the number of meibomian gland acini was also slightly lower.No inflammatory cell or fiber necrosis was observed in NH group.After three times of IPL treatment(5/10 mice in each group,and the other 5 mice served as non-IPL control),MGOS was significantly lower in IPL-treated mice in NH group(P<0.01).After three times of IPL treatment,the MGOS of NH group was significantly lower than that in the CFA group(P<0.01).CONCLUSION:We develop a novel animal model that studies the role of inflammation in the development of MGD and IPL treatment.This model indicates that persistent inflammatory state may be the cause of MGD and weaken the therapeutic effect of IPL.展开更多
AIM:To assess the prevalence of meibomian gland dysfunction(MGD)in staffs and faculty members of Sichuan University,China.METHODS:The records of the annually systemic physical examination of 4404 consecutive staffs an...AIM:To assess the prevalence of meibomian gland dysfunction(MGD)in staffs and faculty members of Sichuan University,China.METHODS:The records of the annually systemic physical examination of 4404 consecutive staffs and faculty members of Sichuan University were analyzed retrospectively.Ocular symptoms and signs of ocular surface were evaluated.RESULTS:MGD was diagnosed in 1424 participants(32.3%),with a mean age of 43.0±9.6 y.Of these,718(50.4%)were females and no significant difference was found between males and females.The highest prevalence was found in the age 50-59 y(36.0%).Logistic regression analysis showed that age is an impact factor of MGD(P<0.001,odds ratio=1.014).CONCLUSION:The prevalence of MGD in staffs and faculty members of a Chinese university is 32.3%,and increases with age.展开更多
AIM:To evaluate the clinical efficacy of topical 0.05%cyclosporine nano-emulsion in the treatment of dry eye syndrome(DES)with meibomian gland dysfunction(MGD).METHODS:This prospective study included 64 patients with ...AIM:To evaluate the clinical efficacy of topical 0.05%cyclosporine nano-emulsion in the treatment of dry eye syndrome(DES)with meibomian gland dysfunction(MGD).METHODS:This prospective study included 64 patients with DES and MGD who were randomly assigned to three groups:Group 1(n=24,conventional cyclosporine),Group 2(n=21,nano-emulsion cyclosporine),and Group 3(n=19,control).Lid margin telangiectasia(LMT),meibomian gland secretion(MGS),conjunctival injection(CI),corneal staining(CS),tear break-up time(TBUT),Schirmer test I(STI),Ocular Surface Disease Index(OSDI),and lipid layer thickness(LLT)was evaluated at 4,8,and 12wk of treatment.RESULTS:In Group 3(control),LMT,CS,and CI improved after 8wk,MGS,TBUT after 12wk of treatment.In Group 1(conventional cyclosporine),LMT,MGS,and TBUT improved significantly after 4wk,whereas CS,CI,STI,and LLT improved significantly after 8wk,and OSDI at 12wk.In Group 2(nano-cyclosporine),LMT,MGS,CS,CI,TBUT,and OSDI significantly improved after 4wk,and STI after 8wk.Especially,LLT was significantly higher than other groups after 4wk.CONCLUSION:Cyclosporine and nano-cyclosporine shows significant improvement in DES with MGD than the control group.In contrast,the nano-cyclosporine group shows more statistically improved CI and CS at 4wk,especially LLT at 4,8,and 12wk compared to the conventional cyclosporine group.展开更多
Objective:To explore the clinical effect of Chinese medicine aerosol fumigation on demodex infection related meibomian gland dysfunction.Methods:In this prospective study,60 patients(120 eyes)were selected and randoml...Objective:To explore the clinical effect of Chinese medicine aerosol fumigation on demodex infection related meibomian gland dysfunction.Methods:In this prospective study,60 patients(120 eyes)were selected and randomly divided into 2 groups:the treatment group(30 cases,60 eyes)was treated with Chinese medicine aerosol fumigation and meibomian gland massage,the control group(30 cases,60 eyes)was treated with meibomian gland massage.Observation of Demodex count,symptom scores,break-up time(BUT),Schirmer I test(SIT),meibomian gland secretion function scores and eyelid fat traits scores were used to compare the difference between before and after treatment.Results:There was no significant difference in Demodex count,symptom scores,BUT,SIT,meibomian gland secretion function scores and eyelid fat traits scores between the 2 groups before treatment(P>0.05).After treatment,symptom scores,meibomian gland secretion function scores and eyelid fat traits and Demodex count of the treatment group were significantly reduced(P<0.01).Conclusion:Chinese medicine aerosol fumigation can relieve symptoms of of demodex infection related meibomian gland dysfunctionand reduce the number of ocular Demodex.展开更多
●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
OBJECTIVE:To observe the clinical efficacy on improving the quality of meibum in patients suffer from dry eye disease(DED)due to meibomian gland dysfunction(MGD)with hyperactivity of Yang due to Yin deficiency pattern...OBJECTIVE:To observe the clinical efficacy on improving the quality of meibum in patients suffer from dry eye disease(DED)due to meibomian gland dysfunction(MGD)with hyperactivity of Yang due to Yin deficiency pattern after being treated with Pinggan Yuyin Qingre formula(平肝育阴清热方,PGYYQR).METHODS:Totally 120 patients who met the inclusion criteria were included and stratified into three levels according to the level of MGD(1-3),and patients in each level was randomly allocated into the treatment group and control group according to a 1∶1 ratio.Both groups were treated with sodium hyaluronate eye drops,and the treatment group was also given PGYYQR granules.Both groups were treated continuously for eight weeks.The score of the properties of meibomian gland(MG)secretion,the score of the palpebral margins,the average noninvasive tear breakup time(NITBUTav),lipid layer thickness(LLT),and Traditional Chinese Medicine(TCM)syndrome efficacy were compared between the two groups after treatment.RESULTS:A total of 116 cases were included in the statistical analysis.The differences were statistically significant in the score of the properties of MG secretion,the score of the palpebral margins,and NITBUTav between the two groups after treatment,the treatment group was superior to the control group;there was no evidence of a difference in LLT.In terms of TCM syndrome efficacy,the total effective rate was 84.7%in the treatment group and 50.9%in the control group,with the statistically significant difference.None of the included cases had adverse reactions.CONCLUSIONS:PGYYQR is effective in improving the quality of meibum,and the tear film stability which thereby relieving the ocular symptoms in MGD-related DED patients with hyperactivity of Yang due to Yin deficiency pattern.展开更多
The presence of inflammation in dry eye disease(DED)results in increased patient symptomatology,ocular surface damage and worsening tear dysfunction.It also affects the health of meibomian glands and their secretions ...The presence of inflammation in dry eye disease(DED)results in increased patient symptomatology,ocular surface damage and worsening tear dysfunction.It also affects the health of meibomian glands and their secretions which further aggravates ocular surface disease.This article reviews current knowledge regarding ocular surface inflammation in DED and explores the relationships between the vicious cycles of DED,inflammation and meibomian gland dysfunction(MGD).The clinical evaluation of eyes with such changes,markers that identify the presence of inflammation on the ocular surface and current treatment options are discussed.展开更多
The tear film covers the anterior eye and the precise balance of its various constituting components is critical for maintaining ocular health.The composition of the tear film amphiphilic lipid sublayer,in particular,...The tear film covers the anterior eye and the precise balance of its various constituting components is critical for maintaining ocular health.The composition of the tear film amphiphilic lipid sublayer,in particular,has largely remained a matter of contention.The limiting concentrations of lipid amphiphiles in tears have also posed considerable challenges to their detection and accurate quantitation.Using systematic and sensitive lipidomic approaches,we reported the most comprehensive human tear lipidome to date;and conferred novel insights to the compositional details of the existent tear film model,in particular the disputable amphiphilic lipid sublayer constituents,by demonstrating the presence of cholesteryl sulfate,O-acyl-ω-hydroxy fatty acids,and various sphingolipids and phospholipids in tears.Lipidomic analysis of human tear fluid from patients with various subtypes of dry eye syndrome(DES)revealed structure-specific lipid alterations in DES,which could potentially serve as unifying indicators of disease symptoms and signs.The meibomian glands constitute the predominant source of lipid supply to the human tear fluid.Meibomian gland dysfunction(MGD)is a leading cause of evaporative dry eye and ocular discomfort,characterized by an unstable tear film principally attributed to afflicted delivery of lipids to the ocular surface.We investigated the longitudinal tear lipid alterations associated with disease alleviation and symptom improvement in a cohort of MGD patients undergoing eyelid-warming treatment for 12 weeks.Our preliminary data indicated that excess ocular surface phospholipase activity detrimental to tear film stability could be alleviated by eyelid warming alone without application of steroids and identify tear OAHFAs as suitable markers to monitor treatment response in MGD.展开更多
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 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.
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.
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 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.
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.
基金Supported by National Natural Science Foundation of China(No.81700797)Science and Technology Commission of Shanghai Municipality(No.17411961800).
文摘AIM:To establish a new inflammatory animal model of meibomian gland dysfunction(MGD)in C57BL/6 mice.METHODS:C57BL/6 mice were randomly divided into complete Freund’s adjuvant(CFA)group(14 animals,14 eyes),naphthazolin hydrochloride(NH)group(14 animals,14 eyes)and control group(14 animals,14 eyes).In CFA group,CFA was used in eyelid conjunctiva injection;in NH group,NH eye drops were used twice a day;control group was injected with equal dose of saline at the same time point and same site with animals in CFA group.The meibomian gland orifices score(MGOS)was evaluated on a scale of 0 to 3 in the middle five meibomian gland orifices of the upper and lower eyelid using slit lamp.After the successful induction of each animal model,intense pulsed light(IPL)was introduced on each mouse in CFA and NH group.Oil red O(ORO),hematoxylin and eosin(H&E)staining were performed before and after successful induction of CFA,NH and control group.RESULTS:At 12wk after CFA injection,inflammatory cell infiltration and fiber necrosis was observed,with acinar density and duct dilatation significantly lower compared with control group.In NH group,the meibomian gland acini were relatively smaller and deformed compared with control group,the number of meibomian gland acini was also slightly lower.No inflammatory cell or fiber necrosis was observed in NH group.After three times of IPL treatment(5/10 mice in each group,and the other 5 mice served as non-IPL control),MGOS was significantly lower in IPL-treated mice in NH group(P<0.01).After three times of IPL treatment,the MGOS of NH group was significantly lower than that in the CFA group(P<0.01).CONCLUSION:We develop a novel animal model that studies the role of inflammation in the development of MGD and IPL treatment.This model indicates that persistent inflammatory state may be the cause of MGD and weaken the therapeutic effect of IPL.
基金Supported by the National Natural Science Foundation of China(No.81870665)。
文摘AIM:To assess the prevalence of meibomian gland dysfunction(MGD)in staffs and faculty members of Sichuan University,China.METHODS:The records of the annually systemic physical examination of 4404 consecutive staffs and faculty members of Sichuan University were analyzed retrospectively.Ocular symptoms and signs of ocular surface were evaluated.RESULTS:MGD was diagnosed in 1424 participants(32.3%),with a mean age of 43.0±9.6 y.Of these,718(50.4%)were females and no significant difference was found between males and females.The highest prevalence was found in the age 50-59 y(36.0%).Logistic regression analysis showed that age is an impact factor of MGD(P<0.001,odds ratio=1.014).CONCLUSION:The prevalence of MGD in staffs and faculty members of a Chinese university is 32.3%,and increases with age.
基金Supported by Biomedical Research Institute Grant(No.20200026),Pusan National University Hospital。
文摘AIM:To evaluate the clinical efficacy of topical 0.05%cyclosporine nano-emulsion in the treatment of dry eye syndrome(DES)with meibomian gland dysfunction(MGD).METHODS:This prospective study included 64 patients with DES and MGD who were randomly assigned to three groups:Group 1(n=24,conventional cyclosporine),Group 2(n=21,nano-emulsion cyclosporine),and Group 3(n=19,control).Lid margin telangiectasia(LMT),meibomian gland secretion(MGS),conjunctival injection(CI),corneal staining(CS),tear break-up time(TBUT),Schirmer test I(STI),Ocular Surface Disease Index(OSDI),and lipid layer thickness(LLT)was evaluated at 4,8,and 12wk of treatment.RESULTS:In Group 3(control),LMT,CS,and CI improved after 8wk,MGS,TBUT after 12wk of treatment.In Group 1(conventional cyclosporine),LMT,MGS,and TBUT improved significantly after 4wk,whereas CS,CI,STI,and LLT improved significantly after 8wk,and OSDI at 12wk.In Group 2(nano-cyclosporine),LMT,MGS,CS,CI,TBUT,and OSDI significantly improved after 4wk,and STI after 8wk.Especially,LLT was significantly higher than other groups after 4wk.CONCLUSION:Cyclosporine and nano-cyclosporine shows significant improvement in DES with MGD than the control group.In contrast,the nano-cyclosporine group shows more statistically improved CI and CS at 4wk,especially LLT at 4,8,and 12wk compared to the conventional cyclosporine group.
基金National Natural Science Foundation of China(No.81574029)Jinming National Famous and Old Traditional Chinese Medicine Expert Inheritance Studio,and"Hundreds of Millions"Talent Project(No.Qihuang Project)for Qihuang Scholar of Inheritance and Innovation of Traditional Chinese Medicine.
文摘Objective:To explore the clinical effect of Chinese medicine aerosol fumigation on demodex infection related meibomian gland dysfunction.Methods:In this prospective study,60 patients(120 eyes)were selected and randomly divided into 2 groups:the treatment group(30 cases,60 eyes)was treated with Chinese medicine aerosol fumigation and meibomian gland massage,the control group(30 cases,60 eyes)was treated with meibomian gland massage.Observation of Demodex count,symptom scores,break-up time(BUT),Schirmer I test(SIT),meibomian gland secretion function scores and eyelid fat traits scores were used to compare the difference between before and after treatment.Results:There was no significant difference in Demodex count,symptom scores,BUT,SIT,meibomian gland secretion function scores and eyelid fat traits scores between the 2 groups before treatment(P>0.05).After treatment,symptom scores,meibomian gland secretion function scores and eyelid fat traits and Demodex count of the treatment group were significantly reduced(P<0.01).Conclusion:Chinese medicine aerosol fumigation can relieve symptoms of of demodex infection related meibomian gland dysfunctionand reduce the number of ocular Demodex.
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.
基金Capital Health Development Research Project:Clinical Efficacy of the Pinggan Yuyin Qingre Formula in Treating Evaporative Dry Eye Disease Causing by Meibomian Gland Dysfunction(No.2016-2-2055)Zhi Nan National Famous and Senior Chinese Medicine Experts Inheritance Studio Construction Project[No.75(2022),the Personnel and Education Department of the National Administration of Traditional Chinese Medicine promulgated]the Sixth Batch of Beijing Municipal Academic Experience Inheritance Project for Traditional Chinese Medicine Experts[No.160(2021),Beijing Administration of Traditional Chinese Medicine promulgated]。
文摘OBJECTIVE:To observe the clinical efficacy on improving the quality of meibum in patients suffer from dry eye disease(DED)due to meibomian gland dysfunction(MGD)with hyperactivity of Yang due to Yin deficiency pattern after being treated with Pinggan Yuyin Qingre formula(平肝育阴清热方,PGYYQR).METHODS:Totally 120 patients who met the inclusion criteria were included and stratified into three levels according to the level of MGD(1-3),and patients in each level was randomly allocated into the treatment group and control group according to a 1∶1 ratio.Both groups were treated with sodium hyaluronate eye drops,and the treatment group was also given PGYYQR granules.Both groups were treated continuously for eight weeks.The score of the properties of meibomian gland(MG)secretion,the score of the palpebral margins,the average noninvasive tear breakup time(NITBUTav),lipid layer thickness(LLT),and Traditional Chinese Medicine(TCM)syndrome efficacy were compared between the two groups after treatment.RESULTS:A total of 116 cases were included in the statistical analysis.The differences were statistically significant in the score of the properties of MG secretion,the score of the palpebral margins,and NITBUTav between the two groups after treatment,the treatment group was superior to the control group;there was no evidence of a difference in LLT.In terms of TCM syndrome efficacy,the total effective rate was 84.7%in the treatment group and 50.9%in the control group,with the statistically significant difference.None of the included cases had adverse reactions.CONCLUSIONS:PGYYQR is effective in improving the quality of meibum,and the tear film stability which thereby relieving the ocular symptoms in MGD-related DED patients with hyperactivity of Yang due to Yin deficiency pattern.
文摘The presence of inflammation in dry eye disease(DED)results in increased patient symptomatology,ocular surface damage and worsening tear dysfunction.It also affects the health of meibomian glands and their secretions which further aggravates ocular surface disease.This article reviews current knowledge regarding ocular surface inflammation in DED and explores the relationships between the vicious cycles of DED,inflammation and meibomian gland dysfunction(MGD).The clinical evaluation of eyes with such changes,markers that identify the presence of inflammation on the ocular surface and current treatment options are discussed.
文摘The tear film covers the anterior eye and the precise balance of its various constituting components is critical for maintaining ocular health.The composition of the tear film amphiphilic lipid sublayer,in particular,has largely remained a matter of contention.The limiting concentrations of lipid amphiphiles in tears have also posed considerable challenges to their detection and accurate quantitation.Using systematic and sensitive lipidomic approaches,we reported the most comprehensive human tear lipidome to date;and conferred novel insights to the compositional details of the existent tear film model,in particular the disputable amphiphilic lipid sublayer constituents,by demonstrating the presence of cholesteryl sulfate,O-acyl-ω-hydroxy fatty acids,and various sphingolipids and phospholipids in tears.Lipidomic analysis of human tear fluid from patients with various subtypes of dry eye syndrome(DES)revealed structure-specific lipid alterations in DES,which could potentially serve as unifying indicators of disease symptoms and signs.The meibomian glands constitute the predominant source of lipid supply to the human tear fluid.Meibomian gland dysfunction(MGD)is a leading cause of evaporative dry eye and ocular discomfort,characterized by an unstable tear film principally attributed to afflicted delivery of lipids to the ocular surface.We investigated the longitudinal tear lipid alterations associated with disease alleviation and symptom improvement in a cohort of MGD patients undergoing eyelid-warming treatment for 12 weeks.Our preliminary data indicated that excess ocular surface phospholipase activity detrimental to tear film stability could be alleviated by eyelid warming alone without application of steroids and identify tear OAHFAs as suitable markers to monitor treatment response in MGD.
